A.

Indication or uses of the drug:

1. Improve breathing in patients with sudden severe heart failure

2. Lowering blood pressure
3. For Renal impairment
4. For Hepatic impairment

B. Rout of administration and dose

Nesiritide is recommended to be administered as an IV bolus of 2 mcg/kg over 60
seconds followed by continuous fixed dose infusion of 0.01 mcg/kg/min. The
reconstituted drug must be used within 24 hours. There is limited data on the
infusion of Nesiritide beyond 48 hours.

C. Mechanism of actions :

It increases intracellular concentration of guanosine 3’5’-cyclic monophosphate ( cGMP ) in

vascular smooth muscle resulting in vasodilation, reduce pulmonary capillary wedge pressure
( PCWP ).

D. PK and PD
pd-Nesiritide works by facilitating cardiovascular homeostasis through the
negative regulation of the renin-angiotensin-aldosterone system. This
regulation will in order stimulate cyclic guanosine monophosphate and smooth
muscle cell relaxation. In simpler terms, it promotes vasodilation, natriuresis,
and diuresis.

E. Side effects

1. Hypotension
2. Serum creatinine raised
3. Reduced Ventricular tachycardia
4. Reduced ventricular ectopy
5. Extravasation

F. Contraindications

1. Patients with abnormally high nitrogen-containing compounds in the blood

 2. Patients with renal impairment
3. Patients with abnormally low blood pressure

G. Drug-drug or food-drug interaction

References :

1. https://reference.medscape.com/drug/natrecor-nesiritide-342466#0

2. https://www.drugs.com/mtm/nesiritide.html#:~:text=Nesiritide%20is%20used%20to
%20improve,listed%20in%20this%20medication%20guide

3. https://go.drugbank.com/drugs/DB04899#:~:text=Nesiritide%20works%20by%20facilitating
%20cardiovascular,vasodilation%2C%20natriuresis%2C%20and%20diuresis

4. https://www.webmd.com/drugs/2/drug-21736/nesiritide-intravenous/details/list-
contraindications

5.