Ventavis

iloprost

(eye-lo-prost) iloprost,

Ventavis

(trade name)

Classification

Therapeutic: vasodilators
Pharmacologic: prostacyclins
Pregnancy Category: C

Indications

Pulmonary arterial hypertension (WHO Group 1).

Action

Dilates pulmonary and arterial vasculature.

Therapeutic effects

Improved exercise capacity.

Pharmacokinetics

Absorption: Unknown.Distribution: Unknown.Metabolism and Excretion: Any absorbed iloprost is metabolized.Half-life: 20–30 min (plasma).

Time/action profile (improved exercise capacity)

ROUTE	ONSET	PEAK	DURATION
Inhaln	unknown	unknown	up to 2 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Systolic BP <85 mm Hg; Lactation: Lactation.Use Cautiously in: Concurrent use of drugs or coexisting medical conditions that may ↑ risk of syncope; COPD, asthma, or acute pulmonary infection (may ↑ risk of bronchospasm); Hepatic impairment (may need to ↑ dosing interval); Pediatric: Safety not established; Obstetric: Use only if maternal benefit outweighs fetal risk.

Adverse Reactions/Side Effects

Central nervous system

dizziness
fainting
headache
insomnia

Ear, Eye, Nose, Throat

epistaxis

Respiratory

cough (most frequent)
bronchospasm
dyspnea
hemoptysis
wheezing

Cardiovascular

HF (life-threatening)
vasodilation (most frequent)
chest pain
hypotension
peripheral edema
supraventricular tachycardia

Gastrointestinal

diarrhea
gingival bleeding
nausea
vomiting

Genitourinary

renal failure

Dermatologic

facial flushing

Musculoskeletal

back pain
jaw-muscle spasm
muscle cramps

Interactions

Drug-Drug interaction

↑ risk of hypotension with other vasodilators or diuretics.Risk of bleeding may be ↑ by anticoagulants.

Route/Dosage

Inhalation (Adults) 2.5 mcg initially, then 5 mcg/dose 6–9 times daily; not more than every 2 hr.

Hepatic Impairment

Inhalation (Adults) Child Pugh Class B or C—Consider ↑ dosing interval to every 3–4 hr.

Availability

Solution for inhalation: 10 mcg/mL ampules, 20 mcg/mL ampules

Nursing implications

Nursing assessment

Assess respiratory status (exercise intolerance, symptoms, deterioration) prior to and periodically during therapy.
Monitor vital signs prior to and throughout therapy. Do not administer if BP <85 mm Hg.
Assess for signs of pulmonary edema (dyspnea, jugular venous distension). If signs occur, discontinue iloprost immediately; may be a sign of pulmonary venous hypertension.

Potential Nursing Diagnoses

Activity intolerance (Indications)
Ineffective breathing pattern (Indications)

Implementation

Avoid iloprost contact with skin or eyes, or oral ingestion.
Inhalation: Prepare medication by one ampule of iloprost into Prodose ADD System or I-neb ADD system medication chamber immediately before use. Do not mix with other medications. Administer 6–9 times/day during waking hours, according to patient's needs and tolerability. Discard solution remaining in chamber after inhalation. Follow manufacturer's instructions for cleaning components after administration of each dose.

Patient/Family Teaching

Instruct patient in use of iloprost and Prodose ADD System or I-neb ADD system, frequency, ampule dispensing, and cleaning of equipment. See manufacturer's instructions. Advise patient that inhalation intervals should not be less than 2 hr, but acute benefits of medication may not last 2 hr.
May cause dizziness and fainting due to hypotension. Caution patient to change positions slowly to minimize orthostatic hypotension.

Evaluation/Desired Outcomes

Improved exercise tolerance, decrease in symptoms of pulmonary edema, and lack of deterioration in patients with pulmonary arterial hypertension.

Ventavis

a brand name for ILOPROST TROMETAMOL.