The evolving role of nesiritide in advanced or decompensated heart failure.
Nesiritide is a recombinant form of human brain natriuretic peptide (BNP) that is structurally and biochemically identical to endogenously produced BNP. In humans, BNP is important in hemodynamic and neurohormonal equilibrium, helping to maintain adequate vascular volume and pressure in response to volume overload. The pharmacodynamic effects of nesiritide mimic the biologic effects of BNP. The molecular biology and actions of nesiritide and BNP are reviewed, with the therapeutic rationale for nesiritide in patients with acute or advanced decompensated heart failure highlighted. In addition, recommendations for its administration are provided, and unresolved therapeutic considerations are discussed.
Department of Pharmacy Practice, College of Pharmacy, University of Florida, P.O. Box 100486, Gainesville, FL 32610, USA. zineh@cop.ufl.edu
Issam
I
Zineh
Richard S
RS
Schofield
Julie A
JA
Johnson
D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D020097:Natriuretic Peptide, Brain