Inhaled nitric oxide: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: | *Type: Inhalational agent | ||
*Dosage Forms: | *Dosage Forms: Metal cylinders, 100 ppm and 800 ppm | ||
*Routes of Administration: | *Routes of Administration: Inhaled | ||
*Common Trade Names: | *Common Trade Names: INOmax | ||
==Adult Dosing== | ==Adult Dosing== | ||
5 - 80 ppm | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
20 ppm | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: Unknown | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
*Adult: | *Adult: | ||
| Line 24: | Line 26: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Hypotension | |||
*Inhibits platelets - bleeding | |||
*Rebound htn and hypoxia | |||
*Renal failure | |||
===Common=== | ===Common=== | ||
*Hypotension | |||
*Withdrawal | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 5 seconds | ||
*Metabolism: | *Metabolism: reacts with oxyhemoglobin to form methemoglobin and nitrate, and also reacts with deoxy-hemoglobin. | ||
*Excretion: | *Excretion: Renally; 70% of inhaled NO excreted within 48 hrs as nitrate in urine | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
*Acts via diffusion from alveoli | |||
*Relaxes smooth muscle of pulmonary vessels via conversion of GTP to cGMP, which activates a phosphorylatio cascade | |||
*Enhances V/Q matching by increasing blood flow to well-ventilated areas of lung | |||
*Decreases PVR | |||
*Decreases PA pressure | |||
==Indications== | |||
*Pulmonary hypertension of newborn | |||
*Pulmonary hypertension of adults | |||
*Cystic Fibrosis | |||
*ARDS | |||
*Right heart failure (post-VAD, transplant, post cardiac surgery) | |||
*Graft failure post lung transplant | |||
==Comments== | ==Comments== | ||
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==References== | ==References== | ||
*Ichinose F, Roberts JD Jr, Zapol WM. Inhaled nitric oxide: a selective pulmonary vasodilator: current uses and therapeutic potential. Circulation. 2004 Jun 29;109(25):3106-11. Review. PubMed PMID: 15226227. | |||
*Medscape | |||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Latest revision as of 10:49, 1 August 2016
Administration
- Type: Inhalational agent
- Dosage Forms: Metal cylinders, 100 ppm and 800 ppm
- Routes of Administration: Inhaled
- Common Trade Names: INOmax
Adult Dosing
5 - 80 ppm
Pediatric Dosing
20 ppm
Special Populations
- Pregnancy Rating: C
- Lactation risk: Unknown
Renal Dosing
- Adult:
- Pediatric:
Hepatic Dosing
- Adult:
- Pediatric:
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- Hypotension
- Inhibits platelets - bleeding
- Rebound htn and hypoxia
- Renal failure
Common
- Hypotension
- Withdrawal
Pharmacology
- Half-life: 5 seconds
- Metabolism: reacts with oxyhemoglobin to form methemoglobin and nitrate, and also reacts with deoxy-hemoglobin.
- Excretion: Renally; 70% of inhaled NO excreted within 48 hrs as nitrate in urine
Mechanism of Action
- Acts via diffusion from alveoli
- Relaxes smooth muscle of pulmonary vessels via conversion of GTP to cGMP, which activates a phosphorylatio cascade
- Enhances V/Q matching by increasing blood flow to well-ventilated areas of lung
- Decreases PVR
- Decreases PA pressure
Indications
- Pulmonary hypertension of newborn
- Pulmonary hypertension of adults
- Cystic Fibrosis
- ARDS
- Right heart failure (post-VAD, transplant, post cardiac surgery)
- Graft failure post lung transplant
Comments
See Also
References
- Ichinose F, Roberts JD Jr, Zapol WM. Inhaled nitric oxide: a selective pulmonary vasodilator: current uses and therapeutic potential. Circulation. 2004 Jun 29;109(25):3106-11. Review. PubMed PMID: 15226227.
- Medscape