NORADRENALINA GIDROTARTRAT (Noradrenalini hydrotartras). l-1- (3, 4-Dioksifenil) -2 - aminoetanola gidrotartrat.

     Synonyms : Arterenol, Noradrenalinum hydrotartaricum, Levarterenol, Levarterenoli bitartras, Levarterenol bitartrate, Levophed, Norartrinal, Norepinephrine, Norexadrine and others.

     White or almost white crystalline powder and odourless. The easily soluble in water, dry in alcohol. It can be easily altered by light and oxygen to the air. Aqueous solutions (pH 3, 0, 4, 5) in sterile 100 'C for 15 min.

     On chemical structure differs from Levophed via lack of methyl groups from atom of nitrogen, amino side chain.

     Step noradrenalina due to the influence of a priority-adrenoretseptory (namely, a 1-adrenoretseptory). It features of adrenal stronger sosudosuzhivayuschim and pressornym action, less incentive effects on the heart, weak broncholithic effect, a weak influence on metabolism (no express giperglikemicheskogo effect).

     Kardiotropnoe noradrenalina linked to the enabling its impact on the b-adrenoretseptory heart, but b-adrenostimuliruyuschee a veiled reflexive aetiology and rising tone wandering nerve caused by increased blood pressure.

     Introduction noradrenalina increases heart emissions, increases blood pressure rises applying pressure in the coronary arteries. However, the increases peripheral vascular resistance and central venous pressure.

     Applied to increase blood pressure in acute demote him by surgical intervention, injuries, poisoning involving oppression sosudodvigatelnyh centers, etc., as well as to stabilize blood pressure in operational intervention in the sympathetic nervous system by removing feohromotsitomy and others.

     Norepinephrine is a very effective way to raise blood pressure and increased heart. However, increased blood pressure is due to increased peripheral vascular resistance and heartbeat. Influenced noradrenalina also reduced blood flow in the kidney and vascular mesenterique. Perhaps there zheludochkovyh departments. Therefore kardiogennom shock, especially in severe cases, the use noradrenalina considered it (EI Wednesday). Usually severe cases kardiogennogo (and bloody) shocked by the reaction vazokonstriktornoy peripheral vascular diseases. Introduction of these cases noradrenalina and other substances that increase the resistance of peripheral vessels, may have a negative effect. It should also be borne in mind that under the influence noradrenalina (and other simpatomimeticheskih amines) increasing demand, in the heart of oxygen.

     If there is evidence to impose Levophed intravenous (drip). Ampulny solution noradrenalina grow in 5% glucose solution or isotonic sodium chloride solution, assuming that 1 L of solution containing 2 ml of 0.2-4% solution (4 to 8 mg) gidrotartrata noradrenalina (which is approximately 2 to 4 mg grounds preparation). The initial speed of 10 to 15 drops per minute. To achieve therapeutic effect (systolic pressure of 100 to 115 mm Hg. Art.) The rate of increase is usually 20 to 60 drops per minute.

     It care solution noradrenalina under the skin and muscle due to the risk of developing necrosis.

     Introduction noradrenalina contraindicated in ftorotanovom and tsiklopropanovom anaesthesia. There should also Levophed full atrioventrikulyarnoy blockade in heart weakness, has expressed atherosclerosis.

     Product : 0.2% solution of 1 ml ampoules.

     Storage : List B. In the dark spot.

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