PROSTIN VR PEDIATRIC Rx
Generic Name and Formulations:
Alprostadil 500mcg/mL; soln for IV infusion after dilution; contains dehydrated alcohol.
Indications for PROSTIN VR PEDIATRIC:
Palliative therapy to maintain ductus arteriosus patency until corrective or palliative surgery can be performed in neonates with congenital heart defects and who depend on patent ductus for survival.
Use lowest effective dose for shortest duration. Give by continuous IV infusion into large vein (preferred) or through an umbilical artery catheter placed at the ductal opening. Initially 0.05–0.1mcg/kg/min. Reduce dose from 0.1 to 0.05 to 0.025 to 0.01mcg/kg/min after therapeutic response is achieved to provide lowest dose that maintains response. If inadequate response to 0.05mcg/kg/min; may increase up to 0.4mcg/kg/min.
Apnea in neonates with congenital heart defects; use where ventilatory assistance is immediately available.
Respiratory distress syndrome: not recommended. Bleeding disorders. Prolonged therapy (>120hrs): monitor for antral hyperplasia and gastric outlet obstruction. Monitor respiratory status, arterial pressure, blood oxygenation, BP, blood pH; decrease infusion rate if arterial pressure falls significantly. Neonates <2kg at birth.
Caution with anticoagulants.
Apnea, fever, flushing, bradycardia, hypotension, tachycardia, seizures, diarrhea, sepsis, cortical proliferation of the long bones (long-term infusion).
Neurology Advisor Articles
- Excess Abdominal Obesity Linked to Severe Disability in Multiple Sclerosis
- Change in Dietary Patterns Over 5 Years in Early Multiple Sclerosis
- High-Dose Biotin May Be an Effective Treatment for Progressive MS
- Biobank Data Suggest Vitamin D Reduces Risk for Multiple Sclerosis
- Poor Functional Outcomes Tied to Depressive Symptoms in Multiple Sclerosis
- Oxidized Low-Density Lipoprotein May Predict Risk for Recurrent Stroke
- Inappropriate Prescribing Protocols in Parkinson Disease
- Physical Activity Decreases Vascular Comorbidities in Multiple Sclerosis
- Review of Factors Impacting Sport-Related Concussion Headaches
- Congress Passes Bill to Fight Opioid Crisis