Qupirin Injection (Norepinephrine Tartrate Hydrate)

Adult administration

In cases of acute hypotension or shock, 8 mg of norepinephrine tartrate hydrate (4 mg of norepinephrine) is diluted in 1000 mL of 5% dextrose injection or 5% dextrose saline and administered as a continuous intravenous infusion at a rate of 2-3 mL per minute, adjusting appropriately while monitoring for response. The maintenance dose is 0.5-1.0 mL per minute. In case of cardiac arrest, administer intravenously after ensuring effective circulation and ventilation through other means during resuscitation.

This medication may contain glass particles when the injection container is cut, so care should be taken during use, especially for children and the elderly. It should not be administered to patients who have hypovolemia and hypotension, patients with hypertension, hyperthyroidism, certain tumors, severe kidney disease, pulmonary heart disease, severe arrhythmias, patients with specific site anesthesia, pregnant women, or women of childbearing potential. Particular caution should be exercised when administering it to patients with cocaine addiction, ventricular tachycardia, atherosclerosis, heart disease, bradycardia, vascular thrombosis, myocardial infarction, certain angina patients, and the elderly, as allergic reactions or asthma attacks may occur due to the components in this drug. Cardiovascular side effects may include increased heart rate, bradycardia, chest pain, abnormal blood pressure, cardiac arrhythmias, and limb necrosis, while neurological symptoms may include headaches, dizziness, tremors, and anxiety. Nausea, vomiting, dyspnea, necrosis at the injection site, and decreased plasma volume during prolonged use may also occur, so caution is necessary. This medication helps maintain blood pressure during shock treatment, but there is a risk of excessive blood pressure increase, pulmonary edema, and cardiac arrest; therefore, the infusion rate and blood pressure should be monitored frequently during use. Long-term use without volume replacement may lead to peripheral and visceral vasoconstriction and tissue hypoxia, so it should be used alongside appropriate blood volume supplementation. This medication may interact with certain anesthetics, catecholamines, antidepressants, antihistamines, thyroid medications, and hypoglycemics, so caution is needed when used together. It should not be given to pregnant women or those who may become pregnant due to the increased risk of fetal vasoconstriction and should be used cautiously in breastfeeding situations. Caution should be exercised in elderly patients as the blood pressure-increasing effects may be more pronounced. In cases of overdose, symptoms may include decreased cardiac output, severe blood pressure increase, bradycardia, headaches, and pulmonary edema; if any abnormal symptoms occur, administration should be stopped immediately, and proper treatment should be initiated. Care should be taken to avoid excessive blood pressure during intravenous administration, and the injection site should be frequently checked, as extravasation can lead to local necrosis. In such cases, alpha-blocker phentolamine should be administered immediately, and this medication should be diluted with 5% dextrose injection or dextrose saline solution before use. It should not be mixed with other specific medications.

Serious side effects

• Dyspnea
• pallor
• severe sweating
• headache
• retrosternal pain

Mild side effects

• Palpitations
• bradycardia
• chest pain
• abnormal blood pressure increase
• arrhythmias
• headaches
• dizziness
• tremors
• anxiety
• nausea

This medication should be stored in a tightly sealed container that blocks light, and the storage temperature should be maintained between 1 to 30 degrees Celsius at room temperature. This ensures the efficacy and safety of the medication.

Appearance

A colorless, transparent solution contained in a brown ampoule.

Package unit

10 ampoules/box [(4 mL/1 ampoule)], 10 ampoules/box [(10 mL/1 ampoule)], 10 ampoules/box [(20 mL/1 ampoule)]