Nitric oxide
Clinical data
Pharmacodynamics
Pharmacokinetics
Physical and chemical data
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Nitric oxide (NO) is a naturally occurring endothelial-derived vasodilator that exhibits most of its vasodilatory effects in the pulmonary vasculature.[1] It is frequently indicated for patients with right heart failure and hypoxemia. It exists as a colorless odorless gas, and is administered inhalationally.

Uses

  • Pulmonary HTN
    • After heart transplant
  • Right ventricular failure

Contraindications

Absolute contraindications

Precautions

Pharmacology

Pharmacodynamics

Mechanism of action

Nitric oxide diffuses to smooth muscle of pulmonary vasculature -> activates soluble guanylate cyclase (sGC) -> converts GTP to cGMP -> activates protein kinase G -> increases Ca2+ reuptake -> decreased calcium decreasing myosin phosphorylation -> relaxation of smooth muscle.

Adverse effects

Pharmacokinetics

Chemistry and formulation

History

Initially discovered in 1987. Won Nobel Prize in Physiology and Medicine in 1998.

References

  1. Ichinose, Fumito; Roberts, Jesse D.; Zapol, Warren M. (2004-06-29). "Inhaled Nitric Oxide". Circulation. 109 (25): 3106–3111. doi:10.1161/01.CIR.0000134595.80170.62.