noradrenaline acid

CLINICAL USE

Hypotension Cardiac arrest (sympathomimetic)

DOSE IN NORMAL RENAL FUNCTION

(Doses expressed as noradrenaline acid tartrate)Acute hypotension: 80 mcg/mL solution, initially 0.16–0.33 mL/minute; adjust according to responseCardiac arrest: 200 mcg/mL solution, 0.5–0.75 mL

PHARMACOKINETICS

Molecular weight :337.3

%Protein binding :~50

%Excreted unchanged in urine : ~16

Volume of distribution (L/kg) :0.09–0.4

half-life – normal/ESRD (hrs) :1 minute/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Not dialysed. Dose as in normal renal function

HDF/high flux :Unknown dialysability. Dose as in normal renal function

CAV/VVHD :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAdrenergic neurone blockers: antagonise hypotensive effect

Antidepressants: tricyclics may cause hypertension and arrhythmias; MAOIs and moclobemide may cause hypertensive crisis

Beta-blockers: can cause severe hypertension

Clonidine: possibly increased risk of hypertension

Dopaminergics: effects possibly increased by entacapone; avoid concomitant use with rasagiline

Sympathomimetics: effects possibly enhanced by dopexamine

ADMINISTRATION

Reconstition

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Route

Rate of Administration

According to response

Comments

Preferably give centrally (low pH) Dilute 1–4 mg in 100 mL glucose 5% Can be given undiluted

OTHER INFORMATION

Do not mix with alkaline drugs/solutions The pharmacokinetics of noradrenaline are not significantly affected by renal or hepatic diseasenoradrenaline acid tartrate (norepinephrine bitartrate).

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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