A neonate with suspected duct-dependent congenital heart disease is started on intravenous prostaglandin E1. Nursing staff must be prepared for which important dose-related adverse effect?

• A Severe hypertension
• B Apnoea requiring ventilatory support ✓
• C Hyperkalaemia
• D Bradycardia unresponsive to atropine

Explanation

Prostaglandin E1 commonly causes fever, flushing and hypotension, and its most dangerous dose-related effect is apnoea, particularly at higher infusion rates, so facilities for intubation must be available when starting the drug. Long-term therapy can cause cortical hyperostosis. Hypertension and hyperkalaemia are not recognized effects, and tachycardia rather than bradycardia is typical, which eliminates those distractors.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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