Inhaled nitric oxide: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: | *Type: inhalational agent | ||
*Dosage Forms: | *Dosage Forms: metal cylinders | ||
*Routes of Administration: | *Routes of Administration: inhaled | ||
*Common Trade Names: | *Common Trade Names: | ||
==Adult Dosing== | ==Adult Dosing== | ||
5 - 80 ppm | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Hypotension | |||
*Inhibits platelets - bleeding | |||
*Rebound htn and hypoxia | |||
*Renal failure | |||
===Common=== | ===Common=== | ||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 5 seconds | ||
*Metabolism: reacts with oxyhemoglobin to form methemoglobin and nitrate, and also reacts with deoxy-Hb. | *Metabolism: reacts with oxyhemoglobin to form methemoglobin and nitrate, and also reacts with deoxy-Hb. | ||
*Excretion: Urinary; 70% of inhaled NO excreted within 48 hrs as nitrate | *Excretion: Urinary; 70% of inhaled NO excreted within 48 hrs as nitrate | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
*Relaxes smooth muscle of pulmonary vessels via conversion of GTP to cGMP | *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 | *Enhances V/Q matching by increasing blood flow to well-ventilated areas of lung | ||
*Decreases PVR | |||
*Decreases PA pressure | |||
==Indications== | ==Indications== | ||
*Pulmonary HTN of newborn | *Pulmonary HTN of newborn | ||
*Pulmonary HTN of adults | *Pulmonary HTN of adults | ||
*Right heart failure (post-VAD, transplant, post cardiac surgery) | |||
*Graft failure post lung transplant | |||
==Comments== | ==Comments== | ||
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==References== | ==References== | ||
*Inhaled | *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. | ||
2004; 109: 3106- | |||
<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Revision as of 23:58, 26 April 2016
Administration
- Type: inhalational agent
- Dosage Forms: metal cylinders
- Routes of Administration: inhaled
- Common Trade Names:
Adult Dosing
5 - 80 ppm
Pediatric Dosing
Special Populations
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
Pharmacology
- Half-life: 5 seconds
- Metabolism: reacts with oxyhemoglobin to form methemoglobin and nitrate, and also reacts with deoxy-Hb.
- Excretion: Urinary; 70% of inhaled NO excreted within 48 hrs as nitrate
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 HTN of newborn
- Pulmonary HTN of adults
- 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.