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Name: Alprostadil

Pregnancy Category (not applicable)

Drug classes

Prostaglandin

Therapeutic actions

Relaxes vascular smooth muscle; the smooth muscle of the ductus arteriosus is especially sensitive to this action and will relax and stay open; this is beneficial in infants who have congenital defects that restrict pulmonary or systemic blood flow and who depend on a patent ductus arteriosus for adequate blood oxygenation and lower body perfusion.

Indications

Palliative therapy to temporarily maintain the patency of the ductus arteriosus until corrective or palliative surgery can be performed in neonates with congenital heart defects who depend on a patent ductus (eg, pulmonary atresia or stenosis, tetralogy of Fallot, coarctation of the aorta)

Contraindications/cautions

Contraindicated in the presence of respiratory distress syndrome.

Use caution in the presence of bleeding tendencies (drug inhibits platelet aggregation).

Adverse effects

  • CNS: Seizures, cerebral bleeding, hypothermia, jitteriness, lethargy, stiffness
  • GI: Diarrhea
  • CV: Bradycardia, flushing, tachycardia, hypotension, cardiac arrest, heart block, CHF
  • Respiratory: Apnea, respiratory distress
  • Hematologic: Inhibited platelet aggregation, bleeding, anemia, disseminated intravascular coagulation, hypokalemia
  • Other: Cortical proliferation of the long bones (with prolonged use, regresses after treatment is stopped), sepsis

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