Noradrenaline [1 bag $3.60] ADMINISTRATION ROUTES:
ALTERNATIVE NAMES: Levophed
ICU INDICATIONS: 5. septicshock 6. otherdistributiveshock
PRESENTATION AND ADMINISTRATION:
Use 10mg in 100ml (0.1mg/ml) pre-mixed bags; 2mg in 2ml vials (1:1000) can be used to make up double strength noradrenaline if required by adding 20mg of noradrenaline to 100ml of compatible IV fluid. Compatible with the following IV fluids:
5% dextrose dextrose with sodium chloride Store at room temperature
0-20ml/hr (higher doses may occasionally be required)
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY: No dosage adjustment is required
DOSAGE IN PAEDIATRICS:
0.15mg/kg in 50ml D5W at 1-10ml/hr (1ml/hr equal 0.1mcg/kg/min)
CLINICAL PHARMACOLOGY: Norepinephrine bitartrate functions as a peripheral vasoconstrictor (alpha-adrenergic action) and as an inotropic stimulator of the heart and dilator of coronary arteries (beta- adrenergic action). The alpha action predominates.
WARNINGS Norepinephrine injection contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people.
Norepinephrine 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.
No tests additional to routine ICU tests are required.
Drug/Laboratory Test Interactions
IMPORTANT DRUG INTERACTIONS FOR THE ICU None of note
Body as a Whole:
Ischemic injury due to potent vasoconstrictor action tissue hypoxia.
Bradycardia, probably as a reflex result of a rise in blood pressure, arrhythmias.
Anxiety, transient headache.