How Do Patent Ductus Arteriosus Agents Work?

Patent ductus arteriosus (PDA) agents are prostaglandin inhibitors used to treat PDA in the neonate and in premature infants. PDA is an opening between two blood vessels leading from the heart. Ductus arteriosus (communication between two major blood vessels of the heart, thoracic aorta [carries oxygenated blood], and pulmonary artery [carries deoxygenated blood]) is normal in fetal circulation and usually closes shortly after birth, and if it remains open (patent), it is called a PDA.

PDA agents work by blocking an enzyme cyclooxygenase that is essential for the synthesis of prostaglandins derived from the metabolism of arachidonic acid. Prostaglandins are responsible for maintaining the patency of the ductus arteriosus and the ductus closes when this prostaglandin effect is withdrawn.

Surgical ligation of PDA is performed when pharmacological closure fails, or PDA recurs.

Intravenous PDA agents are used for pharmacological closure of PDA in the neonate and in premature infants.

The most common side effects of PDA agents include:

• Severe hypoxia (decrease in oxygen supply to the tissues)
• Transient oliguria (production of urine is decreased abnormally for a short period of time)
• Renal toxicity (decreased renal function caused by toxic nature of the drug)
• Decrease in cerebral, mesenteric (peritoneal fold that attaches the stomach, small intestine, and other organs to the posterior wall of the abdomen), and renal blood flow.
• Altered platelet function
• Increased bleeding tendency
• Necrotizing enterocolitis (infection and inflammation that destroys the wall of the intestine, typically seen in premature infants)
• Pulmonary hypertension (increased blood pressure in the arteries of the lung and the right side of the heart)
• Severe lung disease (scarring of lung tissue causing long-term breathing problem in premature infants)

Drug names include:

• Advil
• Ibuprofen
• Motrin
• PediaCare Children's Pain Reliever/Fever Reducer IB
• PediaCare Infant's Pain Reliever/Fever Reducer IB