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EMERGENCY DRUGS

Noradrenaline is a potent vasopressor used to treat severe hypotension, particularly in septic shock, with a typical IV infusion dosage of 0.05 to 0.2 µg/kg/min. It primarily acts on α1 receptors to induce vasoconstriction and increase blood pressure, while also exhibiting some β1 receptor activity that enhances cardiac contractility. Continuous monitoring of blood pressure and organ function is essential during administration due to potential side effects such as arrhythmias and ischemia.

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6 views23 pages

EMERGENCY DRUGS

Noradrenaline is a potent vasopressor used to treat severe hypotension, particularly in septic shock, with a typical IV infusion dosage of 0.05 to 0.2 µg/kg/min. It primarily acts on α1 receptors to induce vasoconstriction and increase blood pressure, while also exhibiting some β1 receptor activity that enhances cardiac contractility. Continuous monitoring of blood pressure and organ function is essential during administration due to potential side effects such as arrhythmias and ischemia.

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arabickingcobra
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EMERGENCY DRUGS

PRIYADHARSHINI A
ANAESTHESIA TUTOR
NOR-ADRENALINE
• NAME ; NOR ADRENALINE BITARTARATE
• MG ; 2MG/ML
• ML ; 2ML
• DOSAGE ; IV INFUSION 0.05 TO 0.2 MUG/KG/MIN
• DURATION ; 3-5 MIN

• METABOLISM AND ELIMINATION ;


IT IS METABOLIZEY BY COMT (CATECHOL - OMETHYL
TRANSFERASE)& MAO (MONOAMINE OXIDASE) ENZYMES.
MECHANISM OF ACTION/PHARMACOLOGY

• Noradrenaline is a vasoconstrictor that predominantly stimulates


α1 receptors to cause peripheral vasoconstriction and increase
blood pressure.
• It also has some β1 receptor agonist activity that results in a
positive inotropic effect on the heart at higher doses.1,2
Onset of action

• 1–2 minutes.
• Duration of action: 5–10 minutes.
• Half-life: 3 minutes.
DOSING

• The usual doseis 8 to 12microg/min continuous IV


infusion.
• Maintenance dose ; 2 to 4 mcg /min continuous IV
transfusion
• 1mg(milligram) = 1000mcg(microgram)
INDICATIONS

• To increase blood pressure in acute, severe, hypotensive


states when low systemic vascular resistance persists
despite adequate fluid resuscitation.
• Noradrenaline is the vasopressor of choice for managing
septic shock.
• Flight - Fight Response
USE , DOSE AND ROUTRE ;

• AS A VASOPRESSOR ;
 NOR ADRENALINE IS A NATURALLY OCCURING
DIRECTLY ACTING - CATECHOLAMINE .
 IT IS A POWERFUL VASOPRESSOR , ACTING ON THE
ALPHA RECEPTOR .
 IT IS ALSO AN INOTROPE AS IT HAS BETA RECEPTOR
STIMULANT PROPERTIES BUT THE VASOCONSTRICTIVE PROPERTIES
PREDOMINATE.
 IT IS GIVEN AS AN INTRAVENOUS OF CHOICE IN
SEPTIK SHOCK . IT AMY ALSO BE USED TO COUNTER
INOTROPE ;
• An inotrope is an agent , which increase or decreases the
force or energy of muscular contractions.
• Positive inotrope agent enhances myocardial contractility
so cardiac out , amount of blood ejected by the heart with
each beat , will also increase .
Special precautions

• Since it is a powerful vasoconstrictor, it can increase the


afterload to the left ventricle, can affect splanchnic circulation
(comprise the gastric , colonic , pamcreatic , hepatic and splenic
circulation) and other peripheral tissues if used random.
• Hence, whenever noradrenaline infusion is required, invasive
blood pressure monitor-ing is warranted.
• It is desirable that the systemic vascular resistance is
measured, particularly when renal dysfunction is also present
and higher dose of noradrenaline is being used to main-tain
APPLICABLE AREAS

• THIS SECTION WILL BE LEFT BLANK FOR


EACH HOSPITAL TO COMPLETE IN
ACCORDANCE WITH
LOCAL PRACTICE.
• EXAMPLES: ICU, ED, OR
MONITORING

•  Continuous blood pressure and cardiac monitoring for


the duration of the infusion
•  Monitor fluid balance
•  Assess for organ ischaemia (including myocardium,
kidneys, gastrointestinal tract and peripheral extremities)
SIDE EFFECTS
• Headaches , weakness , tremor
• Myocardial ischaemia
• Arrhythmias
• Anorexia , nausea , vomiting
• Tachycardia , palpitations ,Hypertension
• Myocardial, renal or peripheral (digital) ischaemia – can manifest as acute myocardial infarction,
gastrointestinal infarction, decreased urine output/creatinine clearance or gangrene
• Cautions:
To be used with caution in patients with
cardiovascular and cerebrovascular disease. Infusions of
catecholamines should preferably be given through central
venous catheters.
CONNECTION;
Anorexia
• applicable areas ;

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