Nesiritide: a new drug for the treatment of decompensated XXXX .

@entity1 @entity64 @entity712 @entity1369 @entity452 @entity2232 @entity63 @entity1242 @entity3876 @entity299 @entity177 @entity10 @entity551 @entity972 @entity2661 @entity943
Nesiritide, a recombinant @entity1 B-type natriuretic peptide, is the first in a new drug class for the treatment of decompensated @entity712 . The drug binds to receptors in the vasculature, kidney, adrenal gland, and brain, and overcomes resistance to endogenous @entity3876 present in @entity1 with CHF. Nesiritide administration leads to a rapid and balanced vasodilatory effect, which results in a significant decrease in right and left ventricular filling pressures and systemic vascular resistance and at the same time in an increase in @entity64 volume and cardiac output without a change in heart rate. These early hemodynamic changes result in a rapid improvement in symptoms of @entity712 . In addition, nesiritide lowers @entity1369 , @entity2661 , and @entity2232 levels and its effect on the kidney leads to an increased natriuresis and diuresis without effect on serum @entity972 or renal function. Prior to its approval for clinical use, nesiritide was studied in 10 different clinical trials involving 941 @entity1 with moderate and severe CHF, including elderly @entity1 , @entity1 with both @entity299 , and @entity1 with @entity943 , @entity177 , and @entity63 . In comparative studies with available vasoactive therapies frequently used for treatment of @entity1 with decompensated @entity712 , nesiritide was proven comparable in efficacy to inotropic drugs such as @entity452 , but superior in safety. In a recent study, nesiritide was found to be more effective and better tolerated than the vasodilator, @entity1242 . The most common side effects expected with the use of nesiritide are @entity10 and decrease in blood pressure. At the recommended dose of nesiritide, @entity10 was reported during the first 24 hours of treatment in 8% of @entity1 and symptomatic @entity551 in 4% of @entity1 , compared to 20% and 5% in @entity1242 -treated @entity1 .
