Enter only intravenously.
Individual dose of the drug Noradrenaline is established by the doctor depending on the clinical condition of the patient.
Noradrenaline should be administered via central venous access devices, in order to reduce the risk of extravasation and subsequent tissue necrosis.
Breeding:
- For injection with a syringe infusion pump, add 4 ml of Noradrenalin 1 mg / ml with 46 ml of a 5% dextrose solution. Do not mix with other drugs.
- For administration with a dropper, add 460 ml of 5% dextrose solution to 40 ml of Noradrenaline 1 mg / ml. Do not mix with other drugs.
In both methods of dilution, the final concentration of the resulting solution for intravenous administration should be 80 mg / l, which is equivalent to 40 mg / l of norepinephrine base.
The recommended initial dose of norepinephrine and the rate of reference is 0.1 to 0.3 μg / kg / minute. The infusion rate is progressively increased by titration step-by-step, at 0.05 to 0.1 μg / kg / min, according to the observed pressor effect until the desired normotonia is achieved. There are individual differences in the dose necessary to achieve and maintain normotonia. The goal is to reach the lower limit of the norm of systolic pressure (100 - 120 mm Hg) or to reach a sufficient level of the average value (above 65 - 80 mm Hg, depending on the patient's condition).
- Before or during therapy, correction of hypovolemia, hypoxia, acidosis, hypercapnia is necessary.
- Norepinephrine should be used concomitantly with adequate replenishment of the circulating blood volume.
Arterial pressure:
The duration, rate of administration and dosing of the solution of Norepinephrine are determined by cardiac monitoring data and under compulsory medical control of blood pressure (every 2 minutes until normotonia, after every 5 minutes during the entire infusion) to avoid the occurrence of hypertension.
Discontinuation of therapy:
Therapy Norepinephrine should be reduced in stages, as abrupt reversal can lead to acute hypotension.
The course of treatment can last from several hours to 6 days.
It is necessary to guard against the introduction of norepinephrine solution under the skin and in the muscles because of the danger of developing necrosis (See section "Special instructions").