medEasy MedEasy
Norline

Norline4 mg/2 ml

Injection

By
MRP ৳ 250.005% Off
Best PriceTk /
1
Section

Medicine overview

Indications of Norline 4 mg/2 ml

increased heart rateincreased air entryincreased blood glucose

Theropeutic Class

Anaphylaxis, Mydriatic and Cycloplegic agents, Other adrenoceptor stimulants, Respiratory stimulants: analeptics

Pharmacology

The actions of epinephrine resemble the effects of stimulation of adrenergic nerves.

Absorption

It acts on both alpha and beta receptor sites of sympathetic effector cells. Its most prominent actions are on the beta receptors of the heart, vascular and other smooth muscle.

Distribution

When given by rapid intravenous injection, it produces a rapid rise in blood pressure, mainly systolic, by (1) direct stimulation of cardiac muscle which increases the strength of ventricular contraction, (2) increasing the heart rate and (3) constriction of the arterioles in the skin, mucosa and splanchnic areas of the circulation. When given by slow intravenous injection, epinephrine usually produces only a moderate rise in systolic and a fall in diastolic pressure.

Metabolism

Although some increase in pulse pressure occurs, there is usually no great elevation in mean blood pressure. Accordingly, the compensatory reflex mechanisms that come into play with a pronounced increase in blood pressure do not antagonize the direct cardiac actions of epinephrine as much as with catecholamines that have a predominant action on alpha receptors.

Dosage & Administration of Norline 4 mg/2 ml

Cardiac arrest
Dosage:Intravenous injection: 1 mg injection repeated every 2-3 minutes as necessary
Endotracheal
Dosage:2-3 mg via an endotracheal tube, repeated as necessary
Intracardiac
Dosage:0.1 to 1 mg, direct into the atrium of the heart
Intraspinal
Dosage:Usual dose is 0.2 to 0.4 mg added to anesthetic spinal fluid mixture (to prolong anesthetic action by limiting absorption)
Anaphylaxis, asthma or severe bronchospasm
Dosage:Adult dose is 0.25 0.5 mg
Notes:It may be repeated at 5 minutes intervals until perfusion and respiratory status normalizes
In case of dose dilution
Dosage:1 mg of Norline 4 mg/2 ml to be diluted in 9 ml Normal Saline
Children
Dosage:Initially 10 mcg/kg body weight, not to exceed 250 mcg
Notes:May be repeated every 3-5 minutes if necessary. Subsequent doses should be 100 mcg/kg

Dosage of Norline 4 mg/2 ml

Cardiac arrest
Dosage:Intravenous injection: 1 mg injection repeated every 2-3 minutes as necessary
Endotracheal
Dosage:2-3 mg via an endotracheal tube, repeated as necessary
Intracardiac
Dosage:0.1 to 1 mg, direct into the atrium of the heart
Intraspinal
Dosage:Usual dose is 0.2 to 0.4 mg added to anesthetic spinal fluid mixture (to prolong anesthetic action by limiting absorption)
Anaphylaxis, asthma or severe bronchospasm
Dosage:Adult dose is 0.25 0.5 mg
Notes:It may be repeated at 5 minutes intervals until perfusion and respiratory status normalizes
In case of dose dilution
Dosage:1 mg of Norline 4 mg/2 ml to be diluted in 9 ml Normal Saline
Children
Dosage:Initially 10 mcg/kg body weight, not to exceed 250 mcg
Notes:May be repeated every 3-5 minutes if necessary. Subsequent doses should be 100 mcg/kg

Interaction of Norline 4 mg/2 ml

Use of Norline 4 mg/2 ml with excessive doses of digitalis, mercurial diuretics or other drugs that sensitize the heart to arrhythmias is not recommended. The adverse effects of Norline 4 mg/2 ml may be potentiated by tricyclic antidepressants; certain antihistamines; e.g, Diphenhydramine, Tripelennamine, Chlorpheniramine and L-thyroxine Sodium.

Contraindications

Hypertension, arteriosclerosis, coronary disease and hyperthyroidism. Not to be given to patients taking monoamine oxidase inhibitors.

Side Effects of Norline 4 mg/2 ml

Common side effects are anxiety, restlessness, dizziness, headache, palpitations, rapid pulse, tremors, weakness and coldness of the extremities may be reported even with small doses and especially when given in conjunction with local anaesthetics.

Pregnancy & Lactation

Pregnancy Category C. It crosses the placenta and is excreted in breast milk. Norline 4 mg/2 ml should only be used in pregnancy if the potential benefits outweigh the risks to the fetus. It is excreted in breast milk and therefore Norline 4 mg/2 ml is not recommended for use during lactation because of the risk of adverse effects of infants.

