Norepinephrine (medication)
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| Trade names | Levarterenol, Levophed, Norepin, other |
| AHFS/Drugs.com | Monograph |
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| Routes of administration | Intravenous |
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| Physiological data | |
| Source tissues | Locus coeruleus; sympathetic nervous system; adrenal medulla |
| Target tissues | System-wide |
| Receptors | α1, α2, β1, β3 |
| Agonists | Sympathomimetic drugs, clonidine, isoprenaline |
| Antagonists | Tricyclic antidepressants, Beta blockers, antipsychotics |
| Metabolism | MAO-A; COMT |
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| Pharmacokinetic data | |
| Metabolism | MAO-A; COMT |
| Excretion | Urine (84–96%) |
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Noradrenaline (R)-(–)-Norepinephrine l-1-(3,4-Dihydroxyphenyl)-2-aminoethanol |
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| Formula | C8H11NO3 |
| Molar mass | 169.18 g/mol |
| 3D model (JSmol) | |
| Density | 1.397±0.06 g/cm3 |
| Melting point | 217 °C (423 °F) (decomposes) |
| Boiling point | 442.6 °C (828.7 °F) ±40.0°C |
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Norepinephrine, also known as noradrenaline, is a medication used to treat people with very low blood pressure.[1] It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids.[2] It is the same molecule as the hormone and neurotransmitter norepinephrine. It is given by slow injection into a vein.[1]
Common side effects include headache, slow heart rate, and anxiety. Other side effects include an irregular heartbeat. If it leaks out of the vein at the site it is being given, norepinephrine can result in limb ischemia. If leakage occurs the use of phentolamine in the area affected may improve outcomes. Norepinephrine works by binding and activating alpha adrenergic receptors.[1]
Norepinephrine was discovered in 1946 and was approved for medical use in the United States in 1950.[1][3] It is available as a generic medication.[1] The wholesale cost in the developing world as of 2015 is about 0.42 USD per vial of four milligrams.[4] In the United Kingdom this amount costs the NHS about 4.40 pounds.[5]
Medical uses
Norepinephrine is used mainly as a sympathomimetic drug to treat people in vasodilatory shock states such as septic shock and neurogenic shock, while showing fewer adverse side-effects compared to dopamine treatment.[6]
Mechanism of action
It acts on both α1 and α2 adrenergic receptors to cause blood vessel contraction. Its effects are often limited to the increasing of blood pressure through agonist activity on α1 and α2 receptors, and causing a resultant increase in peripheral vascular resistance.
Names
Norepinephrine is the INN while noradrenaline is the BAN.
References
- 1 2 3 4 5 "Norepinephrine Bitartrate". The American Society of Health-System Pharmacists. Retrieved 26 March 2017.
- ↑ Latifi, Rifat (2016). Surgical Decision Making: Beyond the Evidence Based Surgery. Springer. p. 67. ISBN 9783319298245.
- ↑ Encyclopedia of the Neurological Sciences. Academic Press. 2014. p. 224. ISBN 9780123851581.
- ↑ "Norepinephrine". mshpriceguide.org. Retrieved 26 March 2017.
- ↑ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 145. ISBN 9780857111562.
- ↑ De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL (March 2010). "Comparison of dopamine and norepinephrine in the treatment of shock". The New England Journal of Medicine. 362 (9): 779–89. PMID 20200382. doi:10.1056/nejmoa0907118.