After cyclooxygenase (COX) enzymes act to convert arachidonic acid to prostaglandin H2, prostacyclin synthase converts PGH2 into PGI2 also known as prostacyclin. Several other eicosanoids are formed from PGH2.
Prostacyclin analogs work by vasodilating arteries in the lungs and the body. This is why they are effective in treating pulmonary hypertension.
Prostacyclin analogs have antithrombotic properties that work to balance the actions of prothrombotic thromboxane A2 molecules. Patients may need to monitor for coagulation labs when taking this medication.
Prostacyclin analogs are indicated for patients with pulmonary hypertension. They help to relax pulmonary vasculature and keep pressures down.
Side effects of protacyclin analogs include flushing from capillary vasodilation.
Another side effect from taking prostacyclin analogs is jaw pain.
Epoprostenol has a short half-life of 2–3 minutes. It can be continuously administered via central venous catheter or a peripherally inserted central catheter (PICC).
Iloprost has a half-life of 20–25 min and requires six to nine treatments per day. Giving iloprost requires a specially designed adaptive aerosol delivery device which matches the patient's individual breathing pattern.
Treprostinil can also be administered continusouly via intravenous access. It has a half-life of 4 hours.
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