Nesiritide (Brain Natriuretic Hormone) – Part 4
Of interest to clinicians is that patients with elevated levels of endogenous BNP act as though they have a low level phyisologically – they are vasoconstricted instead of the expected vasodilated and sodium avid instead of in sodium retention. So, while patients in heart failure for some reason have not responded to their own elevated levels of BNP, they will respond to exogenously administered BNP.
It is typically given as an initial intravenous bolus of 2 mcg/kg and is followed by a continous infusion of 0.01 mcg/kg/min which may be increased to a maximum rate of 0.03 mcg/kg/min. There is no dose adjustment for renal insufficiency. The drug begins working within the first hour after administration and for up to 6 to 24 hours after discontinuation.
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