Prostaglandin E1, United States Pharmacopeia (USP). PGEi, Alprostadil (Prostin VR Pediatric), is a naturally occurring prostaglandin that has found particular use in maintaining a patent (opened) ductus arteriosus in infants with congenital defects that restrict pulmonary or systemic blood flow.
Alprostadil must be administered intravenously continually at a rate of approximately 0.1 ^g/kg/min to temporarily maintain the patency of the ductus arteriosus until corrective surgery can be performed. Up to 80% of circulating al-prostadil may be metabolized in a single pass through the lungs. Because apnea has been observed in 10% to 12% of neonates with congenital heart defects, this product should be administered only when ventilatory assistance is immediately available. Other commonly observed side effects include decreased arterial blood pressure, which should be monitored during infusion; inhibited platelet aggregation, which might aggravate bleeding tendencies; and diarrhea. Prostin VR Pediatric is provided as a sterile solution in absolute alcohol (0.5 mg/mL) that must be diluted in saline or dextrose solution before intravenous administration. A liposomal preparation is available (Liposome Company) to extend the biological half-life of the active prostaglandin.
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