Aliases:
Alprostadil
Prostin E1
Prostin VR

Topic aliases are alternate phrasings for a particular topic.


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Indicated for palliative, not definitive, therapy to temporarily maintain the patency of the ductus arteriosus until corrective or palliative surgery can be performed in neonates who have congenital heart defects and who depend upon the patent ductus for survival. Such congenital heart defects include pulmonary atresia, pulmonary stenosis, tricuspid atresia, tetralogy of-Fallot, interruption of the aortic arch, coarctation of-the-aorta, or transposition of-the-great-vessels with or without other defects.
In infants with restricted pulmonary blood flow, the increase in blood oxygenation is inversely proportional to pretreatment pO2 values; that is, patients with low pO2 values respond best, and patients with pO2 values of 40 torr or more usually have little response.
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Stable dose is usually 5-10ncg/kg/hr

In a periarrest scenario in a duct dependent cardiac lesion requiring reopening of the ductus a dose of up to 100ncg/kg/hr

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"Apnea is experienced by about 10 to 12% of neonates with congenital heart defects treated with PROSTIN VR PEDIATRIC Sterile Solution. Apnea is most often seen in neonates weighing less than 2 kg at birth and usually appears during the first hour of drug infusion. Therefore, respiratory status should be monitored throughout treatment, and PROSTIN VR PEDIATRIC should be used where ventilatory assistance is immediately available."
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Enteral feeding whilst on a prostin infusion may increase the risk of nectrotising enterocolitis, especially with left sided obstructive lesions.

Consider enteral feeding if the patient will be on a prolonged prostin infusion however

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Rebound pulmonary hypertension may be seen in patients in which this drug is abruptly stopped.

If the infusion has been running for more than a few days consider weaning the infusion rather than stopping abruptly.
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The half-life of prostaglandin E1 is one circulation time and therefore a continuous uninterrupted infusion must be maintained.
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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.
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