Source: Medicines & Healthcare Products Regulatory Agency (GB) Revision Year: 2018 Publisher: LABORATOIRE AGUETTANT, 1, rue Alexander Fleming, 69007, LYON, FRANCE
Pharmacotherapeutic group: Adrenergic and dopaminergic agents
ATC code: C01CA03
Noradrenaline provides a strong stimulation of alpha receptors in blood vessels at which these are counter-extracted. Noradrenaline also has an effect on beta-1 receptors in the heart leading to a positive inotropic and initially positive chronotropic effect. The increase in blood pressure may cause a reflex reduction in heart rate. Vasoconstriction may lead to decreased blood flow in the kidneys, liver, skin and smooth muscle. Local constriction of the vessels may cause hemostasis and/or necrosis.
The pressor effect disappears 1-2 min after termination of infusion. Development of tolerance to the effects of noradrenaline may occur.
Two stereoisomers of noradrenaline exist, the biologically active L-isomer is the one present in Noradrenaline 0.08 mg/ml, solution for infusion.
Subcutaneous: Poor.
Oral: Noradrenaline is rapidly inactivated in the gastro-intestinal tract following oral administration.
After intravenous administration noradrenaline has a plasmatic half-life of about 1 to 2 minutes.
Noradrenaline is rapidly cleared from plasma by a combination of cellular reuptake and metabolism. It does not readily cross the blood-brain barrier.
Noradrenaline is mainly eliminated as glucuronide or sulphate conjugates of the metabolites in the urine.
Most of the undesirable effects can be derived from sympathomimetic results from excessive stimulation of the sympathetic nervous system through the various adrenergic receptors.
Noradrenaline may impair placental perfusion and induce fatal fetal bradycardia. It may also exert a contractile effect on the pregnant uterus and lead to fatal fetal asphyxia in late pregnancy.
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