L-NMMA + norepinephrine

L-NMMA + norepinephrine is a combination of two pharmacological agents used primarily in research and experimental clinical settings to manage severe hypotension and shock states. - **L-NMMA (N(G)-monomethyl-L-arginine)** is a non-selective inhibitor of nitric oxide synthase (NOS), which reduces the production of nitric oxide (NO), a potent endogenous vasodilator. By inhibiting NO synthesis, L-NMMA increases vascular tone and systemic vascular resistance, leading to elevated blood pressure[6][8]. - **Norepinephrine** is an endogenous catecholamine that acts as a potent vasopressor by stimulating alpha-1 and alpha-2 adrenergic receptors on vascular smooth muscle cells, causing vasoconstriction and increasing systemic vascular resistance[9]. It also has some beta-adrenergic activity that can increase cardiac output at higher doses. The combination has been studied in models of septic shock and other forms of distributive shock where profound vasodilation leads to life-threatening hypotension. The rationale for combining these drugs is to achieve more effective hemodynamic support by targeting different mechanisms involved in pathological vasodilation—directly counteracting NO-mediated relaxation with L-NMMA while providing adrenergic-mediated constriction with norepinephrine[2][3].

Other names

L-NMMA + noradrenaline