Equis ISSN 2398-2977

Norepinephrine

Synonym(s): Noradrenaline

Contributor(s): Adam Auckburally, Joanne Michou

Introduction

Name

  • Norepinephrine (as acid tartrate).

Class of drug

  • Sympathomimetic.
  • Catecholamine.
  • Vasopressor.
  • Inotrope.

Description

Chemical name

  • 4-[(1R)-2-amino-1-hydroxyethyl]benzene-1,2-diol.

Molecular formula

  • C8H11NO3.

Molecular weight

  • 169.18 g (337.3 g as acid tartrate).

Physical properties

  • Clear, colorless solution.
  • Available as 1:1000 single use ampule.

Storage requirements

  • Store <25°C.
  • Protect from light.

Uses

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Indications

  • Restoration of tissue perfusion during vasodilatory shock in foals.
  • Specifically - markedly decreased systemic vascuarl resistance or mean arterial blood pressure which is unresponsive to fluid or alternative inotropes and/or pressor drugs, eg dobutamine   Dobutamine  and/or dopamine   Dopamine hydrochloride  .
  • Can be administered in combination with dobutamine   Dobutamine  .
  • Support of blood pressure during isoflurane induced hypotension in foals.
  • Indication for use in adult horses remains unclear.
  • Listed within the Substances Essential for the Treatment of Equidae (Commission Regulation 1950/2006) and therefore can be administered to horses intended for human consumption within the EU.

Administration

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Pharmocokinetics

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Precautions

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Interactions

with other drugs

  • Monoamine oxidase inhibitors - action of norepinephrine will be potentiated and prolonged.
  • Superior cardiovascular responses to norepinephrine in foals occur when used in combination with other vasoactive or inotropic drugs, eg dobutamine   Dobutamine  , vasopression.

Adverse Reactions

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Further Reading

Publications

Refereed papers

  • Recent references fromPubMed.
  • Dickey E J, McKenzie H C & Furr M O (2010)Use of pressor therapy in 34 hypotensive critically ill neonatal foals.Aus Vet J88, 472-477PubMed.
  • Craig C A, Haskins S C & Hildebrand S V (2007)The cardiopulmonary effects of dobutamine and norepinephrine in isoflurane-anesthetized foals.Vet Anaes Analg34, 367-377PubMed.
  • Valverde A, Giguère S, Sanchez C Let al(2006)Effects of dobutamine, norepinephrine, and vasopressin on cardiovascular function in anesthetized neonatal foals with induced hypotension.Am J Vet Res67, 1730-1737PubMed.
  • Corley K T, McKenzie H C III, Amoroso L Met al(2000)Initial Experience with Norepinephrine Infusion in Hypotensive Critically III Foals.J Vet Em Crit Care10, 267-276.

Other sources of information

  • Levophed® summary of product characteristics (SPC)

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