Noradrenaline :
Trade names: Norepinephrine
Class:Vasoconstrictor sympathomimetics

Pregnancy: (Category C)
Action:
Noradrenalin (Norepinephrine) tartrate is a substance released naturally by the nerve cells. It produces wide ranging effects on many areas of the body and is often referred to as a 'fight or flight' chemical, as it is responsible for the body's reaction to stressful situations.
Uses:
  • Sudden, life threatening low blood pressure (acute hypotension)
Use with caution in:
  • A severe form of angina pectoris, not caused by exertion (Prinzmetal's angina)
  • Abnormally high amount of carbon dioxide in the blood (hypercabnia)
  • Blood clot in one of the blood vessels in the extremities (peripheral vascular thrombosis)
  • Blood clot in the artery which supplies blood to the heart (coronary thrombosis)
  • Blood clot in the artery which supplies blood to the intestines (mesenteric thrombosis)
  • Low blood pressure following a heart attack
  • Low levels of oxygen in the tissues (hypoxia)
Dose:
Acute hypotension, by intravenous infusion, via central venous catheter, of a solution containing noradrenaline acid tartrate 80 micrograms/mL (equivalent to noradrenaline base 40 micrograms/mL) at an initial rate of 0.16–0.33 mL/minute, adjusted according to response
Contraindications:
  • Children.
  • Allergy.
Side effects:
  • Headache
  • Slow heart rate (bradycardia)
  • High blood pressure (hypertension)
  • Inadequate blood flow leading to low levels of oxygen in the tissues of the extremities (peripheral ischemia), which may lead to gangrene
Nursing considerations:
The infusion must be changed every 24 hours ·
Monitor urine output hourly and check distal pulses ·
Monitor serum glucose.
Give via volumetric pump to regulate flow.
During infusion monitor ECG,BP, CO, CVP, PAWP, HR, urine output, color and temperature of extremities initially every 2 minutes.
Check infusion site frequently for signs of extravasation If occurs stop infusion immediately, infiltrate the area with 5 - 10 mg Phentolamine(alpha blocker) diluted in 10 - 15 ml 0.9 % normal saline subcutaneously and liberally