Nitric Oxide

Drug #1526

Nitric Oxide is an endogenous chemical messenger that acts as a potent vasodilator. Nitric Oxide is also involved in platelet aggregation, neurotransmission, and the immune system and exhibits antimicrobial, antitumour, and antiviral activity. Nitric oxide is synthesised from L-arginine by the action of enzyme, nitric oxide synthase and is believed to be the same substance as that of endothelium-derived relaxing factor (EDRF). Inhaled nitric oxide is highly selective pulmonary vasodilator and Nitric Oxide is under invastigation for the management of pulmonary hypertension and other bronchopulmonary disorders. Organic nitrates like glyceryl trinitrate and other nitrovasodilators such as sodium nitroprusside are now believed to exert their vasodilatory action through nitric oxide and therefore termed as nitric oxide donors.

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Primary Characteristics

Nitric Oxide is also known as Nitrogen Monoxide.

It is of Natural origin.

Molecular Weight: 30.01 · Non-proprietary name: Nitric Oxide.

Pharmacokinetics

Distribution: Nitric Oxide has a volume of distribution is 2 - 6 l/kg.

Elimination: it is metabolised via Lung, plasma half-life is 2-6 sec, renal excretion is Major.

Indications

Nitric Oxide is primarily indicated in conditions like Asthma, Bronchopulmonary dysplasia, Cardiopulmonary bypass, Congenital heart disease, Obstructive pulmonary disease, Pulmonary hypertension, Respiratory distress syndrome, Respiratory failure.

Contraindications

Nitric Oxide is contraindicated in conditions like Methaemoglobinaemia.

Dosage

Nitric Oxide's dosage details are as follows:

Dose	Single Dose	Frequency	Route
Adult Dosage
20 ppm	20 ppm	—	Inh
Paediatric Dosage (20kg)
No data.
Neonatal Dosage (3kg)
No data.

Drug Interactions

Unknown3 interactions

Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Side Effects

Nitric Oxide in overdosage may give rise to further complications which include Rebound Pulmonary Hypertension.

Nitric Oxide produces potentially life-threatening effects which include Methemoglobinemia, Paradoxical hypoxia. Careful monitoring is needed with proper medical management.

The signs and symptoms that are produced after acute overdosage of Nitric Oxide are Death , Pulmonary edema , Methemoglobinemia.

Nitric Oxide is known to cause more or less tolerable side effects which are usually transient. These include Headache, Hematuria, Hypotension , Increased bleeding time.

Warnings / Precautions

Abrupt discontinuation may lead to worsening hypotension, oxygenation, and increasing pulmonary artery pressure (PAP). Worsening oxygenation and increasing PAP may occur in patients who do not respond. Doses above 20 ppm should not be used because of the increased risk of methemoglobinemia and elevated nitrogen dioxide (NO2) levels. Methemoglobin levels and NO2 should be monitored.

Available Brands

None recorded.

Storage Conditions

Nitric Oxide should be stored Gas Supplier.

Drug Classification

1.12.3.7 — Direct vasodilators