Norepinephrine Agetan - instructions for use, dose, side effects, contraindications

Pharmacodynamics:Norepinephrine is a true agonist α1 and α2 adrenergic receptors. He weakly excites ß1- and practically does not affect ß2-adrenergic receptors. Because of this noradrenaline, affecting large vessels, has a potent vasoconstrictor effect, leads to increased blood pressure.

Pharmacokinetics:

Not absorbed in the gastrointestinal tract. When administered intravenously, it quickly reaches a maximum plasma concentration (2-3 minutes). It is metabolized in the liver, kidneys and blood plasma with the participation of MAO and COMT to virtually inactive metabolites that are excreted through the kidneys.

Indications:

- for intravenous perfusion in acute hypotension, accompanying cardiovascular collapse and shock to restore and maintain blood pressure.

Contraindications:

Contraindicated in patients:

- with arterial hypotension due to hypovolemia. An exception in these cases is the need to administer a drug to maintain blood flow of the coronary arteries of the heart and brain arteries before the end of therapy aimed at restoring the volume of circulating blood,

- with thrombosis of mesenteric and peripheral vessels in connection with the risk of aggravation of ischemia and an increase in the infarction zone,

- when carrying out fluorotan and cyclopropane general anesthesia in connection with the risk of developing ventricular tachycardia and fibrillation,

- with severe hypoxia and hypercapnia,

- with severe hypersensitivity to the drug.

Carefully:

Carefully apply

- with severe left ventricular failure, acute heart failure, recently transferred myocardial infarction,

- while simultaneous administration of MAO inhibitors of imipramine and triptyline in connection with the risk of developing a pronounced and prolonged increase in blood pressure,

- When symptoms of cardiac arrhythmia appear, a dose reduction is necessary. With polymorphic extrasystole or the appearance of volleys of extrasystoles, the dose of the drug should be significantly reduced or canceled treatment. If Norepinephrine Agetan is needed and a blood or plasma transfusion, the drug is administered separately.

Pregnancy and lactation:Pregnancy is not a limitation of norepinephrine use Agetan. There is no experience of using the drug in lactating women.

Dosing and Administration:

Norepinephrine Agetan is administered intravenously, preferably into the ulnar vein vein. Concentrate should be diluted in a 5% solution of glucose or 0.9% solution of sodium chloride. Do not mix with other drugs. When norepinephrine is administered, Agetan needs to constantly monitor blood pressure and heart rate.

After diluting the concentrate, the solution should be used within 12 hours. Individual dose is determined depending on the clinical state of the patient. Recommended initial dose and rate of administration from 0.1 to 0.3 μg / kg / minute norepinephrine tartrate.The maximum dose and rate of administration used in the treatment of septic and hemorrhagic shock can reach 3-5 μg / kg / minute.

Side effects:

When Noradrenalin Agetan is administered, the following symptoms may occur:

- ischemic disorders up to necrosis, caused by vasoconstriction and tissue hypoxia, as well as during extravasation,

- arrhythmia,

- reflex bradycardia,

- anxiety,

- difficulty breathing,

- tremor,

- transient headache, retrosternal or pharyngeal pain,

- vegetative reactions - pallor, increased sweating, vomiting, tachycardia,

In particularly sensitive patients, increased blood pressure may

accompanied by headache, photophobia, stinging retrosternal pain, paleness of the skin, increased sweating and vomiting.

With long-term use, dose adjustment is necessary to avoid recurrent hypotension when the drug is withdrawn.

Overdose:

Symptoms: There may be a spasm of the vessels of the skin, collapse, anuria, a marked increase in blood pressure.

Treatment: When the onset of overdose, the dose of the drug should be reduced.

Interaction:

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

When combined with inhaled anesthetics, serious ventricular arrhythmias (increased cardiac excitability)

When combined with serotonergic and noradrenergic antidepressants, as well as derivatives of imipramine and tripeptin, paroxysmal hypertension may develop with a risk of cardiac arrhythmia due to adrenoblocking effects on the sympathetic nervous system.

The combination of Noradrenaline Agetan with selective and non-selective MAO inhibitors, linezolid, is counter-indicative. This results in a synergistic increase in the pressor action of norepinephrine, which requires strict medical control.

Form release / dosage:Concentrate for the preparation of a solution for intravenous administration of 2 mg / ml.

Packaging:Concentrate for the preparation of a solution for intravenous administration of 2 mg / ml in ampoules of colorless glass class 1. The nominal volume of 4 ml and 8 ml. 5 ampoules of one volume are in a plastic box with cells. Two boxes (10 ampoules), together with instructions for use are placed in a cardboard box.

Storage conditions:Keep in dry the dark place at a temperature not inover 30 ° C.

Shelf life:2 years.

Terms of leave from pharmacies:On prescription

Registration number:LSR-002181/08

Date of registration:28.03.2008

The owner of the registration certificate:Laboratory AgetanLaboratory Agetan France

Manufacturer: & nbsp

Laboratoir AGUETTANT France

Representation: & nbspEPIDBIOMED-IMPEX LLC EPIDBIOMED-IMPEX LLC Russia

Information update date: & nbsp07.08.2015

Illustrated instructions

Instructions

Noradrenaline Agetan (Noradrenaline Aguettant)