Nesiritide

Indications:

• Treatment of acutely decompensated congestive heart failure in patients who present with dyspnea at rest or with minimal exertion.

Mechanism of Action: Nesiritide works by binding to guanylate cyclase receptors in vascular smooth muscle and endothelial cells. This leads to increased intracellular concentrations of cyclic guanosine monophosphate (cGMP). Elevated cGMP levels cause vasodilation, which helps reduce the preload and afterload on the heart, leading to improved cardiac function. Additionally, nesiritide promotes natriuresis and diuresis, which can help alleviate fluid overload in heart failure patients.

Pharmacokinetics:

• Absorption: Administered intravenously; its onset of action is rapid.
• Distribution: Distributes in plasma and extracellular fluid.
• Metabolism: Cleared via enzymatic degradation and renal mechanisms.
• Excretion: Urinary excretion.

Form: Nesiritide API is usually available as a lyophilized powder for reconstitution.