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epoprostenol, e-poe-prost-en-ole, belongs to a group, agents, prostaglandins, prostaglandins occur naturally, involved in many biological functions, epoprostenol, treat the symptoms, primary pulmonary hypertension, the high blood pressure that occurs, main artery that carries blood from the right side, the heart, the ventricle, to the lungs, when the smaller blood vessels, lungs become more resistant to blood flow, the right ventricle, must work harder to pump enough blood through the lungs, epoprostenol works by relaxing blood vessels and increasing the supply, blood to the lungs, reducing the workload, the heart, dosage forms, parenteral, injection, using the medicine, weighed against the good it will do, for epoprostenol, allergies tell my health care professional, allergic to any other substances, foods, preservatives, dyes, epoprostenol has not been studied in pregnant women, epoprostenol has not been shown to cause birth defects , other problems in animals, not recommended for use in pregnant women unless absolutely necessary, pregnant, may become pregnant, when breast-feeding , not known whether epoprostenol passes into breast milk, most medicines pass into breast milk in small amounts, used safely while breast-feeding , mothers, taking this medicine and who wish to breast-feed, children although, in children with use in other age groups, is not expected to cause different side effects, problems in children, in adults, haven't been studied specifically in older people, problems in older people, epoprostenol, elderly with use in other age groups, an interaction might occur, change the dose, health care professional know, taking any prescription, nonprescription, over-the-counter, otc, other medical problems, epoprostenol, any other medical problems, heart disease , lung disease, epoprostenol may make these conditions worse, nurse will teach you, prepare the medicine and use the pump for administering the medicine, epoprostenol, administered continuously by a portable pump that is operated by a small computer, the medicine will be delivered directly to the heart through a catheter that will be inserted into a vein, chest, epoprostenol should be reconstituted only with the sterile diluent that is supplied with this medicine, the reconstituted medicine should not be mixed with other solutions, use the following procedure for reconstituting my daily supply, clear an area to work in and clean the area with alcohol, gather my supplies, wash my hands thoroughly with soap and water and then open all packages, remove the vial cap from the vial containing the sterile diluent, clean the tops, the vials with alcohol swabs, let the vial tops dry before proceeding, to withdraw the sterile diluent, not already attached, attach a needle to the syringe, gently pull the plunger out slightly and push it back to break the syringe seal, draw air into the syringe that is about equal to the amount, sterile diluent you've been instructed to withdraw from the vial, insert the needle at an angle, completely through the rubber seal, the vial, turn the vial and syringe upside down, the syringe-vial unit is now vertical, carefully press the plunger, injecting some, all, the air into the vial, then aim the tip, the needle into the fluid and carefully pull the plunger slowly back to withdraw the diluent and/or allow the pressure to fill the syringe with the diluent, continue pushing the remaining air into the vial, allowing the liquid to enter the syringe until the prescribed amount, diluent has been drawn into the syringe, without withdrawing the needle, tap the syringe gently so that any air bubbles trapped, syringe rise toward the top, the syringe, air bubbles appear, depress the plunger gently to force the air bubbles out, into the vial, then withdraw enough additional diluent to restore the needed volume, syringe, holding the syringe-vial as a unit in a vertical position and keeping the needle tip, fluid while withdrawing the diluent may help minimize the amount, air drawn into the syringe, once the required volume has been drawn into the syringe, let the syringe-vial pressure equalize and slowly withdraw the needle from the vial, to reconstitute the epoprostenol, insert the same needle through the rubber seal, the vial, epoprostenol and inject the sterile diluent gently onto the side, the vial, the flow, the sterile diluent should be directed toward the side, the vial and injected slowly in order to prevent the medicine from foaming, once the pressure has equalized, withdraw the needle from the vial, gently swirl the vial to mix the epoprostenol, turn the vial upside down to catch any undissolved powder near the top, the vial, never shake the vials, repeat this process if you need to mix more than one vial, epoprostenol, to draw out the reconstituted epoprostenol, wipe the top, the reconstituted epoprostenol vial with an alcohol swab and let it dry, change the needle on the syringe and then gently pull back the syringe plunger and fill the syringe with the amount, air that is equal to the amount, reconstituted epoprostenol you, instructed to withdraw, insert the needle through the seal, the vial and inject the air into the vial, be sure to keep the needle tip below the fluid line and then pull the plunger back gently to withdraw the reconstituted epoprostenol into the syringe, remove any air, trapped, syringe as described above, withdraw the needle and replace the needle cap on the syringe, to inject the reconstituted epoprostenol into the cassette, remove the end cap from the cassette tubing, carefully remove the needle from the syringe, be sure to discard the needle in an appropriate manner, attach the syringe to the cassette tubing, hold the cassette in one hand and push the plunger to inject the reconstituted solution into the cassette, alternatively, may find it useful to use a tabletop, other solid structure to steady the plunger while pushing down on the syringe to inject the solution, when the syringe is empty, clamp the cassette tubing near the syringe, disconnect the syringe and replace the cassette tubing end cap, to inject the remaining diluent into the partially filled cassette, using a 60 ml syringe, attach a new needle to the syringe and follow, procedures for breaking the syringe seal and wiping the tops, the sterile diluent vials, fill