Noradrenaline Other names: Norepinephrine Noradrenaline

Chemical formula: C₈H₁₁NO₃  Molecular mass: 169.178 g/mol  PubChem compound: 439260

Pharmacodynamic properties

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.

Pharmacokinetic properties

Absorption

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.

Distribution

Noradrenaline is rapidly cleared from plasma by a combination of cellular reuptake and metabolism. It does not readily cross the blood-brain barrier.

Biotransformation

  • Methylation by catechol-o-methyltransferase,
  • Deamination by manoamine oxydase (MAO),
  • Ultimate metabolites from both is 4-hydroxy-3-methoxymandelic acid,
  • Intermediate metabolites include normetanephrine and 3,4-dihydroxymandelic acid.

Elimination

Noradrenaline is mainly eliminated as glucuronide or sulphate conjugates of the metabolites in the urine.

Preclinical safety data

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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