Noradrenaline Pharmacology

Noradrenaline

About Noradrenaline
Directly acting Catecholamine, Adrenergic Alpha/Beta Agonist, Vasopressor.
Mechanism of Action of Noradrenaline
Noradrenaline exerts it`s pharmacological action by acting as an alpha (alpha1 & alpha2) and beta (?1, &?3) adrenergic receptor agonist. It is a power full vasoconstrictor and constricts both capacitance and resistance blood vessels. It increases systolic, diastolic and mean blood pressure. It is a positive inotropic drug through its beta1 action and causes cardiac stimulation. It increases stroke volume and improves coronary blood flow.
Pharmacokinets of Noradrenaline
Absorption: Poorly absorbed after sub cutaneous administration and administered intravenously. Distribution: Distributed in to sympathetic nerve tissues. It crosses placenta but there is no penetration of blood brain barrier. Metabolism: Metabolized to inactive metabolites in sympathetic nerve tissues, liver and other tissues. Excretion: Excreted through urine as metabolites and conjugates.
Onset of Action for Noradrenaline
I.V.: Rapid
Duration of Action for Noradrenaline
I.M.: 1 to 4 hours
I.V.: 1 to 2 minutes
Half Life of Noradrenaline
N/A
Side Effects of Noradrenaline
1.Hypertension
2.Bradycardia
3.Arrhythmias
4.Headache
5.Dizziness
6.Weakness
7.Restlessness
8.Peripheral ischaemia
9.Insomnia
10.Respiratory difficulty
11.Asthmatic episodes
12.Anxiety
13.Tremor
14.Anaphylaxis
15.Necrosis with extravasations

Contra-indications of Noradrenaline
1.Hypersensitivity to the drug
2.Mesenteric or peripheral vascular thrombosis
3.Profound hypoxia
4.Hypercapnia
5.Hypotension resulting from blood volume deficit(except as emergency measure)
6.General anaesthesia with halothane or cyclopropane

Special Precautions while taking Noradrenaline
1.Hypertension
2.Monitor blood pressure during therapy
3.Bronchial asthma
4.Avoid extravasations, and necrosis of overlying tissue
5.Allergy to sulfites
6.Along with MAO inhibitors or triptyline or imipramine type antidepressants
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Noradrenaline
1.To maintain blood pressure in hypotensive states
2.Cardiac arrest
3.Acute hypotension
Interactions for Noradrenaline
Bretylium: May potentiate the action of vasopressors on adrenergic receptors, possibly resulting in arrhythmias.
Guanethidine: May increase the pressor response of the direct acting vasopressor, possibly resulting in severe hypertension.
Halogenated hydrocarbon anaesthetics: May sensitise the myocardium to the effects of catecholamines. Use of vasopressors may lead to serious arrhythmias, use with extreme caution.
Oxytocic drugs: May cause severe persistent hyertension.
Tricyclic antidepressants: The pressor response of the direct acting vasopressors may be potentiated by these agents: use with caution.
MAOIs: Severe, prolonged hypertension may result.
Typical Dosage for Noradrenaline
To maintain blood pressure in hypotensive states:
Adults: Starts with 8 to 16mcg/minute as I.V. infusion; then adjust the dosage to maintain desired blood pressure.
Maintenance dosage: 2 to 4mcg/minute
Children: Starts with 2mcg/minute as I.V. infusion; then adjust the dosage to maintain desired blood pressure. For cardiac life support; initial infusion rate is 0.1mcg/kg/minute.
Cardiac arrest: Rapid intravenous or intracardiac injection; 0.5 to 0.75ml of a solution containing nor epinephrine bitartrate 100mcg/ml.

Schedule of Noradrenaline
C & C1.
Storage Requirements for Noradrenaline
Store at controlled room temperature at a range of 15 to 25 degree C and protects from light.
Effects of Missed Dosage of Noradrenaline
The doctor should be informed immediately if a dose is missed
Effects of Overdose of Noradrenaline
Treatment is supportive and symptomatic. Closely monitor vital signs. Treat extravasations with Phentolamine, treat reflex Bradycardia with Atropine & tachyarrhythmias with beta blockers like Propranolol.

Home Delivery for Noradrenaline in Your City

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However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for noradrenaline and other medicines and health products. Home delivery services for noradrenaline may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take noradrenaline only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for noradrenaline before they complete the sale. You can get this information while placing the order for noradrenaline with the pharmacy.

Noradrenaline is a generic medicine name and there are several brands available for it. Some of the brands for noradrenaline might be better known than noradrenaline itself. If the pharmacy that's willing to deliver medicines to your home doesn't have noradrenaline in stock, you can ask for one of the branded alternatives for noradrenaline.