Nesiritide: Difference between revisions
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| publisher = American Society of Health-System Pharmacists}}</ref> | | publisher = American Society of Health-System Pharmacists}}</ref> | ||
A number of hospitals limit its use to [[critical care unit]]s,<ref>{{citation | A number of hospitals limit its use to [[critical care|critical care unit]]s,<ref>{{citation | ||
| url = http://nursing.uchc.edu/unit_manuals/intensive_care/docs/Natrecor%203-04.pdf | | url = http://nursing.uchc.edu/unit_manuals/intensive_care/docs/Natrecor%203-04.pdf | ||
| title = ICU/CSDU Department - Unit Practice Manual; John Dempsey Hospital-Department of Nursing | | title = ICU/CSDU Department - Unit Practice Manual; John Dempsey Hospital-Department of Nursing | ||
| publisher = The University of Connecticut Health Center}}</ref> although others extend its use to telemetry units and emergency rooms. Patients receiving it do need close nursing observation; the hospitals limiting its use to ICUs may require monitoring with | | publisher = The University of Connecticut Health Center}}</ref> although others extend its use to telemetry units and emergency rooms. Patients receiving it do need close nursing observation; the hospitals limiting its use to ICUs may require monitoring with [[critical care#Pulmonary artery catheterization|pulmonary artery catheterization]] (i.e., [[Swan-Ganz catheter]]). | ||
It physically interacts with [[heparin]] and [[furosemide]]; heparinized intravenous administration sets must not be used with it, and it should not be administered through an IV access that has had a heparin lock. | It physically interacts with [[heparin]] and [[furosemide]]; heparinized intravenous administration sets must not be used with it, and it should not be administered through an IV access that has had a heparin lock. | ||
Latest revision as of 21:01, 2 March 2010
Nesiritide (U.S. trade name Natrecor), a brain (B-type) natriuretic peptide, may help patients with decompensated congestive heart failure according to a randomized controlled trial.[1] Natriuretic peptide causes diuresis, vasodilitation, and suppression of the renin-angiotensin system and sympathetic nervous system.[1]
Nesiritide is considered adjunctive therapy for patients in severe heart failure, principally as a vasodilator, when neither nitroglycerine nor sodium nitroprusside provide sufficient benefit. Small studies suggest it may increase the risk of death, and further trials are underway. It has been suggested that intermittent intravenous infusion, as opposed to continuous microdrip administration, worsens the hazard. [2]
A number of hospitals limit its use to critical care units,[3] although others extend its use to telemetry units and emergency rooms. Patients receiving it do need close nursing observation; the hospitals limiting its use to ICUs may require monitoring with pulmonary artery catheterization (i.e., Swan-Ganz catheter).
It physically interacts with heparin and furosemide; heparinized intravenous administration sets must not be used with it, and it should not be administered through an IV access that has had a heparin lock.
References
- ↑ 1.0 1.1 Colucci WS, et al. Intravenous nesiritide, a natriuretic peptide, in the treatment of decompensated congestive heart failure. Nesiritide Study Group. N Engl J Med. 2000 Jul 27;343(4):246-53. Erratum in: N Engl J Med 2000 Nov 16;343(20):1504. N Engl J Med 2000;343:896. PMID 10911006
- ↑ Natrecor IV, American Society of Health-System Pharmacists
- ↑ ICU/CSDU Department - Unit Practice Manual; John Dempsey Hospital-Department of Nursing, The University of Connecticut Health Center