the syringe with the amount, air that is equal to the amount, sterile diluent you will remove from the first vial, insert the needle through the rubber seal and slowly inject some, the air into the vial, allowing the fluid to flow into the syringe, continue to push air gently into the vial until all, the fluid, vial has flowed into the syringe, remove any air, syringe as described above, allow the pressure to equalize before you pull the needle out, may lose fluid from the syringe, the whole process needs, repeated, withdraw the needle and replace the needle cap on the syringe, may find it easier to hold the larger syringe in an upside down, vertical position while withdrawing the fluid, vial, to inject the sterile diluent into the cassette, uncap the clamped cassette tube and carefully remove the needle from the syringe, discarding the needle in an appropriate manner, attach the syringe to the cassette tubing, unclamp the cassette tubing and carefully inject the solution into the cassette, when the syringe is empty, clamp the cassette tube near the syringe and disconnect the syringe, replace the cap on the cassette tube, more diluent is needed to fill the cassette, repeat steps 6 and 7 with an additional vial, diluent, after completing the transfer, all, the required diluent, clamp the tubing, leave the syringe attached to the cassette tubing while you mix the solution, gently turn the cassette upside down at least 10 times to thoroughly mix the reconstituted epoprostenol with the additional diluent, to remove air from the cassette, to remove the air from inside the cassette, slowly turn the cassette until all, the small bubbles, air join to form one air pocket, tilt the cassette gently so that the air pocket is, corner where the tubing connects to the cassette, unclamp the tube and pull back the plunger, the syringe until you see fluid fill the tubing, clamp the tube near the connector and remove the syringe and replace the cap on the tubing, label the cassette with the current time and date, store the cassette, refrigerator, preferably, the top shelf to avoid spilling any food, drink on it, until, time to use it, make up a new cassette each day and use the cassette you refrigerated the day before so, will always have a back-up cassette, to use the pump, the instructions for the use, the pump may vary depending on the particular make and model, the pump, nurse will give detailed instructions on, use and care for the particular pump and accessories, will use for administering my medicine, instructions should, change the pump battery, cassette, tubing, remember to change the gel packs every 12 hours, every 8 hours if the surrounding temperature approaches 86 °f, maintain sterile technique at all times, suspect, have contaminated anything, throw away the accessories and begin again, epoprostenol will be different for different patients and will be determined by a physician, medicine you take, increased gradually by a physician, must never be stopped suddenly, follow a physician's orders, the directions on the label, the average doses, epoprostenol, dose is different, take depends on the concentration, the reconstituted medicine, rate at which the infusion pump delivers the medicine, for injection, dosage form, for primary pulmonary hypertension and pulmonary hypertension secondary to scleroderma spectrum, disease, initially, 2 nanograms per kilogram, 0.9 nanogram per pound, body weight per minute, a physician may increase my dose as necessary, missed dose epoprostenol has, administered by a continuous intravenous infusion, must never be stopped suddenly, keep out of a child's reach, do not keep outdated medicine, medicine no longer needed, discarded medicine is out of a child's reach, unopened vials, store unopened vials away from heat and direct light, keep the medicine, diluent from freezing, do not store unopened vials, in other damp places, heat, moisture, the medicine to break down, reconstituted injection, store the reconstituted injection, refrigerator, away from direct light, keep the medicine from freezing, any medicine that has been frozen should be thrown away, reconstituted solutions should be kept either, refrigerator, in a cold pouch, a combination, the two, for no more than 48 hours, do not expose reconstituted solution to temperatures higher than 25 °c, 77 °f, the reconstituted solution has particles in it, is discolored, it should be discarded, precautions, know the side effects, important that a physician check my progress at regular visits, this will allow a physician to make sure the medicine is working properly, change the dosage, be sure to report any signs, infection at the catheter site to a physician, develop a sudden fever, contact a physician, avoid the use, saunas, hot baths, sunbathing, other situations, blood vessels to dilate, resulting in low blood pressure and increasing the possibility, dizziness , light-headedness, fainting, do not suddenly stop using this medicine, stopping suddenly may bring on symptoms, condition, be dangerous, check with a physician before stopping completely, carry a medical identification card stating, side effects, along with its needed effects, some unwanted effects, side effects may occur, may need medical attention, check with a physician immediately, side effects occur, signs and symptoms that can occur with initial dosage adjustments and/or dosage excess, diarrhea, fast heartbeat, headache, light-headedness, fainting, nausea, redness, face, neck, flushing, vomiting, side effects occur, anxiety and/or nervousness, diarrhea, dizziness , flu, infection-like symptoms, chills, confusion, delirium, light-headedness, fainting, fast heartbeat, fever, /or rapid, shallow breathing, headache, jaw pain, when chewing, local infection at the catheter site, pain at injection site, pain in muscles, bones, redness, face, flushing, unusual bleeding, nosebleeds, bleeding gums, bruising, altered, abnormal touch sensation, sensitivity, stop using this medicine abruptly, dosage is reduced suddenly, symptoms, condition may recur, medicine is suddenly stopped, reduced, check with a physician immediately, especially if, side effects occur, labored breathing, dizziness , fainting, weakness, other side effects, brand names, flolan, flolan, other commonly used names are prostacyclin; pgi₂; pgx, category antihypertensive, pulmonary, vasodilator