Norepinephrine. Effect on the body, what is it, instructions for use, the difference between the hormone and adrenaline

Norepinephrine is considered one of the most potent medicines for the treatment of pathologies accompanied by a critical decrease in blood pressure.

The action of the medicine on the patient's body helps prevent various complications and improve the condition. The drug is used only in a hospital setting and under the supervision of a doctor, which avoids negative and unforeseen consequences.

Form of release and composition of the drug Norepinephrine

The agent is sold in the form of a concentrated solution for parenteral administration. Transparent and colorless liquid is packaged in ampoules of 4 or 8 ml. 1 ml of solution contains 2 mg of active substance, that is, ampoules of 8 or 16 mg are produced, depending on the volume.

The ampoules are in cardboard boxes of 10. They are always accompanied by detailed instructions for use. As the main component in the composition of the drug, the substance norepinephrine is present.

The solution contains auxiliary ingredients:

• Water for injections.
• Sodium chloride.
• Sodium hydroxide.

The auxiliary ingredients have no therapeutic properties.

The effect of the substance norepinephrine on the body

Norepinephrine has a pronounced vasoconstrictor effect on the body, which helps to increase blood pressure indicators when they are critically reduced.

The drug also:

• helps to stimulate heart activity;
• prevents disorders of the respiratory system;
• contributes to the normalization of indicators;
• increases cardiac output;
• improves myocardial contractility, due to which all cells are saturated with nutrients and oxygen.

Pharmacological properties

The medicinal solution helps to increase blood pressure indicators when they are critically reduced as a result of cardiogenic shock or other acute conditions that threaten a person's life. The agent contributes to the narrowing of the coronary and peripheral vessels, which leads to an increase in pressure on their walls and accelerates the movement of blood through the systemic circulation.

The saturation of tissues with oxygen and nutrients improves the general condition, simulates the work of the brain, and prevents the aggravation of the condition.

The tool has other properties:

• It has cardiotropic properties, which helps to improve the state of the myocardium.
• Increases heart rate.
• Normalizes the functioning of the respiratory system, prevents the development of respiratory failure against the background of heart pathologies.
• It slightly weakens the blood flow in the vessels of the digestive tract and kidneys.
• Improves the functioning of the brain, stimulates the transmission of nerve impulses to tissues.

Against the background of these changes, the state is normalized in case of critical violations against the background of a weakening of the heart or other pathologies.

After parenteral administration, there is a rapid spread of the component through the systemic circulation and the onset of a therapeutic effect. The agent does not accumulate in the blood and tissues, and its maximum concentration in the blood is reached after 20 minutes. The processing of the active substance is carried out in the liver.

The excretion of its decay products is carried out with the help of the kidneys. The evacuation period for ingredients takes up to 24 hours. With damage to the kidneys and liver, a slowdown in the period of processing and excretion of the components of the drug is observed. In patients with severe organ disorders, the effectiveness of therapy is significantly reduced.

Differences between norepinephrine and adrenaline

Norepinephrine is somewhat different from adrenaline, namely, the effect of these components on the patient's body is different. The first component helps to increase blood pressure, but it has a milder effect on the body and does not provoke serious complications.

Adrenaline significantly increases cardiac output, can lead to the development of arrhythmias and severe tachycardia. That is why experts prefer to use norepinephrine in critical conditions.

Doctors also note the ability of adrenaline to significantly increase blood glucose levels, which is not observed with the use of norepinephrine. An important feature of adrenaline is its ability to influence the development of the body's resistance to stress.

Indications for use

The tool is used in various critical conditions, accompanied by a decrease in blood pressure indicators and other disorders.

The main indications for prescribing a medication:

• Surgery on the central or peripheral nervous system. The tool is used to normalize blood pressure. This is usually necessary when using strong anesthetics.
• Poisoning of the body with toxins, poisons or drugs, provoking oppression of the activity of blood vessels and the heart. Against the background of these violations, a critical decrease in blood pressure and heart rate occurs, which can be fatal. Timely use of norepinephrine helps to improve the condition.
• Injuries of extremities, internal organs, accompanied by painful shock and a critical decrease in blood pressure.
• Surgery on internal organs performed under general anesthesia.

