Anticoagulant prostanoids

Epoprostenol is generally used with heparin for anticoagulation of extracorporeal circulations, although heparin interferes with the inhibitory effect of epoprostenol on platelet aggregation in vitro. Heparin dosages can be reduced to a minimum or in some cases prostanoids can completely replace heparin. A reduced risk of bleeding with epoprostenol therapy is a particular advantage in the critically ill ( Weston 1990). The major disadvantage of epoprostenol is the potential for hypotension as a consequence of peripheral vasodilatation. This effect can be minimized by careful attention to volume status. The less potent prostanoid alprostadil has similar effects on anticoagulation, although there is less systemic vasodilatation at equivalent doses.

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