Nesiritide

Nesiritide

Nesiritide is a recombinant DNA-derived type of human B-type natriuretic peptide (hBNP) used in the treatment of congestive heart failure. It is a 32-amino acid peptide that is structurally identical to the naturally occurring human B-type natriuretic peptide, which is secreted by the ventricles of the heart in response to excessive stretching of heart muscle cells (cardiomyocytes).

Mechanism of Action

Nesiritide works by binding to the atrial natriuretic peptide receptor (ANPR-A) in the heart and blood vessels. This binding leads to an increase in the intracellular molecule cyclic guanosine monophosphate (cGMP), which serves as a second messenger for several important cellular functions, such as dilation of blood vessels and inhibition of the release of aldosterone. This results in decreased blood pressure, decreased systemic vascular resistance, and increased natriuresis (excretion of sodium in the urine).

Clinical Use

Nesiritide is used in the treatment of patients with acutely decompensated congestive heart failure who have dyspnea at rest or with minimal activity. It is administered intravenously and has a rapid onset of action. The use of nesiritide has been associated with improved hemodynamics and symptom relief in patients with acute decompensated heart failure.

Side Effects

Common side effects of nesiritide include hypotension (low blood pressure), headache, nausea, and renal impairment. Serious side effects may include kidney failure and allergic reactions.

History

Nesiritide was approved by the Food and Drug Administration (FDA) in 2001. It was developed by Scios Inc., a subsidiary of Johnson & Johnson.

See Also

• Heart failure
• Natriuretic peptide
• Recombinant DNA