II. Background

  1. Janssen Pharmaceuticals discontinued Nesiritide production in U.S. in 2018

III. Indications

  1. Decompensated Congestive Heart Failure

IV. Mechanism

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

V. Dosing

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

VI. Efficacy

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

VII. Monitoring

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

VIII. Adverse Effects

  1. Hypotension
  2. Headache
  3. Nnausea
  4. Back pain

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