Description medications: noradrenaline tartrate (Noradrenalini hydrotartras)
Noradrenaline tartrate (Noradrenalini hydrotartras). l-1- (3, 4-dihydroxyphenyl) -2-aminoethanol tartrate.
Synonyms: Arterenol, Noradrenalinum hydrotartaricum, Levarterenol, Levarterenoli bitartras, Levarterenol bitartrate, Levophed, Norartrinal, Norepinephrine, Norexadrine and others.
White or almost white, crystalline powder. Easily soluble in water, a little - in alcohol. It is easy to change when exposed to light and atmospheric oxygen. Aqueous solutions (pH 3, 0 - 4, 5) are sterilized at 100 "C for 15 min.
Chemically, adrenaline is different from noradrenaline absence of the methyl group on the nitrogen atom of the amino group of the side chain.
The action of norepinephrine is associated with the predominant influence on a-adrenergic receptors (namely a 1-adrenergic receptors). It differs from adrenaline more powerful vasoconstrictor and pressor effect, less stimulating effect on the contraction of the heart, a weak bronchodilator effect, a weak influence on metabolism (no pronounced effect hyperglycemic).
Kardiotropnyh action of norepinephrine is associated with stimulating its influence on b-adrenergic receptors of the heart, but the effect is masked b -adrenostimuliruyuschee reflex bradycardia and increased vagal tone, caused by high blood pressure.
Introduction noradrenaline causes an increase in cardiac output, blood pressure increase due to increased perfusion pressure in the coronary arteries. However, significantly increased peripheral vascular resistance and central venous pressure.
Used to increase blood pressure in acute its lowered due to surgery, trauma, poisoning, involving suppression of vasomotor centers, and m. P., As well as to stabilize blood pressure during surgery on the sympathetic nervous system after removal pheochromocytoma et al.
Norepinephrine is a very effective means to increase blood pressure and increased heart rate. However, high blood pressure is mainly due to an increase in peripheral vascular resistance and heart rate. Under the influence of noradrenaline also it decreases blood flow in the renal and mesenteric vessels. Perhaps the appearance of ventricular arrhythmias. Therefore, in cardiogenic shock, especially in severe cases, the use of norepinephrine is considered inappropriate (EI Chazov). Usually severe cases of cardiogenic (and hemorrhagic) shock accompanied vasoconstrictive reaction of peripheral vessels. Introduction of these cases, noradrenaline and other compounds which increase peripheral resistance may have a negative effect. It should also be borne in mind that under the influence of norepinephrine (and other sympathomimetic amines) increasing demand, myocardial oxygen demand.
Where indicated, norepinephrine is administered intravenously (drip).