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).
Clinical Pain Advisor Articles
- Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain
- Prescribed Opioids Difficulties Scale Effective for Assessing Concerns of Patients With Chronic Pain
- Predictors of Opioid Overdose in High-Risk Users
- Optimal Strategies for Opioid Weaning After Ambulatory Surgery
- Emergency Physicians Offer Recommendations for Identifying and Managing Opioid Use Disorder
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- Higher PainDETECT Scores, Neuropathic Pain Preoperatively May Increase Risk for Chronic Pain Post-TKR
- Terms Used for Addiction May Be Associated With Explicit, Implicit Bias
- Erenumab Reduces Monthly Migraine Days in Patients With Treatment-Resistant Migraine
- Government and Industry Lead the Way in Funding USPSTF Systematic Reviews
- Communication-Based Intervention Increases Goals-of-Care Discussions Between Physicians, Patients With Serious Illness