Drug reference

nitric oxide

Therapeutic gas · Therapeutic gas, Vasodilator

Therapeutic gasTherapeutic gas, Vasodilator

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

2 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactions

Nitrous AcidSevereDatabaseDDInter
PrilocaineSevereDatabaseDDInter

Mechanism

Endogenous cell-signaling molecule produced from l-arginine by NO synthases. Causes vasodilation of smooth muscle cells and inhibition of platelet aggregation and adhesion. Selectively dilates the pulmonary vasculature.

Indications

persistent pulmonary hypertension of the newbornevaluation of pulmonary vasodilating capacity (during cardiac catheterization)determination of diffusion capacity (DL) across the alveolar-capillary unitpersistent PH of the newbornacute hypoxemic respiratory failureacute vasodilator testing in adult patients with PAH

Dosing

Adult: 0.1 to 40 ppm

Pharmacokinetics

Half-life

2–6 sec

Metabolism

Rapid inactivation by hemoglobin binding and oxidation to nitrite, which interacts with oxyhemoglobin to form nitrate and met-hemoglobin.

Excretion

Nitrate (predominant metabolite, >70% of dose) excreted in urine.

Side effects

Common

platelet inhibitionnoisy breathinghematuriaatelectasis

Serious

pulmonary toxicity (with levels >50–100 ppm)
methemoglobinemia
potential to further impair left ventricular performance (in patients with impaired left ventricle function)
lethal at high doses (500–1000 ppm)
elevations in methemoglobin
pulmonary toxicities associated with inspired NO2 (including acute respiratory distress syndrome)
reduced O2 delivery capacity of circulation (due to methemoglobinemia)