Norpin Injection (Norepinephrine Tartrate Hydrate)

Adult administration

As Norepinephrine Tartrate Hydrate: dilute 1 dose of 8mg (equivalent to 4mg of norepinephrine) in 1000ml of 5% dextrose injection or 5% dextrose saline, and administer via intravenous infusion at a rate of 2-3ml per minute. Observe reactions and adjust appropriately; the maintenance rate is 0.5-1.0ml per minute. In cases of cardiac arrest, after ensuring effective heartbeat and ventilation with other methods during cardiopulmonary resuscitation, administer as with acute hypotension or shock.

This medication can have glass particles mixed in when the injection container is cut, so it is important to cut carefully to minimize glass fragments during use. Extra caution is needed especially when used by children or the elderly. This medication should not be used for hypotensive patients with reduced blood volume, hypertensive patients, hyperthyroid patients, patients with pheochromocytoma, patients with severe renal dysfunction, patients with cor pulmonale, patients with severe arrhythmia, patients undergoing anesthesia in the areas of fingers, toes, nose, or penis, and for pregnant women or women who may become pregnant. Caution is required when administering this medication to patients with cocaine addiction, ventricular tachycardia, atherosclerosis, heart disease, bradycardia, patients with thrombosis in the coronary, mesenteric, or peripheral vessels, patients with hypotension due to myocardial infarction, Prinzmetal’s variant angina, and the elderly. Additionally, this medication contains sodium sulfite, which can cause allergic reactions or asthma attacks, so special attention is needed for asthma patients. Cardiovascular side effects such as palpitations, bradycardia, chest pain, elevated blood pressure, severe arrhythmias, and limb gangrene may occur. Neurological symptoms such as headache, dizziness, tremors, and anxiety may also occur. Gastrointestinal symptoms such as nausea, vomiting, as well as respiratory distress, necrosis at the injection site, and depletion of plasma volume have also been reported. This medication can raise blood pressure sharply, leading to risks such as pulmonary edema or cardiac arrest, so it is essential to avoid overdosing. Blood pressure and infusion rates should be checked frequently during use. It is important to use this medication together with blood volume replacement products, and if blood pressure rises excessively, an alpha-blocker should be used for regulation. Interactions may occur when used with other medications, so caution should be taken when using it alongside inhalation anesthetics, catecholamine drugs, MAO inhibitors, tricyclic antidepressants, antihistamines, thyroid medications, hypoglycemics, guanethidine, spironolactone, etc. Pregnant women or women who may become pregnant should not use this medication as it may pose a risk to the fetus, and caution is also required when breastfeeding. Elderly patients may have a risk of excessive blood pressure elevation, so caution must be exercised during administration. In case of overdose, symptoms such as severe hypertension, reduced cardiac output, reflex bradycardia, headache, pulmonary edema may occur, and if these symptoms occur, administration should be stopped immediately and appropriate treatment should be provided. During intravenous injection, care must be taken not to excessively elevate blood pressure, and the injection site should be monitored frequently to prevent local ischemic necrosis if the injection solution leaks. If leakage occurs, alpha-blocker phentolamine should be administered immediately. This medication is diluted with 5% dextrose injection or dextrose saline, and it is recommended to use dextrose solution to prevent the reduction of efficacy due to oxidation. Furthermore, it should not be mixed with alkalizing agents, acidifying agents, barbiturates, certain antibiotics, and other medications.

Serious side effects

• Respiratory distress
• pallor
• severe sweating
• headache
• cerebral hemorrhage
• pulmonary edema
• severe swelling
• elevated blood pressure

Mild side effects

• Palpitations
• bradycardia
• chest pain
• elevated blood pressure
• severe arrhythmias
• headache
• dizziness
• tremors
• anxiety
• nausea

This medication should be stored in a closed container that can block light, and it is advisable to store it at room temperature between 1 to 30 degrees. Proper storage will help maintain the effectiveness of the medication and prevent deterioration.

Appearance

A brown ampoule injection filled with a colorless solution

Package unit

4ml X 10 ampoules/box, 10ml X 10 ampoules/box, 20ml X 5 ampoules/box