[Current status and future prospect of prostacyclin therapy for pulmonary hypertension--intravenous, subcutaneous, inhaled and oral PGI2 derivatives].
Prostacyclin (PGI2) is a potent and a promising vasodilative agent in the treatment of pulmonary hypertension (PH). Epoprostenol (Flolan), an intravenous PGI2, has been used for PPH, and exerts dramatic effects such as reducing pulmonary vascular resistance and increasing cardiac output leading to an improvement of exercise tolerance. However, continuous i.v. infusion accompanies infection, thrombosis, occlusion, battery problems and variable side effects of PGI2 itself. Uniprost, administered subcutaneously, has a rather long half-life. It also needs an ambulatory infusion pump system. Beraprost, an oral PGI2 analogue, is also effective in mild PH patients. It can be absorbed easily and administered tid, or qid fashion. Inhaled iloprost may be an alternative option, but both iloprost and beraprost require frequent administrations because of their short half-life.
Saji
T
T
Department of First Pediatrics, Toho University School of Medicine.
Nakayama
T
T
Ishikita
T
T
Matsuura
H
H
D000280:Administration, Inhalation; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011464:Epoprostenol / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D016285:Iloprost / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous
D000959:Antihypertensive Agents; D011464:Epoprostenol; D016285:Iloprost