Noradrenaline
Trade names:
Norepinephrine
Class: Vasoconstrictor sympathomimetics
Pregnancy:
(Category C) Action:
Noradrenalin (Norepinephrine) tartrate is a
substance released naturally by the nerve cells. It produces wide ranging
effects on many areas of the body and is often referred to as a 'fight or
flight' chemical, as it is responsible for the body's reaction to stressful
situations.
Uses:
• Sudden, life threatening low blood pressure (acute hypotension)
Use with caution in:
• A severe form of angina pectoris, not caused by exertion
(Prinzmetal's angina)
• Abnormally high amount of carbon dioxide in the blood
(hypercabnia)
• Blood clot in one of the blood vessels in the extremities
(peripheral vascular thrombosis)
• Blood clot in the artery which supplies blood to the heart (coronary
thrombosis)
• Blood clot in the artery which supplies blood to the intestines
(mesenteric thrombosis)
• Low blood pressure following a heart attack
• Low levels of oxygen in the tissues (hypoxia) Dose:
Acute hypotension, by
intravenous infusion, via central venous catheter, of a solution containing
noradrenaline acid tartrate 80 micrograms/mL (equivalent to noradrenaline base
40 micrograms/mL) at an initial rate of 0.16–0.33 mL/minute,
adjusted according to response
Contraindications:
• Children.
Allergy.
Side effects:
• Headache
• Slow
heart rate (bradycardia)
• High blood pressure (hypertension)
•
Inadequate blood flow
leading to low levels of oxygen in the tissues of the extremities (peripheral
ischemia), which may lead to gangrene Nursing considerations:
The infusion must be changed every 24 hours · 
Monitor urine output hourly and check distal
pulses · 
Monitor serum glucose.
Give via volumetric pump to regulate flow.
During infusion monitor ECG,BP, CO, CVP, PAWP,
HR, urine output, color and temperature of extremities initially every 2
minutes. Check infusion site frequently for signs of
extravasation If occurs stop infusion immediately, infiltrate the area with 5 -
10 mg Phentolamine(alpha blocker) diluted in 10 - 15 ml 0.9 % normal saline
subcutaneously and liberally
