Home Drug Guide Epoprostenol Sodium

Drug Guide

Generic Name

Epoprostenol Sodium

Brand Names Flolan, Veletri

Classification

Therapeutic: Antiplatelet agent; Vasodilator

Pharmacological: Prostacyclin (PGI2) analog)

FDA Approved Indications

  • Pulmonary arterial hypertension (WHO Group 1)

Mechanism of Action

Epoprostenol is a prostacyclin (PGI2) analog that causes vasodilation and inhibits platelet aggregation by stimulating adenylate cyclase, increasing cyclic AMP levels in platelets and vascular smooth muscle cells.

Dosage and Administration

Adult: Initial dose: 2.5-5 ng/kg/min IV continuous infusion, titrated based on response and tolerability.

Pediatric: Use based on weight and clinical response; consult specific guidelines.

Geriatric: Adjust dose carefully, considering co-morbidities and concurrent medications.

Renal Impairment: No specific adjustment necessary, but monitor closely.

Hepatic Impairment: Data limited; use with caution.

Pharmacokinetics

Absorption: Given IV infusion, bypassing absorption processes.

Distribution: Widely distributed; high affinity for blood components.

Metabolism: Rapidly cleared via hydrolysis and oxidation; no significant hepatic metabolism.

Excretion: Primarily eliminated in urine as metabolites.

Half Life: Approximately 3-6 minutes.

Contraindications

  • Allergy to prostacyclins or any component of the formulation.
  • Severe hypotension.

Precautions

  • Use with caution in patients with heart failure, recent or ongoing hemorrhage, or compromised hepatic or renal function.
  • May cause hypotension, flushing, jaw pain, and headache.

Adverse Reactions - Common

  • Headache (Frequent)
  • Nausea, vomiting (Common)
  • Flushing (Common)
  • Jaw pain (Common)

Adverse Reactions - Serious

  • Hypotension (Uncommon)
  • Severe hypotension leading to ischemia (Rare)
  • Infusion site reactions, thrombosis (Uncommon)

Drug-Drug Interactions

  • Sympathomimetics (may enhance hypotension)
  • Other vasodilators (additive effect).

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, oxygenation, infusion site for thrombosis or infiltration.

Diagnoses:

  • Risk for bleeding
  • Ineffective tissue perfusion due to hypotension

Implementation: Ensure correct infusion rate, monitor for adverse reactions, support airway and oxygenation, maintain infusion equipment.

Evaluation: Assess improvement in pulmonary hypertension symptoms, monitor for infusion-related adverse effects.

Patient/Family Teaching

  • Report signs of bleeding, severe hypotension, or infusion site issues.
  • Do not stop or adjust dose without medical advice.
  • Understand the importance of continuous infusion and the potential need for hospital or specialized infusion services.

Special Considerations

Black Box Warnings:

  • Potential for sudden death if interrupted or stopped abruptly (Veletri).

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Hypotension, headache, flushing, nausea.

Treatment: Supportive care with vasopressors and fluid management; discontinue infusion.

Storage and Handling

Storage: Refrigerate at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Stable when refrigerated; Veletri formulation may have different stability profile — consult specific product labeling.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.