Therapeutic Action
Sympathomimetic
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Drug reference
Sympathomimetic
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Acute hypotension despite fluid therapy in shock (in children, preferably use epinephrine for this indication)
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Administer with caution to patients with hypertension, hypotension due to volume depletion (except as an emergency measure), thrombosis, hyperthyroidism and to older patients. May cause: arrhythmia, hypertension, agitation, headache; tissue necrosis following extravasation (use a large vein for IV administration). Pregnancy and breast-feeding: no contra-indication
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8 mg of norepinephrine tartrate in 4 ml ampoule (2 mg/ml), equivalent to 4 mg of norepinephrine base in 4 ml (1 mg/ml), for IV infusion
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The doses are expressed as norepinephrine tartrate and intended for peripheral IV administration only. Use diluted solution in 0.9% sodium chloride (NaCl 0.9%) or 5% glucose (G5%) or Ringer lactate (RL): Child under 40 kg: add 1 ml (2 mg of NEP tartrate) to 39 ml of NaCl 0.9%, G5% or RL to obtain a 0.05 mg/ml (50 micrograms/ml) solution Child 40 kg and over and adult: add 2 ml (4 mg of NEP tartrate) to 38 ml of NaCl 0.9%, G5% or RL to obtain a 0.1 mg/ml (100 micrograms/ml) solution Administer by continuous IV infusion using an infusion or syringe pump: Child and adult: 0.1 microgram/kg/min, increase if necessary by 0.05 micrograms/kg/min every 10 minutes for the first hour, then every hour (max. 1 microgram/kg/min) Once desired response is achieved, discontinue gradually, in decrements of 0.05 micrograms/kg/min every hour. Do not discontinue abruptly. The infusion rate is calculated as follows: [desired dose (microgram/kg/min) x weight (kg) x 60 min] ÷ concentration (microgram/ml). Example, for a child 20 kg, dose 0.1 microgram/kg/min, solution concentration 50 micrograms/ml: NEP dose (microgram/kg/min) 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45 0.5 Infusion rate (ml/hour) 2.4 3.6 4.8 6 7.2 8.4 9.6 10.8 12
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Norepinephrine is colourless: discard any ampoules with a pink or brownish colour.
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– Below 25 °C
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add 1 ml (2 mg of NEP tartrate) to 39 ml of NaCl 0.9%, G5% or RL to obtain a 0.05 mg/ml (50 micrograms/ml) solution
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add 2 ml (4 mg of NEP tartrate) to 38 ml of NaCl 0.9%, G5% or
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0.1 microgram/kg/min, increase if necessary by 0.05 micrograms/kg/min every
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