Norepynefryn | Norepinephrine agetan ampoules 2 mg / ml 4 ml, 10 pcs.

Latin name

Noradrenaline Aguettant

Release form

Concentrate for preparing a solution for intravenous administration

Packing

10 ampoules of 4 ml.

Pharmacological action

Norepinephrine agetan - adrenomimetic.

Pharmacodynamics

l- and 2-adrenergic receptor agonist. It weakly excites 1 - and practically does not affect ​​2-adrenergic receptors. It has a powerful vasoconstrictor effect, leads to an increase in blood pressure.

Pharmacokinetics

Not absorbed in the digestive tract. With iv administration, it rapidly reaches Cmax in plasma (within 2–3 min).

Metabolized in the liver, kidneys and blood plasma with the participation of MAO and catechol-O-methyltransferase (COMT) to almost inactive metabolites that are excreted through the kidneys.

Indications

Acute hypotension accompanying cardiovascular collapse and shock (to restore and maintain blood pressure - iv perfusion).

Contraindications

Severe hypersensitivity to the drug Norepinephrine Agetan

arterial hypotension due to hypovolemia. An exception in these cases is the need to administer the drug to maintain blood flow in the coronary arteries of the heart and brain arteries until the end of therapy, aimed at restoring bcc

mesenteric and peripheral vascular thrombosis due to the risk of aggravating ischemia and enlarging the

infarction zone, performing fluorotanic and cyclopropane general anesthesia (due to the risk of developing ventricular tachycardia and fibrillation)

severe hypoxia and

Caution: severe left ventricular failure, acute heart failure, recent myocardial infarction

simultaneous administration of MAO inhibitors of imipramine and tryptylin series (due to the risk of developing a pronounced and prolonged increase in blood pressure)

development of symptoms of cardiac arrhythmia (in this case, a dose reduction is necessary ) With polymorphic extrasystole or the development of volleys of extrasystoles, the dose of the drug should be significantly reduced or treatment canceled.

If you need to simultaneously use Norepinephrine Agetan and a blood or plasma transfusion, the drug is administered separately. Severe hypersensitivity to the drug

arterial hypotension due to hypovolemia. An exception in these cases is the need to administer the drug to maintain blood flow in the coronary arteries of the heart and brain arteries before the end of therapy aimed at restoring bcc

mesenteric and peripheral vascular thrombosis due to the risk of aggravating ischemia and enlarging the

infarction zone conducting fluorotan and cyclopropane general anesthesia ( due to the risk of ventricular tachycardia and fibrillation)

severe hypoxia and hypercapnia.

Precautions: severe left ventricular failure, acute heart failure, recent myocardial infarction

simultaneous administration of MAO inhibitors of imipramine and tryptiline series (due to the risk of developing a pronounced and prolonged increase in blood pressure)

development of symptoms of cardiac arrhythmia (in this case, a dose reduction is necessary). With polymorphic extrasystole or the development of volleys of extrasystoles, the dose of the drug should be significantly reduced or treatment canceled.

If necessary, the simultaneous use of Norepinephrine Agetan and a blood or plasma transfusion, the drug is administered separately.

Use during pregnancy and lactation

Pregnancy is not a limitation for the use of Norepinephrine Agetan. At the time of treatment, breast-feeding should be stopped (there is no experience with the drug in nursing women).

Composition

1 ml. contains:

Active ingredient: norepinephrine tartrate monohydrate (in terms of norepinephrine tartrate) 2 mg / ml

Excipients: sodium chloride sodium hydroxide or hydrochloric acid (pH = 3.0ִ.5) water for injection.

Dosage and Administration

Intravenously, preferably in the vein of the elbow.

Concentrate should be diluted in 5% glucose solution or 0.9% sodium chloride solution. Do not mix with other drugs. With the introduction of Noradrenaline Agetan, it is necessary to constantly monitor blood pressure and heart rate.

After diluting the concentrate, the solution should be used within 12 hours.

The individual dose is determined depending on the clinical condition of the patient. An initial dose and rate of administration of 0.1 to 0.3? G / kg / min of norepinephrine tartrate is recommended. The maximum dose and rate of administration used in the treatment of septic and hemorrhagic shock, can reach 3–5? g / kg / min.

Side effects of

With the administration of Norepinephrine agetan, the following symptoms may occur: ischemic disturbances up to necrosis caused by vasoconstriction and tissue hypoxia, as well as extravagant

arrhythmia

reflex bradycardia srdlkrkdrd pain

autonomic reactions - pallor, increased sweating, vomiting, tachycardia. In especially sensitive patients, an increase in blood pressure may be accompanied by headache, photophobia, stitching chest pain, pallor of the skin, increased sweating and vomiting.

With prolonged use, a dose adjustment is necessary to avoid recurrent hypotension during drug withdrawal.

Drug interaction

The main undesirable effects when combined with some groups of drugs are pharmacodynamic. When combined with inhaled anesthesia, serious ventricular arrhythmias (increased cardiac irritability) can occur. When combined with serotonergic and adrenergic antidepressants, and also derivatives of imipramine and amitriptyline, paroxysmal hypertension may develop with a risk of cardiac arrhythmia due to an adrenergic blocking effect on the sympathetic nervous system. The combination of Norepinephrine Agetan with selective and non-selective MAO inhibitors, linezolid is contraindicated. at the same time, a synergistic increase in the pressor action of norepinephrine occurs, which requires careful medical monitoring.

overdose

Symptoms: skin vascular spasm, collapse, anuria, marked BP increase may occur.

Treatment: In the event of overdose, the dose of the drug should be reduced.

Storage conditions

Dry, protected from light at a temperature not exceeding 30 РC.

Shelf life

2 years.

Deystvuyushtee substance

Norэpinefrin

Terms and conditions

prescription

Dosage form

infusion solution

Possible product names

Norepinephrine 2mg / ml4ml№10

NORADRENALINE AHETAN 0.002 / ML 4ML N10AMP CONC.

Norepinephrine Agetan 2 mg / ml 4 ml ngnanald amp. d / prg. solution for iv input. 4ml Amp. X10 B (R)

Norepinephrine agetan ampoules 2 mg / ml 4 ml, 10 pcs.

Laboratory Agetan, France