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Norepinephrine (medication)

About: Norepinephrine (medication) is a research topic. Over the lifetime, 12189 publications have been published within this topic receiving 371139 citations. The topic is also known as: Norepinephrine bitartrate & Norepinephrine (drug).


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Journal ArticleDOI
TL;DR: It is concluded that heart failure is associated with augmented activity of the sympathetic nervous system, reflected in increased norepinephrine excretion and often associated with a deficit of cardiac norpinephrine.

568 citations

Journal ArticleDOI
TL;DR: Hydrocortisone therapy restored hemodynamic stability and differentially modulated the immunologic response to stress in a way of antiinflammation rather than immunosuppression.
Abstract: Within the last few years, increasing evidence of relative adrenal insufficiency in septic shock evoked a reassessment of hydrocortisone therapy. To evaluate the effects of hydrocortisone on the balance between proinflammatory and antiinflammation, 40 patients with septic shock were randomized in a double-blind crossover study to receive either the first 100 mg of hydrocortisone as a loading dose and 10 mg per hour until Day 3 (n = 20) or placebo (n = 20), followed by the opposite medication until Day 6. Hydrocortisone infusion induced an increase of mean arterial pressure, systemic vascular resistance, and a decline of heart rate, cardiac index, and norepinephrine requirement. A reduction of plasma nitrite/nitrate indicated inhibition of nitric oxide formation and correlated with a reduction of vasopressor support. The inflammatory response (interleukin-6 and interleukin-8), endothelial (soluble E-selectin) and neutrophil activation (expression of CD11b, CD64), and antiinflammatory response (soluble tumor necrosis factor receptors I and II and interleukin-10) were attenuated. In peripheral blood monocytes, human leukocyte antigen-DR expression was only slightly depressed, whereas in vitro phagocytosis and the monocyte-activating cytokine interleukin-12 increased. Hydrocortisone withdrawal induced hemodynamic and immunologic rebound effects. In conclusion, hydrocortisone therapy restored hemodynamic stability and differentially modulated the immunologic response to stress in a way of antiinflammation rather than immunosuppression.

558 citations

Journal ArticleDOI
TL;DR: The disappearance of H 3 -norepinephrine administered by the direct injection technique and its modification by drugs are similar to that of material introduced by stereotaxic procedures.

552 citations

Journal ArticleDOI
TL;DR: Ki's for blocking uptake of norepinephrine, serotonin, and dopamine into synaptosomal preparations of rat brain were determined for 25 antidepressants and putative antidepressants, some neuroleptics, stimulants, antihistamines and other monoamines to compare the relative potencies of a drug at the three processes.

548 citations

Journal ArticleDOI
TL;DR: It is concluded that short-term vasopressin infusion spared conventional vasopressor use and improved some measures of renal function in patients with severe septic shock.
Abstract: Background: Septic shock is associated with vasopressin deficiency and a hypersensitivity to its exogenous administration. The goal of the current study was to determine whether shortterm vasopressin infusion in patients experiencing severe septic shock has a vasopressor sparing effect while maintaining hemodynamic stability and adequate end-organ perfusion. Methods: Patients experiencing septic shock that required high-dose vasopressor support were randomized to a doubleblinded 4-h infusion of either norepinephrine (n 11) or vasopressin (n 13), and open-label vasopressors were titrated to maintain blood pressure. To assess end-organ perfusion, urine output and creatinine clearance, gastric mucosal carbon dioxide tension, and electrocardiogram ST segment position were measured. Results: Patients randomized to norepinephrine went from a median prestudy norepinephrine infusion of 20.0 g/min to a blinded infusion of 17.0 g/min at 4 h, whereas those randomized to vasopressin went from a median prestudy norepinephrine infusion of 25.0 g/min to 5.3 g/min a t4h( P < 0.001). Mean arterial pressure and cardiac index were maintained in both groups. Urine output did not change in the norepinephrine group (median, 25 to 15 ml/h) but increased substantially in the vasopressin group (median, 32.5 to 65 ml/h; P < 0.05). Similarly, creatinine clearance did not change in the norepinephrine group but increased by 75% in the vasopressin group (P < 0.05). Gastric mucosal carbon dioxide tension and electrocardiogram ST segments did not change significantly in either group. Conclusions: The authors conclude that short-term vasopressin infusion spared conventional vasopressor use and improved some measures of renal function in patients with severe septic shock. EFFECTIVE cardiovascular support plays an essential role in the management of patients with septic shock. Oxygen delivery must be maintained above a critical threshold, 1 and arterial pressure must exceed a level that al

546 citations


Performance
Metrics
No. of papers in the topic in previous years
YearPapers
20221
2021134
2020116
2019118
2018103
201799