Noradrenaline Agetan

Noradrenaline Agetan – the drug used at the acute hypotension which is followed by cardiovascular shock and a collapse.

Form of release and structure

Noradrenaline Agetan is released in the form of a concentrate for preparation of solution for intravenous administration: colourless transparent liquid (in ampoules on 4 and 8 ml, on 5 ampoules in plastic planimetric packagings, on 2 packagings in a cardboard pack).

Is a part of 1 ml of a concentrate:

• Active agent: Norepinephrinum tartrate (in the form of monohydrate) – 2 mg;
• Auxiliary components: sodium chloride, sodium hydroxide or Acidum hydrochloricum (рН – 3,0-4,5), water for injections.

Indications to use

• The acute arterial hypotension connected with the injuries, overdose of ganglioblokator and other antihypertensives, surgical interventions and poisonings which are followed by oppression of vasomotor centers;
• States after removal of a pheochromocytoma (for stabilization of arterial pressure at the operations performed on a sympathetic nervous system).

Contraindications

• The arterial hypotension caused by a hypovolemia. Drug is used by way of exception in need of maintenance of a blood-groove in coronary arteries of a brain and heart before the end of the treatment directed to recovery of volume of the circulating blood;
• The thrombosis of peripheral and mesenteric vessels connected with risk of increase in a zone of a heart attack and aggravation of ischemia;
• The expressed hypercapnia and hypoxia;
• Carrying out cyclopropane and ftorotanovy general anesthesia (because of risk of emergence of fibrillation and ventricular tachycardia);
• Hypersensitivity to drug components.

Noradrenaline Agetan should be applied with care at the following diseases / states:

• Acute heart failure, the expressed left ventricular failure, recently postponed myocardial infarction;
• Development of symptoms of cardiac arrhythmia (it is necessary to reduce a drug dose). At development of volleys of extrasystoles or polymorphic premature ventricular contraction a dose it is necessary to lower or cancel therapy significantly;
• Concomitant use of monoamine oxidase inhibitors (MAO) of a triptilinovy and imipraminovy row (because of risk of development of the long and expressed increase in arterial pressure).

In case of need simultaneous use of drug with plasma transfusion or blood, it needs to be entered separately.

Route of administration and dosage

Noradrenaline Agetan is entered intravenously, it is desirable in a vein of an elbow bend.

Drug needs to be dissolved in solution 5% of glucose or 0,9% of chloride sodium. It is impossible to mix with other medicines. After cultivation solution can be used within 12 hours.

At use of drug it is necessary to control the arterial pressure and heart rate constantly.

The applied dose is established depending on a clinical condition of the patient. The recommended initial dose and rate of administering – 0,1-0,3 mg/kg a minute, as much as possible – 3-5 mg/kg a minute (at treatment of hemorrhagic and septic shock).

Side effects

During therapy development of the following symptoms is possible:

• The ischemic disturbances caused by a hypoxia and vasoconstriction of fabrics, and also caused by an ekstravazation (up to a necrosis);
• Reflex bradycardia;
• Arrhythmia;
• Breath difficulty;
• Uneasiness;
• Tranzitorny headache;
• Tremor;
• Retrosternal or pharyngeal pain;
• Vegetative reactions: the increased sweating, pallor, tachycardia, vomiting. At especially sensitive patients increase in arterial pressure can be followed by a photophobia, a headache, pallor of integuments, the pricking retrosternal pain, vomiting and increase in sweating.

At long use of drug it is necessary to adjust doses, it will allow to avoid returnable hypotonia at its cancellation.

Special instructions

Noradrenalin Agetan to pregnant women is not recommended to apply, it is connected with danger of a hypoxia of a fruit (administration of drug is possible only according to vital indications, including a myocardial infarction, a collapse).

At use of Norepinephrinum by the patient of advanced age, and also patients with arterial hypertension and atherosclerosis need to control arterial pressure carefully.

At hemorrhagic and cardiogenic shock with the expressed arterial hypotension administration of drug is not recommended as it can lead to a bigger deterioration in blood supply of fabrics.

To avoid emergence of a necrosis of fabrics, to use drug for conduction anesthesia of toes and hands does not follow.

At arterial hypertension, the expressed atherosclerosis and a thyrotoxicosis introduction of Noradrenaline of Agetan is possible only according to vital indications (including a myocardial infarction, a collapse).

In cases if shock is caused by big loss of plasma, use of drug does not replace introduction of blood substitutes or hemotransfusion as it causes only increase in a vascular tone.

At an ekstravazation the skin necrosis can develop.

Medicinal interaction

At simultaneous use of Noradrenaline of Agetan with some medicines there can be undesirable effects:

• MAO inhibitors – synergy strengthening of pressor effects of drug;
• Tricyclic antidepressants (including desipramine, amitriptyline, Imipraminum) – strengthening of effect of drug on cardiovascular system and increase in risk of development of tachycardia, disturbances of a cordial rhythm, heavy arterial hypertension is possible;
• Guanetidin, a bretylium – strengthening of pressor effects of drug;
• Means for an inhalation anesthesia – high probability of development of disturbances of a cordial rhythm;
• Lity a carbonate – decrease in efficiency of Noradrenaline of Agetan is possible;
• Reserpinum – strengthening of effects of drug.

Terms and storage conditions

To store in protected from light, the place, dry, unavailable to children, at a temperature up to 30 °C.

Period of validity – 2 years.