How does nitric oxide gas work?
Nitric oxide gas is used for treating respiratory failure in newborns caused by low tissue saturation of oxygen (hypoxia). Nitric oxide gas improves blood flow and oxygen levels in the pulmonary arteries by relaxing the smooth muscles around pulmonary blood vessels, which dilates them and reduces pulmonary hypertension.
Nitric oxide gas molecules bind to soluble guanylate cyclase (sGC), an enzyme in the cardiopulmonary system, and activate the synthesis of a signaling molecule known as cyclic guanosine monophosphate (cGMP). An increase in cGMP concentration leads to relaxation of the pulmonary vascular smooth muscles.
How is nitric oxide gas used?
Nitric oxide gas is administered through the ventilator using a calibrated nitric oxide delivery system and is approved by FDA for the treatment of hypoxic respiratory failure in newborns. Nitric oxide gas is also being developed for use in other conditions and has orphan designation for the following:
Pediatric
- Prevention of chronic lung disease in premature newborns
- Cystic fibrosis
Adults
- Acute respiratory distress syndrome (ARDS)
- Pulmonary arterial hypertension (PAH)
- Cystic fibrosis
- Sickle cell crises
- Diagnosis of sarcoidosis
- Idiopathic pulmonary fibrosis
- Nontuberculosis mycobacterial infections
What are side effects of nitric oxide gas?
Side effects of nitric oxide gas may include the following:
- Hypotension (low blood pressure)
- Withdrawal
- Atelectasis (complete or partial collapse of a lung’s lobe or an entire lung)
- Hematuria (blood in the urine)
- Hyperglycemia (high blood glucose levels)
- Infection
- Cellulitis
- Sepsis
- Stridor (a whistling sound in breathing due to obstructed airway)
- Intracranial hemorrhage
- Seizure
- Gastrointestinal hemorrhage
- Methemoglobinemia (high blood level of methemoglobin, a form of hemoglobin that does not effectively release oxygen to tissues)
- Acute lung injury
- Hypoxemia (low oxygen levels in the blood)
- Pulmonary edema
- Pulmonary hemorrhage
- Pulmonary toxicity
- Chest discomfort
- Dizziness
- Dry throat
- Dyspnea (shortness of breath)
- Headache
Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.
What are names of some nitric oxide gas products?
Generic and brand names of nitric oxide gas products include:
- Genosyl
- INOmax
- nitric oxide gas