Precautions & Warnings

The solution should not be used if it is pinkish or darker than slightly yellow or if it contains a precipitate. Norline 4 mg/2 ml is readily destroyed by alkalies and oxidizing agents. In the latter category are Oxygen, Chlorine, Iodine, Permanganates, Chromates, Nitrites and salts of easily reducible metals, especially Iron. Norline 4 mg/2 ml should not be mixed with Sodium bicarbonate; the solution is oxidised to adrenochrome and then forms polymers. Administer slowly with caution to elderly patients and to patients with ischemic heart disease, hypertension, diabetes mellitus, hyperthyroidism or psychoneurosis. Use with extreme caution in patients with long-standing bronchial asthma and emphysema who have developed degenerative heart disease. Anginal pain may be induced when coronary insufficiency is present.

Overdose Effects of Norline 4 mg/2 ml

Cardiac arrhythmia leading to ventricular fibrillation, severe hypertension leading to pulmonary edema and cerebral hemorrhage. Combined alpha and beta-adrenergic blocking agents such as Labetalol may counteract the effects of Norline 4 mg/2 ml, or a beta-blocking agent may be used to treat any supraventricular arrhythmias and Phentolamine to control the alpha-mediated effects on the peripheral circulation. Rapidly acting vasodilators such as nitrates and Sodium Nitroprusside may also be helpful. Immediate resuscitation support must be available.

Storage Conditions

Store below 25°C. Protect from light. Keep out of the reach of children.

Drug Classes

Anaphylaxis, Mydriatic and Cycloplegic agents, Other adrenoceptor stimulants, Respiratory stimulants: analeptics

Mode Of Action

The actions of epinephrine resemble the effects of stimulation of adrenergic nerves. It acts on both alpha and beta receptor sites of sympathetic effector cells. Its most prominent actions are on the beta receptors of the heart, vascular and other smooth muscle. When given by rapid intravenous injection, it produces a rapid rise in blood pressure, mainly systolic, by (1) direct stimulation of cardiac muscle which increases the strength of ventricular contraction, (2) increasing the heart rate and (3) constriction of the arterioles in the skin, mucosa and splanchnic areas of the circulation.When given by slow intravenous injection, epinephrine usually produces only a moderate rise in systolic and a fall in diastolic pressure. Although some increase in pulse pressure occurs, there is usually no great elevation in mean blood pressure. Accordingly, the compensatory reflex mechanisms that come into play with a pronounced increase in blood pressure do not antagonize the direct cardiac actions of epinephrine as much as with catecholamines that have a predominant action on alpha receptors.

Pregnancy

Pregnancy Category C. It crosses the placenta and is excreted in breast milk. Norline 4 mg/2 ml should only be used in pregnancy if the potential benefits outweigh the risks to the fetus. It is excreted in breast milk and therefore Norline 4 mg/2 ml is not recommended for use during lactation because of the risk of adverse effects of infants.

Frequently Asked Questions

What is Norline 4 mg/2 ml used for?

Adjunctive use in the management of cardiac arrest. It is used in cardiopulmonary resuscitation. Intracardiac puncture and intramyocardial injection of adrenaline may be effective when external cardiac compression and attempts to restore the circulation by electrical defibrillation or use of a pacemaker ... Read moreAdjunctive use in the management of cardiac arrest. It is used in cardiopulmonary …

What is the dosage of Norline 4 mg/2 ml?

Cardiac arrest: Intravenous injection: 1 mg injection repeated every 2-3 minutes as necessary. Endotracheal: 2-3 mg via an endotracheal tube, repeated as necessary. Intracardiac: 0.1 to 1 mg, direct into the atrium of the heart. Intraspinal: Usual dose is 0.2 to 0.4 mg added to anesthetic spinal fluid mixture (to prolong anesthetic action by limiting absorption). Anaphylaxis, asthma or severe bron…

What are the side effects of Norline 4 mg/2 ml?

Common side effects are anxiety, restlessness, dizziness, headache, palpitations, rapid pulse, tremors, weakness and coldness of the extremities may be reported even with small doses and especially when given in conjunction with local anaesthetics.

Who should not take Norline 4 mg/2 ml?

Hypertension, arteriosclerosis, coronary disease and hyperthyroidism. Not to be given to patients taking monoamine oxidase inhibitors.

What precautions should be taken with Norline 4 mg/2 ml?

The solution should not be used if it is pinkish or darker than slightly yellow or if it contains a precipitate. Adrenaline is readily destroyed by alkalies and oxidizing agents. In the latter category are Oxygen, Chlorine, Iodine, Permanganates, Chromates, Nitrites and salts of easily reducible metals, especially Iron. Adrenaline should not be mixed with Sodium bicarbonate; the solution is oxidis…

Is Norline 4 mg/2 ml safe during pregnancy and breastfeeding?

Pregnancy Category C. It crosses the placenta and is excreted in breast milk. Adrenaline should only be used in pregnancy if the potential benefits outweigh the risks to the fetus. It is excreted in breast milk and therefore Adrenaline is not recommended for use during lactation because of the risk of adverse effects of infants.

Disclaimer

The information provided is accurate to our best practices, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy. The absence of specific information about a drug should not be seen as an endorsement. We are not responsible for any consequences resulting from this information, so consult a healthcare professional for any concerns or questions.

Home