The tool can be used for traumatic shock or in order to prevent the aggravation of the symptoms of pathologies of the cardiovascular system.

Contraindications

The medication is not used for allergies to the main component or auxiliary ingredients of the composition.

Other contraindications include the following violations:

• Acute conditions, accompanied by a critical increase in blood pressure indicators.
• Heart pathologies in which tachycardia, arrhythmia and other severe disorders are observed.
• Complete atrioventricular block. With a partial blockade, the agent is prescribed with extreme caution, only under the supervision of a doctor.
• Hypertensive crisis, accompanied by acute symptoms and a significant deterioration in the condition.
• A severe course of atherosclerosis, in which there is a narrowing of the lumen of the vessels and an increase in pressure on their walls. With a complete overlap of the lumen of any peripheral vessel, the drug can provoke deterioration.
• Anesthesia of the fluorothane or cyclopropane type during surgery.
• Lactation and pregnancy period.

The drug is prescribed with caution to elderly patients suffering from severe chronic heart pathologies. For children and adolescents, the drug is prescribed with extreme caution and only under supervision in a hospital setting.

From what age can you apply?

Norepinephrine (the effect on the body is explained by the presence of norepinephrine in the composition) is used for patients over 2 years old. However, experts pay attention to the possibility of prescribing at an earlier age, if acute indications arise.

Instructions for use, dosage

The medication is administered only intravenously using a dropper. Jet injection is not allowed, even after dilution with saline. For dilution, 0.9% sodium chloride or 5% glucose is used. For every 500 ml of solution, there is no more than 2 ml of norepinephrine solution.

After preparing the composition, it is very slowly injected using a dropper. The patient must be in a horizontal position. It is possible to administer 4 ml of norepinephrine per day, diluted in the required amount of glucose or sodium chloride.

The maximum injection rate is 60 drops per minute. Exceeding it is categorically contraindicated. However, infusion is started at 15-20 drops per minute.

Treatment is not carried out in courses, the solution is used only according to indications, that is, with a decrease in blood pressure and the development of other complications. Usually, it takes no more than 3 days to normalize the condition. During this period, the patient is in the hospital under the strict supervision of a physician.

Side effects

Norepinephrine (the effect on the body in each case individually) often leads to the development complications, even with proper use, which is associated with the pronounced properties of the active component of the composition.

Organs and systems	The most common complications
Nervous system	Headaches and dizziness when using the product occur quite often. These complications arise against the background of a rapid increase in blood pressure as a result of vasospasm. The condition may be accompanied by increased excitability, insomnia and psycho-emotional stress. After discontinuation of therapy, the condition returns to normal within a few days.
Vessels and heart	Violation of the heart rhythm when using the medicinal solution is most often observed. Patients may be disturbed by tachycardia, pain in the region of the heart and a critical increase in blood pressure. Patients who suffer from hypertension, but for whatever reason, develop a shock state, and their indicators decrease, are especially acutely responsive to treatment.
Digestive organs	From the side of the digestive tract, complications do not occur so often. Sometimes patients talk about pain in the stomach, spasm of intestinal smooth muscles and flatulence. In some cases, complications are accompanied by nausea, seizures and vomiting, and upset stools. The condition is aggravated with prolonged persistence of symptoms, dehydration develops, which can have a negative effect on the central nervous system.
Genitourinary system	On the part of the genitourinary system, an increase or decrease in libido, frequent urination, pain in the kidney area is possible, especially in patients who suffer from pathologies of the paired organ.
Skin	On the part of the skin, an allergic reaction is observed. The severity of negative manifestations depends on the duration of the use of the medication. Allergies are the classic symptoms of itchy skin, rashes, and irritation. In severe cases, disorders of the visual apparatus and mucous membranes of the nasal passages join.

Symptoms usually disappear after discontinuation of therapy and do not require special treatment. However, with prolonged therapy, there is a deterioration in the condition and work of internal organs. If negative reactions appear, you must stop using the solution. If they worsen, symptomatic treatment is prescribed.

