Alprostadil
Synonym :
Prostaglandin E1
Mechanism :
Alprostadil (prostaglandin E1) is one of a family of naturally occurring acidic lipids with various pharmacologic effects. Vasodilation, inhibition of platelet aggregation, and stimulation of intestinal and uterine smooth muscle are among the most notable of these effects.
Indication :
- Ductal dependent circulation - pulmonary atresia, pulmonary stenosis, tricuspid atresia, tetralogy of Fallot to keep the duct patent.
Contraindications :
Hypersensitivity to alprostadil or any component; respiratory distress syndrome or persistent fetal circulation.
Dosing :
Continuous IV infusion: Initial: 0.05 to 0.1 mcg/kg/minute; once therapeutic response is achieved, reduce rate to lowest effective dosage; with unsatisfactory response, increase rate gradually; usual maintenance: 0.01 to 0.4 mcg/kg/minute.
Adverse Effect :
Apnoea, fever, seizures, cerebral bleeding, hyperextension of the neck, hyperirritability, hypothermia, jitteriness, lethargy, stiffness, flushing, bradycardia, hypotension, tachycardia, cardiac arrest, edema, congestive heart failure, hyperemia, second degree heart block, shock, spasm of the right ventricle infundibulum, supraventricular tachycardia, ventricular fibrillation, bradypnea, wheezing, hypercapnia, respiratory depression, tachypnea, gastric regurgitation, hyperbilirubinemia, disseminated intravascular coagulation, anemia, bleeding, thrombocytopenia, anuria, hematuria, cortical proliferation of the long bones.
Interaction :
No drug interactions have been reported with the therapy standard in neonates with restricted pulmonary or systemic blood flow.
Hepatic Dose :
No dosage adjustments are recommended.