Dictionary - Definition of EPOPROSTENOL

Epoprostenol


Epoprostenol
Systematic (IUPAC) name
(5Z)-5-[(3aR,4R,5R,6aS)-5-hydroxy-4- [(E,3S)-3-hydroxyoct-1-enyl]-3,3a,4,5,6,6a- hexahydrocyclopenta[d]furan-2-ylidene]pentanoic acid
Identifiers
CAS number	35121-78-9
ATC code	B01AC09
PubChem	114805
DrugBank	APRD00949
Chemical data
Formula	C₂₀H₃₂O₅
Mol. mass	352.465 g/mol
SMILES	eMolecules & PubChem
Pharmacokinetic data
Bioavailability	Not applicable (IV only)
Metabolism	To 6-keto-PGF_1α and 6,15-diketo-13,14-dihydro-PGF_1α
Half life	6 minutes (in vitro)
Excretion	Renal
Therapeutic considerations
Licence data	US
Pregnancy cat.	B(US)
Legal status	℞ Prescription only
Routes	Intravenous

Epoprostenol is a synthetic form of prostacyclin, and is used to treat pulmonary hypertension. It is sold under the trade name Flolan.

Clinical pharmacology

As an analogue of prostacyclin PGI₂, epoprostenol effects vasodilation, which in turn lowers the blood pressure. Epoprotstenol also inhibits platelet aggregation, though the role this phenomenon may play in relation to pulmonary hypertension has yet to be determined.

Administration

Epoprostenol is given via continuous infusion that requires a semi-permanent central venous catheter. This means that the patient must be attached to an infusion pump at all times. This delivery system can cause sepsis and thrombosis. Because epoprostenol is unstable, it must be kept cold, even during administration. Since it has a half-life of 3 to 5 minutes, the infusion has to be continuous (24/7), and an interruption can lead to a potentially fatal rebound of symptoms.

History

Epoprostenol was developed by GlaxoSmithKline and approved in the USA as a medicine in 1995.

Marketing

It was licensed to Myogen, which was subsequently acquired by Gilead Sciences. Flolan is marketed in the United States by Gilead Sciences and elsewhere by GlaxoSmithKline.

Antithrombotics (thrombolytics, anticoagulants and antiplatelet drugs) (B01)

Vitamin K antagonists	Acenocoumarol • Clorindione • Coumatetralyl • Dicoumarol (Dicumarol) • Diphenadione • Ethyl biscoumacetate • Phenprocoumon • Phenindione • Tioclomarol • Warfarin

Heparin group	Antithrombin III • Danaparoid • Heparin • Sulodexide • low molecular weight heparin (Bemiparin, Dalteparin, Enoxaparin, Nadroparin, Parnaparin, Reviparin, Tinzaparin)

Glycoprotein IIb/IIIa inhibitors	Abciximab • Eptifibatide • Tirofiban

Other platelet aggregation inhibitors	Acetylsalicylic acid/Aspirin • Aloxiprin • Ditazole • Carbasalate calcium • Cloricromen • Dipyridamole • Indobufen • Picotamide • Triflusal • ADP receptor inhibitors (Clopidogrel, Ticlopidine, Prasugrel) • prostaglandin analogue (Beraprost, Prostacyclin, Iloprost, Treprostinil)

Enzymes	plasminogen activators (Alteplase/Reteplase/Tenecteplase, Streptokinase, Urokinase/Saruplase, Anistreplase, Monteplase) • other serine endopeptidases (Ancrod, Drotrecogin alfa/Protein C, Fibrinolysin) • Brinase

Direct thrombin inhibitors	Argatroban • Bivalirudin • Dabigatran • Desirudin • Hirudin • Lepirudin • Melagatran • Ximelagatran

Other antithrombotics	Apixaban • Defibrotide • Dermatan sulfate • Fondaparinux • Idraparinux • Otamixaban • Ozagrel • Ramatroban • Rivaroxaban

Non-medicinal	Citrate • EDTA • Oxalate

Medications used in the management of pulmonary arterial hypertension (B01, C02)

Prostacyclin analogues	Beraprost, Epoprostenol, Iloprost, Treprostinil

Endothelin receptor antagonists	Ambrisentan, Bosentan, Sitaxsentan

PDE5 inhibitors	Sildenafil, Tadalafil

Adjunctive therapy	Calcium channel blockers, Diuretics, Digoxin, Oxygen therapy, Warfarin

Eicosanoids: prostaglandins

Endogenous/series 2	D₂ - E₂ (Dinoprostone) - F₂ (Dinoprost) - H₂ - I₂ (Prostacyclin)

Prostaglandin analogues	E: Alprostadil - Enprostil - Misoprostol F: Bimatoprost - Carboprost - Latanoprost - Travoprost I: Beraprost - Epoprostenol - Iloprost - Treprostinil

Source: adapted by the editor from Wikipedia, the free encyclopedia; from the article "Epoprostenol". Image Credit.

Domain	Definition
Health	A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. (references)
Source: compiled by the editor from various references; see credits.		Top

Topics by Level of Interest: EPOPROSTENOL
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Epoprostenol	17	Epoprostenol	17
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Specialty Definition: EPOPROSTENOL

Extended Definition: Epoprostenol

Epoprostenol

Clinical pharmacology

Administration

History

Marketing

Topics by Level of Interest: EPOPROSTENOL