Generic Name:

Alprostadil

Actions:

Vasodilator
Decreases peripheral resistances, which causes reflexive increase in cardiac output and heart rate
Stimulates intestinal and uterine smooth muscle

Indications:

Primary nonfunctional liver transplant characterized by rising Transaminases, minimal bile production, and coagulopathy within 4-34 Hours after transplantation

Protection against FK-506 nephrotoxicity

Pulmonary hypertension

Administration Guidelines:

Usual Dose and Route

0.1 mcg/kg/hr and increase by 0.1 mcg/kg/hr every 2 hours to 0.6 mcg/kg/hr. If patient becomes hypotensive, wean back to previous dose.

Infusion rates should be titrated to patient response.

Standard Concentration:

500 mcg / 250 ml

MICROINFUSION: 1000mcg/50ml (20mcg/ml)

Special Considerations:

- Guidelines used for appropriate dosing and monitoring for side effects include renal perfusion studies (urine output, bun, cr) and blood pressure.

- Dosage modifications should be carefully titrated based on patient response.

- Invasive blood pressure monitoring (e.g. a-line) should be considered when centrally administered vasoactive agents are used or when frequent changes in infusion rate are required.

Precautions and Side Effects:

- Hypotension

- Tachycardia

- Diarrhea

- Hypokalemia, Hypoglycemia,

- Hyperthermia