Further information available here
Drug
Mechanism
Dose and Delivery
Inhaled Nitric Oxide (iNO)
Activates soluble guanyl cyclase n smooth muscle leading to the conversion of GTP to cGMP resulting in vasodilatation
- Start at 5-10 ppm, go up to 160ppm as needed
- The usual dose is around 20 ppm
Nebulised Prostacyclin
Activates adenyl cyclase in smooth muscle leading to increased levels of cAMP. This activates protein kinase A and leads to vasodilatation
- Intermittent therapy: Iloprost: 5mcg over 30 mins given every 2 hours
- Continuous therapy: Epoprostenol: 20-50 ng/kg/min
Nebulised Milrinone
Phosphodiesterase inhibitor preventing cGMP metabolism in smooth muscle resulting in vasodilatation
- Cumulative dose of 50 mcg/kg