Viagra in the NICU

NicuGal, MSN, RN · May 6, 2002

Uh..no...we still use good ole nitric

KRVRN, BSN, RN · May 8, 2002

I've heard of it, but don't know any details.

shanzo89 · May 9, 2002

Read this on the Discovery channel about viagra, hope this helps!

Viagra, Potential for Newborn Lung Disorder

04/27/2002-NEW YORK (Reuters) - New animal research suggests that the impotence drug Viagra could help treat a life-threatening lung condition in newborns.

Scientists in the UK and Denmark found that the drug, when given intravenously, helped treat animals with a condition simulating persistent pulmonary hypertension of the newborn (PPHN).

PPHN is a potentially fatal condition in which the newborn lungs resist blood flow, cutting the circulation of oxygen in the body. Treatment includes therapies aimed at lowering blood vessel resistance in the lungs, such as inhaled nitric oxide.

In the new study, researchers found that intravenous Viagra--known generically as sildenafil--was "at least as effective" as inhaled nitric oxide in relaxing and dilating pulmonary blood vessels. Sildenafil treats impotence by relaxing smooth muscle and increasing blood flow to erectile tissue.

Dr. Lara S. Shekerdemian, of Great Ormond Street Hospital in London, and her colleagues report the findings in the April issue of the American Journal of Respiratory and Critical Care Medicine.

The researchers studied a group of piglets with a PPHN-like condition, all of which were given either IV sildenafil, inhaled nitric oxide or no treatment. Within one hour, sildenafil treatment completely reversed the animals' increased vascular resistance in the lungs, the report indicates. Both treatments reduced pulmonary resistance without changing blood pressure in the rest of the body.

According to the study authors, their findings suggest that sildenafil "may play an important role in the treatment of neonatal PPHN." They note that the IV administration may be "ideal" in unstable newborns.

The study was funded by the Institute of Child Health in London, and the University of Aarhus in Denmark.

donnuchi · May 9, 2002

I attended The National Conference of Neonatal Nursing in Anaheim, CA last month. Two of the physicians mentioned the use of Viagra with PPHN as a possible up and coming study. They did not state which hospitals would be studying this. Can you imagine asking parents for consent?

zumalong · May 9, 2002

Not being a OB nurse or even close to any persons under the age of 20, (at work) I have wondered how they do any research on preemies. I could not imagine having to ask the parent(s) to try this experimental viagra on their newborn.

Do they present it in generic form so that the parents don't recognize the drug. Do they even tell the parents the name of experimental medication????

I can remember when my 18mo old was in ED because we did not know if he got into his grandfather's meds. It was awful. They had given him the activated charcoal enroute to ED. We had to sit for 12 hours and wait and see if he had any symptoms or ekg changes. At about 8 hours the attending came over to my hubby and I and said that chances of him taking anything were probably nil since he was showing no symptoms. He told us to wait another couple of hours, and then we could go home.

The next thing I know a resident comes up to me and wants to know if I want to participate in a Activated charcoal study that has the charcoal flavored with strawberry. When I questioned him why he was receiving more charcoal when the attending told us our son was not going to need more treatment, he stumbled over his tongue then tried to tell me it was new order that was written. Being the assertive (aggressive for my kids) nurse that I am, I questioned the nurses. There was NO order ever written for him to receive any activated charcoal since his admission. :nono:

I imagine that if I had not questioned the orders or if I did not have any medical experience, that my son would have been exposed to the charcoal. This is what is scary--charcoal is one thing--but what if it had been some experimental drug. I know that there are ethical considerations--but I just wonder how closely some practice under this. (we had a young 18 yr old die at the same hospital during a research study--it was quickly hushed up by the hosp;)

:coollook:

Well now that I have stated my paranoia of the day, I think that I am going to take a shower.

. . ULG!!! I must not close my eyes while I am showering........... :eek:

lily0004us · May 10, 2002

imakidnurse · May 10, 2002

Thank you so much for your input. Especially Shanz and Donn for all the info. I work in a teaching facility, but never heard of it before now. In response to Zum, I have seen many studies in our facility and it does pose some of those same questions. You like to think that the doctors are being honest and open with the parents, but unfortunately that isn't always true.

nell · May 18, 2002

Ugh! Gees... first Survanta and what that stuff looks like, now Viagra....An old Nun just isn't safe from being grossed out in the NICU anymore!

prmenrs, RN · May 19, 2002

It's not just a job, it's an adventure every day! We use Nitric and we're in a study protocol using surfactant for MAS, I think.

My only concern is how we're gonna keep the Viagra safe from the attendings (at least the male ones)!! :roll: I didn't even know they made it IV!!!

nell · May 19, 2002

I didn't even think of the potential diversion problem! We already have a problem with getting Survanta (and Epo) from the pharmacy (do they think we're going to sell it on the black market? :confused: ) I bet we'll have to treat the Viagra like a narcotic.

Adele4012 · Jun 25, 2002

The NICU I work in isn't talking about Viagra yet. I still don't understand how it works but if it helps with PPHN then bring it on.

I'm curious of statistics on how it works and if it works. Anyone else know anything new? :confused: