Noradrenaline (Norepinephrine) : Therapeutic uses, Dosage & Side Effects
Noradrenaline or norepinephrine (NA / NE) or noradrenalin (cathecholamine) is a adrenergic agonist (direct acting), used as Pressor agent to treat life-threatening low blood pressure (hypotension) that can occur with certain medical conditions or surgical procedures. This medication is often used during CPR (cardio-pulmonary resuscitation).
Dose : 2-4 μg /min. I.V. infusion
Route : Intravenous
Onset of action : ?
Plasma Half-life : ?
Duration of action : 1 to 2 minutes, following the end of the infusion
Bioavailability : ?
Chemical formula : C8H11NO3
IUPAC name : (R)-4-(2-amino-1-hydroxyethyl)benzene-1,2-diol
Trade name : Levophed, Levophed Bitartrate
Therapeutic uses : Norepinephrine is used to treat shock, because it increases vascular resistance and, therefore, increases blood pressure under certain intensive care conditions.
Note:- NE has no other clinically significant uses even rarely used now as a pressor agent.
Points of interest :
- NE should not be administered in peripheral veins, if possible.
- The infusion should be made high in the limb, preferably through a long plastic cannula extending centrally.
- Impaired circulation at injection sites, with or without extravasation of NE, may be relieved by infiltrating the area with α receptor antagonist Phentolamine.
- Blood pressure must be determined frequently during the infusion and particularly during adjustment of the rate of the infusion.
Side effects : Adverse effects of Norepinephrine are as follows:
On CNS
- Anxiety,
- Fear,
- Restlessness
- Tension,
- Headache,
- Tremor
- Cerebral hemorrhage
On CvS
- Cardiac arrhythmias, particularly if the patient is receiving digoxin.
- Angina (in patients with coronary artery disease)
- Tachycardia
- Hypertension (& increased peripheral resistance)
Others
- Pulmonary edema
- Blanching and sloughing of skin along an injected vein
- Tissue necrosis (if extravasation occurs)
Warnings :
- Norepinephrine should be used with extreme caution in patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe, prolonged hypertension may result.
Contraindications :
For detailed query or in case of uncertainty, Always consult your doctor or pharmacist.