Names and pronunciation
[eye′-loe-prost] Ventavis
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Drug reference
[eye′-loe-prost] Ventavis
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Func. class.: Pulmonary vasodilator
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Chem. class.: Prostacyclin analog
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ACTION: Produces vasodilation and antiproliferative effects; mechanism for vasodilation is unclear. Hemodynamic effects following relaxation of vascular smooth muscle and vasodilation include decreased pulmonary vascular resistance, increased cardiac index, increased oxygen delivery. Also decreases platelet aggregation
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USES: PAH in those with NYHA Class III or IV symptoms
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CONTRAINDICATIONS: Hyper sensitivity Precautions: Asthma, breastfeeding, chil- dren, COPD, driving, geriatrics, hepatic disease, hypotension, pregnancy, pulmo- nary edema
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SIDE EFFECTS CNS: Headache, insomnia, syncope CV: Hypotension, chest pain, vasodila- tion, palpitations, heart failure, supraven tricular tachycardia, edema GI: Nausea, vomiting, mouth/tongue discomfort GU: Renal failure RESP: Cough, dyspnea, pneumonia, flu- like symptoms
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INTERACTIONS Increase: bleeding risk—anticoagulants, platelet inhibitors; assess for bleeding Increase: hypotension—antihyperten- sives, vasodilators; monitor B/P Drug/Lab Test: Increase: alkaline phosphatase
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DOSAGE AND ROUTES • Adult: INH 2.5 mcg using adaptive aerosol delivery (AAD) or Prodose (AAD); may increase to 5 mcg 6-9×/day as needed separated by ≥2 hr, max 5 mcg 9×/day • Geriatric: INH start at low end of dose Hepatic dose • Adult: INH increase dosing interval to q3-4h
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Available forms: INH solution 10, 20 mcg/mL
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Administer: • Use only delivery devices provided • Do not take orally; avoid ocular expo- sure, contact with skin • If signs of pulmonary edema occur in those with pulmonary hypertension, treatment should be stopped immediately; this may be a sign of pulmonary venous hypertension
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Assess: • Pulmonary arterial hypertension (PAH): dizziness, light-headedness, fainting be- cause of lowered B/P; patients should use caution when driving or operating machin- ery until effect is known • Syncope: because of risk of syncope, vital signs should be monitored while initiating; in those with low systemic blood pressure, avoid further hypotension; do not use in sys- tolic blood pressure <85 mm Hg; if syncope occurs during physical exertion, dose may need to be adjusted • Renal failure: monitor closely in pa tients with renal impairment; effect may be extended • Bronchospasm: may occur especially in susceptible patients with hyperreactive airways; avoid use in COPD, severe asthma, acute respiratory infection • Pregnancy/breastfeeding: use during pregnancy only if benefits to mother clearly outweigh potential risk to fetus; not known whether product crosses placenta
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To take as prescribed; not to double doses; to take 2 hr before physical exer- tion; not to save leftover product; to al- ways keep enough product and backup inhalation device; not to mix with other medications; not to miss doses or stop abruptly, risk of rebound hypertension • To keep away from skin and eyes • To avoid driving or other hazardous activities until reaction is known; dizzi- ness, syncope may occur; to rise slowly to minimize orthostatic hypotension • To monitor B/P; do not take if systolic B/P <85 mm Hg HIGH ALERT
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PHARMACOKINETICS Half-life 30 min, peak 5 min, duration 30-60 min
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• Adult: INH 2.5 mcg using adaptive aerosol delivery (AAD) or Prodose (AAD); may increase to 5 mcg 6-9×/day as needed separated by ≥2 hr, max 5 mcg 9×/day
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• Adult: INH increase dosing interval to q3-4h
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