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Inhaled alternatives to nitric oxide.
1Department of Anesthesiology, University of Virginia Health Services Foundation, Charlottesville, VA, USA.
Critical Care Medicine
|March 9, 2005
Summary
Alternative inhaled vasodilators show promise for pulmonary hypertension management. Inhaled prostanoids are well-studied, with emerging interest in phosphodiesterase inhibitors and neuropeptides.
Area of Science:
- Pulmonary Medicine
- Pharmacology
Background:
- Inhaled nitric oxide is established for pulmonary hypertension.
- Concerns regarding cost, toxicity, and outcome data for inhaled nitric oxide exist.
- Interest is growing in alternative inhaled selective pulmonary vasodilators.
Purpose of the Study:
- To review alternative inhaled selective pulmonary vasodilators studied to date.
- To describe their molecular mechanisms, side effects, and physiological effects.
Main Methods:
- Literature review of inhaled pulmonary vasodilators excluding nitric oxide.
- Analysis of animal and clinical studies on alternative agents.
Main Results:
- Several agents demonstrate comparable physiological effects to inhaled nitric oxide.
- Inhaled prostanoids (prostacyclin, iloprost) are the most studied alternatives.
- Phosphodiesterase inhibitors and neuropeptides are emerging therapies.
Conclusions:
- Alternative inhaled vasodilators offer comparable physiological effects to inhaled nitric oxide.
- Inhaled prostanoids are the leading alternatives currently.
- Novel therapies like phosphodiesterase inhibitors and neuropeptides warrant further investigation.