国: カナダ
言語: 英語
ソース: Health Canada
NITRIC OXIDE
INO THERAPEUTICS
R07AX01
NITRIC OXIDE
800PPM
GAS
NITRIC OXIDE 800PPM
INHALATION
353/1963L
Prescription
NITRATES AND NITRITES
Active ingredient group (AIG) number: 0151361002; AHFS:
APPROVED
2005-09-23
PRODUCT MONOGRAPH INOMAX ® NITRIC OXIDE FOR INHALATION 800 ppm Distributed by: C.R.I. 4 Innovation Drive Dundas ON Canada L9H 7P3 Manufactured by: Mallinckrodt Manufacturing LLC 1060 Allendale Drive Port Allen, LA 70767 Control Number: Date of Revision: 199061 OCTOBER 4, 2017 Page 2 of 27 PRODUCT MONOGRAPH INOMAX ® NITRIC OXIDE FOR INHALATION 800 ppm ACTIONS AND CLINICAL PHARMACOLOGY Nitric oxide is a compound produced by many cells of the body. It relaxes vascular smooth muscle by binding to the heme moiety of cytosolic guanylate cyclase, activating guanylate cyclase and increasing intracellular levels of cyclic guanosine 3’,5’-monophosphate, which then leads to vasodilation. When inhaled, nitric oxide produces selective pulmonary vasodilation. Nitric oxide is very rapidly inactivated by binding to hemoglobin. Thus, delivered via inhalation, nitric oxide improves V/Q matching and is a selective pulmonary vasodilation agent. Inhaled nitric oxide appears to increase the partial pressure of arterial oxygen (PaO 2 ) by dilating pulmonary vessels in better ventilated areas of the lung, redistributing pulmonary blood flow away from lung regions with low ventilation/perfusion (V/Q) ratios toward regions with normal ratios. Effects on Pulmonary Vascular Tone in PPHN: Persistent pulmonary hypertension of the newborn (PPHN) occurs as a primary developmental defect or as a condition secondary to other diseases such as meconium aspiration syndrome (MAS), pneumonia, sepsis, hyaline membrane disease, congenital diaphragmatic hernia (CDH), and pulmonary hypoplasia. In these states, pulmonary vascular resistance (PVR) is high, which results in hypoxemia secondary to right-to-left shunting of blood through the patent ductus arteriosus and foramen ovale. Inhalation of nitric oxide reduces the oxygenation index (OI= mean airway pressure in cm H 2 O x fraction of inspired oxygen concentration [FiO 2 ] x 100 divided by systemic arterial concentration in mm Hg [PaO 2 ]) and increases PaO 2 . CLINICAL STUDIES The efficacy of INO 完全なドキュメントを読む