Instruction for use: Noradrenaline Aguettant

Trade name of the drug – Noradrenaline Aguettant

Active substance: Norepinephrine

ÀÒÕ Code C01CA03 Norepinephrine

Pharmacotherapeutic group:

Sympathomimetic drug

Nosological classification (ICD-10)

I95 Hypotension

R55 Syncope [syncope] and collapse

R57.0 Cardiogenic shock

CompositionThe concentrate for solution for intravenous injection 1 ml

norepinephrine tartrate monohydrate (converted to norepinephrine tartrate) 2 mg / ml

Excipients: sodium chloride; Sodium hydroxide or hydrochloric acid (pH = 3.0-4.5); water for injections

in vials of 4 ml or 8; in contour plastic packaging 5 vials; 2 In the paper cartons packaging. Characteristic

Clear, colorless liquid.

Pharmachologic effect
adrenomimetiki.

pharmacodynamics

Agonist αl- and α2-adrenergic receptors. He weakly excites β1- and almost no effect on β2-adrenergic receptors. Has a powerful vasoconstrictor effect, increases the blood pressure.

Pharmacokinetics

Not absorbed in the gastrointestinal tract. The on / in the introduction quickly reaches Cmax in plasma (2-3 minutes).

It is metabolized in the liver, kidneys and blood plasma with the participation of MAO and catechol-O-methyltransferase (COMT) to virtually inactive metabolites that are excreted through the kidneys.

Indications for Noradrenaline Aguettant
Acute hypotension accompanying cardiovascular collapse and shock (to restore and maintain blood pressure - in / perfusion).

Contraindications for Noradrenaline Aguettant

severe hypersensitivity to the drug;

hypotension due to hypovolemia. An exception in these cases is the need for administration of the drug to maintain blood flow in the coronary arteries of the heart and arteries of the brain until the end of therapy to restore the BCC;

mesenteric thrombosis and peripheral vascular disease because of the risk of worsening of myocardial ischemia and increasing zone;

holding ftorotanovoy cyclopropane and general anesthesia (due to the risk of ventricular tachycardia and atrial fibrillation);

severe hypoxia and hypercapnia.

Restrictions:

severe left ventricular failure, congestive heart failure, recent myocardial infarction;

simultaneous reception of MAO inhibitors and imipraminovogo triptilinovogo series (due to the risk of pronounced and long-lasting increase in blood pressure);

symptoms develop cardiac arrhythmia (in this case to reduce the dose of the drug). When polymorphic beats or extrasystoles development volleys dose should substantially reduce or cancel treatment.

If necessary, the simultaneous application of norepinephrine Agetan and transfusion of blood or plasma drug administered alone.

Pregnancy and breast-feeding

Pregnancy is not a limitation for the use of norepinephrine Agetan. At the time of treatment should stop breastfeeding (no experience of the drug in lactating women).

Side effects

The following symptoms may occur when administered norepinephrine Agetan:

- Up to the ischemic necrosis induced vasoconstriction and tissue hypoxia and extravasation caused;

- Arrhythmia;

- Reflex bradycardia;

- Anxiety;

- Difficulty in breathing;

- Tremors;

- Transient headache;

- Retrosternal or pharyngeal pain;

- Vegetative reactions - pallor, sweating, vomiting, tachycardia. In particularly sensitive patients, increase in blood pressure may be accompanied by headache, photophobia, stabbing chest pain, pale skin, sweating and vomiting.

With prolonged use need dose adjustment in order to avoid hypotension return to remove the drug.

interaction

The main adverse effects when combined with certain drugs are groups pharmacodynamic.

When combined with inhaled anesthetic agents may occur serious ventricular arrhythmias (increased cardiac excitability).

When combined with serotonergic and adrenergic antidepressants, as well as derivatives of imipramine and amitriptyline can develop hypertension with paroxysmal cardiac arrhythmia risk by adrenoceptor blocking effect on the sympathetic nervous system.

Contraindicated combination of norepinephrine Agetan with selective and non-selective MAO inhibitors, linezolid, as thus there is a synergistic increase in the pressor effect of norepinephrine, which requires careful medical supervision.

Noradrenaline Aguettant Dosage and Administration
preferably in the vein of the elbow.

Concentrate, dilute 5% glucose solution or 0.9% sodium chloride solution. Do not mix with other drugs. With the introduction of norepinephrine Agetan need to constantly monitor the blood pressure and heart rate.

After dilution of the concentrate solution should be used within 12 hours.

Individual dose is determined depending on the clinical condition of the patient. The recommended initial dose and rate of administration of from 0.1 to 0.3 .mu.g / kg / min of noradrenaline tartrate. The maximum dose and rate of administration, used in the treatment of septic and hemorrhagic shock, can reach 3-5 .mu.g / kg / min.

Overdose

Symptoms may occur spasmodermia, collapse, anuria, marked increase in blood pressure.

Treatment: should be reduced at a dose manifestations of overdose.

Storage conditions of Noradrenaline Aguettant
In a dry, dark place at a temperature no higher than 30 ° C.

Keep out of the reach of children.
Shelf life of Noradrenaline Aguettant
2 years.
Do not use beyond the expiration date printed on the package.