Comprehensive Nursing Pharmacology Q 10
The most serious adverse effect of Alprostadil (Prostin VR pediatric injection) administration in neonates is:
A. Bleeding tendencies.
B. Apnea.
C. Hypotension.
D. Pyrexia.
Correct Answer: B. Apnea.
All items are adverse reactions of the drug. However, apnea appearing during the first hour of drug infusion occurs in 10-12 percent of neonates with congenital heart defects. Clinicians deciding to utilize alprostadil must be prepared to intubate and mechanically ventilate the infant. Careful monitoring for apnea or respiratory depression is mandatory. In some institutions, elective intubation occurs prior to the initiation of the medication.
Option A: Alprostadil inhibits platelet aggregation and therefore can increase the risk of bleeding. Use intravenous alprostadil cautiously in patients with bleeding tendencies or receiving anticoagulant therapy. Additionally, caution should be used in patients at risk of coagulopathy.
Option C: Alprostadil is known to cause hemodynamic instability causing hypotension/hypertension, and flushing. It is advisable to monitor blood pressure, heart rate, and temperature before and after the use of the drug.
Option D: Alprostadil is a prostaglandin used to maintain patent ductus arteriosus in neonates with ductus arteriosus dependent congenital heart malformations. Alprostadil administration results in fever in ?14% of treated neonates. The occurrence of fever in this setting often leads to extensive investigations to identify the source of fever, as well as to empiric antibiotic therapy and the postponement of cardiac surgery. These measures can lead to several neonatal complications.