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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