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Norepinephrine
Norepinephrine (medication)
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Norepinephrine (medication)

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Norepinephrine
Norepinephrine.svg
Skeletal formula of noradrenaline
Noradrenaline-from-xtal-view-1-3D-bs-17.png
Ball-and-stick model of the zwitterionic form of noradrenaline found in the crystal structure
Clinical data
Trade names Levarterenol, Levophed, Norepin, other
Other names Noradrenaline
(R)-(–)-Norepinephrine
l-1-(3,4-Dihydroxyphenyl)-2-aminoethanol
AHFS/Drugs.com Monograph
License data
Pregnancy
category
  • AU: B3
Routes of
administration		 Intravenous
ATC code
Physiological data
Source tissues Locus coeruleus; sympathetic nervous system; adrenal medulla
Target tissues System-wide
Receptors α1, α2, β1, β3
Agonists Sympathomimetic drugs, clonidine, isoprenaline
Antagonists Tricyclic antidepressants, Beta blockers, antipsychotics
Metabolism MAO-A; COMT
Legal status
Legal status
Pharmacokinetic data
Metabolism MAO-A; COMT
Excretion Urine (84–96%)
Identifiers
  • 4-[(1R)-2-amino-1-hydroxyethyl]benzene-1,2-diol
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
Chemical and physical data
Formula C8H11NO3
Molar mass 169.180 g·mol−1
3D model (JSmol)
Density 1.397±0.06 g/cm3
Melting point 217 °C (423 °F) (decomposes)
Boiling point 442.6 °C (828.7 °F) ±40.0°C
  • Oc1ccc(cc1O)[C@@H](O)CN
  • InChI=1S/C8H11NO3/c9-4-8(12)5-1-2-6(10)7(11)3-5/h1-3,8,10-12H,4,9H2/t8-/m0/s1 checkY
  • Key:SFLSHLFXELFNJZ-QMMMGPOBSA-N checkY
  (verify)

Norepinephrine, also known as noradrenaline, is a medication used to treat people with very low blood pressure. It is the typical medication used in sepsis if low blood pressure does not improve following intravenous fluids. It is the same molecule as the hormone and neurotransmitter norepinephrine. It is given by slow injection into a vein.

Common side effects include headache, slow heart rate, and anxiety. Other side effects include an irregular heartbeat. If it leaks out of the vein at the site it is being given, norepinephrine can result in limb ischemia. If leakage occurs the use of phentolamine in the area affected may improve outcomes. Norepinephrine works by binding and activating alpha adrenergic receptors.

Norepinephrine was discovered in 1946 and was approved for medical use in the United States in 1950. It is available as a generic medication.

Medical uses

Norepinephrine is used mainly as a sympathomimetic drug to treat people in vasodilatory shock states such as septic shock and neurogenic shock, while showing fewer adverse side-effects compared to dopamine treatment.

Mechanism of action

It stimulates α1 and α2 adrenergic receptors to cause blood vessel contraction, thus increases peripheral vascular resistance and resulted in increased blood pressure. This effect also reduces the blood supply to gastrointestinal tract and kidneys. Norepinephrine acts on beta-1 adrenergic receptors, causing increase in heart rate and cardiac output. However, the elevation in heart rate is only transient, as baroreceptor response to the rise in blood pressure as well as enhanced vagal tone ultimately result in a sustained decrease in heart rate. Norepinephrine acts more on alpha receptors than the beta receptors.

Names

Norepinephrine is the INN while noradrenaline is the BAN.

External links


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