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Respiratory Care Pharmacology
Respiratory Care Pharmacology

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Norepinephrine



Norepinephrine, also called noradrenaline, is an organic chemical in the catecholamine family that functions in the human brain and body as a hormone and neurotransmitter. Noradrenaline is the common name in the United Kingdom (BAN), while norepinephrine is the International Nonproprietary Name and typically used in the United States. Areas of the body that produce or are affected by norepinephrine are referred to everywhere as noradrenergic.Norepinephrine is synthesized and released by the central nervous system and also by a division of the autonomic nervous system called the sympathetic nervous system. In the brain, norepinephrine comes from several nuclei that are small in size but project to most other parts of the brain and exert powerful effects on their targets. The most important source of norepinephrine in the brain is the locus coeruleus, located in the pons. In the sympathetic nervous system norepinephrine is used as a neurotransmitter by sympathetic ganglia located near the spinal cord or in the abdomen, and is also released directly into the bloodstream by the adrenal glands. Regardless of how and where it is released, norepinephrine acts on target cells by binding to and activating noradrenergic receptors located on the cell surface.In the most basic terms, the function of norepinephrine is to mobilize the brain and body for action. Norepinephrine release is lowest during sleep, rises during wakefulness, and reaches much higher levels during situations of stress or danger, in what has been called the fight-or-flight response. In the brain norepinephrine increases arousal and alertness, promotes vigilance, enhances formation and retrieval of memory, and focuses attention; it also increases restlessness and anxiety. In the rest of the body, norepinephrine increases heart rate and blood pressure, triggers the release of glucose from energy stores, increases blood flow to skeletal muscle, reduces blood flow to the gastrointestinal system, and promotes voiding of the bladder and large intestines.A variety of medically important drugs work by altering the actions of norepinephrine systems. Norepinephrine itself is widely used as an injectable drug for the treatment of critically low blood pressure. Beta blockers, which counter some of the effects of norepinephrine, are frequently used to treat glaucoma, migraine, and a range of cardiovascular problems. Alpha blockers, which counter a different set of norepinephrine effects, are used to treat several cardiovascular and psychiatric conditions. Alpha-2 agonists often have a sedating effect, and are commonly used as anesthesia-enhancers in surgery, as well as in treatment of drug or alcohol dependence. Many important psychiatric drugs exert strong effects on norepinephrine systems in the brain, resulting in side-effects that may be helpful or harmful.
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