Overdose

Prolonged administration of the solution in high doses can provoke an overdose, which is accompanied by many negative reactions with sides of internal organs and systems:

• Critical increase in blood pressure indicators. The condition is accompanied by a headache, redness of the skin of the face, a feeling of heat and an irregular heart rhythm. In this case, the patient becomes weak, irritable, tries to spend more time in a horizontal position.
• Vascular spasm of the outer layer of the skin.
• Increased urination or abnormal absence of urine.
• Sleep disturbance, accompanied by irritability, up to a severe form of nervous disorder.
• Lachrymation, swelling of the mucous membranes of the eyes, itching and redness.
• Allergic rhinitis, accompanied by the discharge of a large amount of clear mucus from the nose, difficulty breathing, and some other disorders.

Overdose is often accompanied by collapse. The condition threatens not only the health, but also the patient's life, therefore, requires immediate medical attention. Usually, when signs of an overdose appear, a specialist reduces the dose of the drug and monitors the patient's condition.

If symptoms gradually disappear, treatment can be continued, but reduced doses are used. If there is no improvement within a few hours, therapy is canceled.

special instructions

Norepinephrine (the effect on the body may differ for different regimens) is used only under strict indications and under the supervision of a physician. In this case, the most important point of therapy is the regular monitoring of blood pressure and heart rate.

With a critical increase in indicators, treatment is canceled. The use of the drug in a hospital setting can significantly reduce the likelihood of developing severe negative reactions. It is strictly forbidden to use the medicine at home. Patients also cannot independently exceed the dosage and duration of the medication. Doctors adjust the therapy regimen according to indications.

The use of the solution is stopped immediately after the state is normalized. Norepinephrine is not a medication that is used for long courses, but some patients are prescribed it in a critical condition, for example, to maintain blood pressure indicators at one level.

Drug interactions

The solution is not used in combination with medicines that have similar ingredients in the composition or have the same therapeutic properties. Do not prescribe the drug simultaneously with drugs aimed at increasing blood pressure and increasing heart rate.

Using the medicine with certain antidepressants, for example, with amitriptyline and its analogues, can lead to the development of severe hypertension and arrhythmias. Prescribing concurrently with INR inhibitors can lead to an increase in the action of norepinephrine, which negatively affects the state of the nervous, cardiovascular system.

Analogs

The tool has analogues that can be used if it is not available in pharmacies or if it is impossible to prescribe for various reasons.

The most effective substitutes:

• Mezaton - a solution for parenteral administration containing phenylephrine as the main active ingredient. The tool helps to fight pathological hypotension, diseases accompanied by a critical decrease in indicators and dysfunction of the heart. The drug is considered potent, therefore it is prescribed only by a doctor and is used only in a hospital. If the instructions are violated, it often leads to deterioration, as well as serious complications.
• Dopamine - solution for intravenous drip in order to maintain blood pressure and heart rate at a normal level. The solution contains the active ingredient of the same name, which has a pronounced effect on the body. The tool is used only in a hospital setting, it is never injected in a jet, since severe complications are possible.
• Dopamine - a drug based on dopamine, which has pronounced therapeutic properties and is available in the form of a solution for intravenous drip administration. The drug is not poured in a stream. The medicine helps to increase blood pressure and improves myocardial contractility, which has a beneficial effect on the patient's condition.

Analogues belong to potent medicines, therefore, use is allowed in a hospital setting. Otherwise, the risk of complications increases.

Terms, conditions of sale and storage

During storage, it is important to prevent direct sunlight from entering the solution, as well as to restrict access to children. Do not put ampoules in the refrigerator.

The maximum storage time is 2 years. After the expiration of this period, the use of the solution is categorically contraindicated. The production date of the medication is indicated on the packaging. The purchase of a medicine is carried out only with a prescription from a doctor.

Price

The average cost of 10 ampoules is 1500-1600 rubles. A solution with a lower dosage of the active ingredient costs slightly less (1200-1300 rubles).

Norepinephrine is an effective medication that is often used to treat the symptoms of critical conditions. The action of the drug on the body helps not only to increase blood pressure, but also to improve the functioning of the heart, which prevents the development of severe complications.

When used correctly, the medicine is beneficial, but violation of the instructions will certainly provoke negative reactions.

Video about norepinephrine

Chemistry of norepinephrine: