A neonate with transposition of the great arteries requires emergency management before surgery. Which drug maintains patency of the ductus arteriosus to sustain mixing and survival?
- A Indomethacin
- B Prostaglandin E1 (alprostadil) ✓
- C Ibuprofen
- D Aspirin
Correct answer: B. Prostaglandin E1 (alprostadil)
Explanation
Prostaglandin E1 (alprostadil) keeps the ductus arteriosus patent by stimulating EP2 and EP4 prostaglandin receptors, maintaining smooth muscle relaxation. This is critical in ductal-dependent congenital heart lesions like transposition of the great arteries to sustain systemic-pulmonary mixing. Indomethacin and ibuprostaglandin synthesis and are used to CLOSE the ductus arteriosus, making them contraindicated here.
Reference: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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