Norepinephrine (sometimes referred to as l-arterenol/Levarterenol or l-Norepinephrine) is a sympathomimetic amine which differs from epinephrine by the absence of a methyl group on the nitrogen atom. Norepinephrine bitartrate is (-)-α-(aminomethyl)-3,4-dihydroxybenzyl alcohol tartrate (1:1) (salt) monohydrate and has the following structural formula: Norepinephrine is supplied in sterile aqueous solution in the form of the bitartrate salt to be administered by intravenous infusion following dilution. Norepinephrine is sparingly soluble in water, very slightly soluble in alcohol and ether, and readily soluble in acids. Each mL contains the equivalent of 1 mg base of Norepinephrine, sodium chloride for isotonicity. It has a pH of 3 to 4.5. The air in the ampules has been displaced by nitrogen gas. Slideshow Norepinephrine - Clinical Pharmacology Norepinephrine functions as a peripheral vasoconstrictor (alpha-adrenergic action) and as an inotropic stimulator of the heart and dilator of coronary arteries (beta-adrenergic action). Server metin2 gata facut in romana pvp. Astept Pareri/Sugesti Merit si eu un Multumesc?!:'> Metinul nu e facut de mine! Dr Meharban SinghIndications and Usage for Norepinephrine For blood pressure control in certain acute hypotensive states (e.g., pheochromocytomectomy, sympathectomy, poliomyelitis, spinal anesthesia, myocardial infarction, septicemia, blood transfusion, and drug reactions). As an adjunct in the treatment of cardiac arrest and profound hypotension. Etymological derivation (Vyutpatti), syntactical derivation (Niruktti) and definition of the word Itihas. GirindrNath Mukhopadhyaya. A Short history of Aryan Medical Science. Bhagwat Singh. History of Indian Medicine. Hindu Medicine. Pediatrics Emergencies by Meharban Singh. (Ayurvedic Pediatrics): Definition, importance. Weight and drug preparations). Meharban Singh 6. Paediatric Emergencies - Meharban Singh 7. Contraindications Norepinephrine Bitartrate Injection, USP should not be given to patients who are hypotensive from blood volume deficits except as an emergency measure to maintain coronary and cerebral artery perfusion until blood volume replacement therapy can be completed. If Norepinephrine Bitartrate Injection, USP is continuously administered to maintain blood pressure in the absence of blood volume replacement, the following may occur: severe peripheral and visceral vasoconstriction, decreased renal perfusion and urine output, poor systemic blood flow despite 'normal' blood pressure, tissue hypoxia, and lactate acidosis. Norepinephrine Bitartrate Injection, USP should also not be given to patients with mesenteric or peripheral vascular thrombosis (because of the risk of increasing ischemia and extending the area of infarction) unless, in the opinion of the attending physician,the administration of Norepinephrine Bitartrate Injection, USP is necessary as a life-saving procedure. Cyclopropane and halothane anesthetics increase cardiac autonomic irritability and therefore seem to sensitize the myocardium to the action of intravenously administered epinephrine or Norepinephrine. Hence, the use of Norepinephrine Bitartrate Injection,USP during cyclopropane and halothane anesthesia is generally considered contraindicated because of the risk of producing ventricular tachycardia or fibrillation. The same type of cardiac arrhythmias may result from the use of Norepinephrine Bitartrate Injection, USP in patients with profound hypoxia or hypercarbia. Warnings Norepinephrine should be used with extreme caution in patients receiving monoamine oxidase inhibitors (MAOI) or antidepressants of the triptyline or imipramine types, because severe, prolonged hypertension may result. Precautions General Avoid Hypertension: Because of the potency of Norepinephrine and because of varying response to pressor substances, the possibility always exists that dangerously high blood pressure may be produced with overdoses of this pressor agent. It is desirable, therefore, to record the blood pressure every two minutes from the time administration is started until the desired blood pressure is obtained, then every five minutes if administration is to be continued. The rate of flow must be watched constantly, and the patient should never be left unattended while receiving Norepinephrine. Headache may be a symptom of hypertension due to overdosage. Site of Infusion: Whenever possible, infusions of Norepinephrine should be given into a large vein, particularly an antecubital vein because, when administered into this vein, the risk of necrosis of the overlying skin from prolonged vasoconstriction is apparently very slight. Some authors have indicated that the femoral vein is also an acceptable route of administration.
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