II. Indications

III. Mechanism

  1. Recombinant Human Brain Natriuretic Peptide
  2. Results in venous and arterial vasodilation

IV. Dosing

  1. Bolus: 2 mcg/kg IV bolus
  2. Maintenance: 0.01 mcg/kg/min for 24-48 hours

V. Efficacy

  1. Improves CHF symptoms
  2. Increases mortality within first 30 days
  3. Sackner-Bernstein (2005) JAMA 293:1900-5 [PubMed]

VI. Cost

  1. Typical course is 2 vials at $530 per vial

VII. Monitoring

  1. Blood Pressure during administration (Hypotension risk)
  2. Serum Creatinine

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Ontology: Nesiritide (C0054015)

Definition (NCI) Brain natriuretic peptide 32 (32 aa, ~3 kDa) is encoded by the human NPPB gene. This protein plays a role in the modulation of diuresis, vasorelaxation and secretion of renin and aldosterone.
Definition (NCI) A recombinant version of the cardiac neurohormone, human B-type natriuretic peptide (hBNP) produced by the ventricular myocardium. Nesiritide binds to natriuretic peptide receptors on vascular smooth muscle and endothelial cells, through which it triggers guanylate cyclase dependent signal transduction resulting in increase of intracellular concentrations of cGMP. This leads to smooth muscle cell relaxation causing arterial and venous dilatation.
Definition (MSH) A PEPTIDE that is secreted by the BRAIN and the HEART ATRIA, stored mainly in cardiac ventricular MYOCARDIUM. It can cause NATRIURESIS; DIURESIS; VASODILATION; and inhibits secretion of RENIN and ALDOSTERONE. It improves heart function. It contains 32 AMINO ACIDS.
Definition (PDQ) A recombinant version of the cardiac neurohormone, human B-type natriuretic peptide (hBNP) produced by the ventricular myocardium. Nesiritide binds to natriuretic peptide receptors on vascular smooth muscle and endothelial cells, through which it triggers guanylate cyclase dependent signal transduction resulting in increase of intracellular concentrations of cGMP. This leads to smooth muscle cell relaxation causing arterial and venous dilatation. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=434520&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=434520&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C47636" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Hormone (T125)
MSH D020097
SnomedCT 385678006, 385677001, 385680000, 385679003, 407059007
English Nesiritide (HBNP), 1,2-Dithia-5,8,11,14,17,20,23,26,29,32,35,38,41,44,47,50-hexadecaazacyclotripentacontane, Cyclic Peptide Derivative, L-Histidine, L-seryl-L-prolyl-L-lysyl-L-methionyl-L-valyl-L-glutaminylglycyl-L-serylglycyl-L-cysteinyl-L-phenylalanylglycyl-L-arginyl-L-lysyl-L-methionyl-L-alpha-aspartyl-L-arginyl-L-isoleucyl-L-seryl-L-seryl-L-seryl-L-serylglycyl-L-leucylglycyl-L-cysteinyl-L-lysyl-L-valyl-L-leucyl-L-arginyl-L-arginyl-, Cyclic (10-26)-disulfide, Human Brain Natriuretic Factor-32, Natriuretic factor-32, Natriuretic factor, brain, Brain Natriuretic Peptide, Natriuretic Peptide, Brain, Peptide, Brain Natriuretic, nesiritide (medication), nesiritide, Nesiritide, NESIRITIDE, Natriuretic Peptide, Brain [Chemical/Ingredient], b-type natriuretic peptide, brain natriuretic peptides, brain natriuretic peptide, b type natriuretic peptide, b type natriuretic peptides, brain natriuretic factor, type b natriuretic peptide, Brain Natriuretic Peptide 32, BNP(1-32), Human B-type natriuretic peptide (substance), BNP-32, B-Type Natriuretic Peptide, BNP 32, BNP Gene Product, Brain Natriuretic Peptide-32, Natriuretic Factor 32, Natriuretic Factor-32, Natriuretic Peptide Type B, Natriuretic Peptide Type-B, Natriuretic Peptide, B-Type, Natriuretic Peptide, Type-B, Natriuretic Peptide-32, Brain, Peptide-32, Brain Natriuretic, Type-B Natriuretic Peptide, Type B Natriuretic Peptide, Human B-type natriuretic peptide (product), Human B-type natriuretic peptide, Nesiritide (product), Nesiritide (substance), Brain natriuretic peptide (substance), Natriuretic Peptide B Type, B-type natriuretic peptide, Brain natriuretic peptide
Portuguese Peptídeo Encefálico Natriurético, Peptídeo Natriurético Encefálico, Peptídeo Natriurético Cerebral, Peptídeo Cerebral Natriurético, Nesiritida
Spanish Péptido Natriurético Encefálico, Péptido Encefálico Natriurético, péptido natriurético cerebral humano de tipo B, nesiritide (sustancia), nesiritide, nesiritida (sustancia), péptido natriurético humano tipo B (sustancia), Péptido Cerebral Natriurético, Péptido Natriurético Cerebral, nesiritida (producto), nesiritida, péptido natriurético humano tipo B (producto), péptido natriurético humano tipo B, péptido natriurético cerebral (sustancia), péptido natriurético cerebral, péptido natriurético tipo B, Nesiritida
Swedish Natriuretisk peptid, hjärna
Czech natriuretický peptid typu B, B-natriuretický peptid, natriuretický peptid B, BNP, mozkový natriuretický peptid, nesiritid
Finnish B-tyypin natriureettinen peptidi
French Facteur natriurétique de type B, BNP-32, Peptide cérébral natriurétique, Peptide natriurétique de type B, Nésiritide, BNP32, BNP (Brain Natriuretic Peptide), Peptide natriurétique cérébral, Produit du gène BNP
Russian NATRIIURETICHESKII PEPTID MOZGA, MOZGA GOLOVNOGO NATRIIURETICHESKII PEPTID, NATRIIURETICHESKII PEPTID MOZGOVOI, НАТРИЙУРЕТИЧЕСКИЙ ПЕПТИД МОЗГОВОЙ, НАТРИЙУРЕТИЧЕСКИЙ ПЕПТИД МОЗГА, МОЗГА ГОЛОВНОГО НАТРИЙУРЕТИЧЕСКИЙ ПЕПТИД
Japanese 脳性ナトリウム利尿ペプタイド, 脳性利尿ペプチド, ナトリウム利尿ペプチド-脳性, 脳ナトリウム利尿ペプチド, 脳内ナトリウム利尿ペプチド, ナトリウム利尿ペプチド-B型, クエン酸ネシリチド, 脳性ナトリウム利尿ペプチド, ネシリチド, ネシリチドクエン酸塩, B型ナトリウム利尿ペプチド
Polish Peptyd natriuretyczny mózgowy
Croatian MOŽDANI NATRIJURETSKI PEPTID, NATRIURETSKI PEPTID, MOŽDANI, NATRIJURETSKI PEPTID, MOŽDANI
Norwegian Natriuretisk faktor-32, Type-B-natriuretisk peptid, Natriuretisk peptid type-B, Nesiritid, Natriuretisk peptid, hjerne, Hjernenatriuretisk peptid, B-type natriuretisk peptid, BNP-32
German Gehirn, natriuretisches Peptid, Natriuretisches Peptid, Gehirn
Italian Peptide natriuretico del cervello

Ontology: Natrecor (C1170421)

Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116)
MSH D020097
French Natrecor
English natrecor, Natrecor
Norwegian Natrecor
Czech Natrecor