Notes

Epoprostenol is active on both pulmonary and systemic circulations.

Although alprostadil is claimed to be metabolised in the lung and have only pulmonary vasodilating effects, falls in systemic blood pressure are not uncommonly seen, especially if metabolism is incomplete.

Avoid extravasation into peripheral tissues as solution has high pH.

Effects last up to 30min following discontinuation of the drug.

Prostaglandins may potentiate the effect of heparin.

Recent studies have shown improvement in gas exchange by selective pulmonary vasodilatation following inhalation of epoprostenol at doses of 10-15ng/kg/min. The efficacy appears similar to that of nitric oxide inhalation but is not as rapid.

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