Nesiritide
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Nesiritide is a recombinant natriuretic peptide used for the treatment of patients with acutely decompensated congestive heart failure who have dyspnea at rest or with minimal activity.
Nesiritide is a recombinant natriuretic peptide used for the treatment of patients with acutely decompensated congestive heart failure who have dyspnea at rest or with minimal activity.
Human BNP binds to the particulate guanylate cyclase receptor of vascular smooth muscle and endothelial cells, leading to increased intracellular concentrations of guanosine 3'5'-cyclic monophosphate (cGMP) and smooth muscle cell relaxation. Cyclic GMP serves as a second messenger to dilate veins and arteries. Nesiritide has been shown to relax isolated human arterial and venous tissue preparations that were precontracted with either endothelin-1 or the alpha-adrenergic agonist, phenylephrine. In human studies, nesiritide produced dose-dependent reductions in pulmonary capillary wedge pressure (PCWP) and systemic arterial pressure in patients with heart failure. In animals, nesiritide had no effects on cardiac contractility or on measures of cardiac electrophysiology such as atrial and ventricular effective refractory times or atrioventricular node conduction. Naturally occurring atrial natriuretic peptide (ANP), a related peptide, increases vascular permeability in animals and humans and may reduce intravascular volume. The effect of nesiritide on vascular permeability has not been studied.
适用于急性代偿性心力衰竭、慢性失代偿性心力衰竭、心肌梗死、心脏导管手术等。由于静脉使用起效快,更适用于急性心力衰竭。
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