Verify Norepinephrine (noradrenaline)

Drug JSON

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{
  "slug": "norepinephrine",
  "nameEn": "Norepinephrine (noradrenaline)",
  "nameTh": "นอร์อิพิเนฟริน (นอร์อะดรีนาลีน)",
  "class": "Vasopressor — α1-adrenergic agonist (critical care)",
  "mechanism": "กระตุ้น α1-adrenergic receptor เป็นหลัก (ออกฤทธิ์ β1 บ้าง) ทำให้หลอดเลือดหดตัว เพิ่ม systemic vascular resistance และ mean arterial pressure เป็น vasopressor ทางเลือกแรกใน vasodilatory/septic shock ที่ไม่ตอบสนองต่อสารน้ำ",
  "brandNamesTh": [
    "Levophed"
  ],
  "indications": [
    {
      "text": "ภาวะความดันโลหิตต่ำรุนแรงหรือช็อกที่ไม่ตอบสนองต่อการให้สารน้ำ (vasodilatory shock, septic shock, ความดันต่ำระหว่างดมยาสลบ)",
      "cites": [
        "merck-cv-pharm",
        "dailymed-norepinephrine"
      ]
    }
  ],
  "contraindications": [
    {
      "text": "ภาวะ hypovolemia ที่ยังแก้ไขไม่เสร็จ — ต้อง resuscitate ด้วยสารน้ำก่อน ระวังการรั่วของยาออกนอกหลอดเลือด (extravasation) ที่ทำให้เนื้อเยื่อตาย ควรให้ทาง central line เมื่อทำได้",
      "cites": [
        "merck-cv-pharm",
        "dailymed-norepinephrine"
      ]
    }
  ],
  "sideEffects": [
    {
      "text": "หลอดเลือดส่วนปลายหดตัวมากเกินจนขาดเลือด, reflex bradycardia, ภาวะหัวใจเต้นผิดจังหวะ, เนื้อตายบริเวณที่ยารั่ว",
      "cites": [
        "merck-cv-pharm",
        "wikipedia-Norepinephrine"
      ]
    }
  ],
  "dosages": [
    {
      "species": "canine",
      "indication": "Vasodilatory/septic shock (hypotension)",
      "route": "IV",
      "dose": "CRI 0.05–2 mcg/kg/min IV (เริ่ม ~0.1 mcg/kg/min แล้ว titrate ตาม MAP และ ECG)",
      "cites": [
        "merck-cv-pharm",
        "plumbs"
      ]
    },
    {
      "species": "feline",
      "indication": "Vasodilatory/septic shock (hypotension)",
      "route": "IV",
      "dose": "CRI 0.05–2 mcg/kg/min IV titrate ตาม MAP",
      "cites": [
        "merck-cv-pharm",
        "plumbs"
      ]
    }
  ],
  "citations": [
    {
      "id": "atc-C01CA03",
      "type": "regulatory-database",
      "title": "WHO ATC/DDD Index — Norepinephrine (C01CA03)",
      "year": 2026,
      "url": "https://www.whocc.no/atc_ddd_index/?code=C01CA03&showdescription=no",
      "note": "WHO Anatomical Therapeutic Chemical classification. Authoritative for class + INN.",
      "cid": null
    },
    {
      "id": "dailymed-norepinephrine",
      "type": "package-insert",
      "title": "Norepinephrine — DailyMed (US FDA label)",
      "year": 2026,
      "url": "https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=norepinephrine",
      "note": "US FDA structured product label. Authoritative for mechanism, indications, contraindications.",
      "cid": null
    },
    {
      "id": "merck-cv-pharm",
      "type": "textbook",
      "title": "Systemic Pharmacotherapeutics of the Cardiovascular System — Merck Veterinary Manual",
      "year": 2026,
      "url": "https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system",
      "note": "Merck (MSD) Veterinary Manual. Authoritative veterinary clinical reference.",
      "cid": null
    },
    {
      "id": "plumbs",
      "type": "textbook",
      "title": "Plumb's Veterinary Drug Handbook, 10th Edition",
      "authors": "Plumb DC",
      "year": 2023,
      "edition": "10th",
      "url": "https://www.plumbs.com/",
      "note": "Standard veterinary drug reference. Dose cross-checked against this handbook.",
      "cid": null
    },
    {
      "id": "wikipedia-Norepinephrine",
      "type": "monograph",
      "title": "Norepinephrine — Wikipedia",
      "year": 2026,
      "url": "https://en.wikipedia.org/wiki/Norepinephrine",
      "note": "Tertiary cross-check for class + mechanism. CC BY-SA 4.0. Not sole authority.",
      "cid": null
    }
  ],
  "mirroredFrom": [
    {
      "id": "who-atc",
      "name": "WHO ATC/DDD Index",
      "url": "https://www.whocc.no/atc_ddd_index/",
      "asOfDate": "2026-06-07",
      "license": "WHO publication, free for use with attribution"
    }
  ],
  "mirrorCIDs": [],
  "codes": {
    "atc": {
      "code": "C01CA03",
      "name": "Norepinephrine",
      "level": 5
    }
  },
  "drafting": {
    "aiAssisted": false,
    "aiModel": null,
    "aiPromptHash": null,
    "humanReviewer": "palmzamak2547",
    "humanReviewedAt": "2026-06-07",
    "humanEditsRatio": null
  },
  "signatures": [],
  "reviewedBy": null,
  "lastUpdated": "2026-06-07",
  "version": 1,
  "changelog": [
    {
      "version": 1,
      "date": "2026-06-07",
      "summary": "New entry — clinical content compiled from cited authoritative sources (Merck Vet Manual / Plumb’s / RECOVER 2024 / WHO ATC / FDA label), cross-checked. Every statement cited. Reviewed by palmzamak2547. Pending faculty canonical signature."
    }
  ]
}

Public keys used

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