What is Remodulin Pump for Pulmonary Hypertension?

Pulmonary hypertension is not a common disorder. Around 1% of the global population is affected by this disease. The condition of this disease is worse over time as treatment is not supportive in many individuals. However, certain drugs like vasodilator and oxygen therapy can minimize the symptoms and improve quality of life. Remodulin is the most prescribed vasodilator medication used by pulmonary hypertension patients. It is a synthetic analog of prostacyclin, chemically known as treprostinil, which is sold under the trade names as Remodulin for infusion, Orenitram for oral, and Tyvaso for inhalation.

What is Remodulin Pump for Pulmonary Hypertension?

What is Remodulin Pump for Pulmonary Hypertension?

Remodulin pump is a small implantable pump used by patients for intravenous infusion therapy with Remodulin. This pump is weightless, easy to program, and routinely can be used. It is a revolutionary development for pulmonary hypertension patients.

Remodulin is approved by FDA organization in the USA. It is used in adult patients who had New York Heart Association (NYHA) Class I, II and III pulmonary arterial hypertension. These patients immediately require intravenous delivery of Remodulin. It stops the narrowing of the pulmonary arteries, help in supply of blood to the lungs, and keep a patient’s blood pressure within a healthy range.

Remodulin is infused continuously in patient’s body with the help of catheter and pump. It is usually done by intravenous infusion or subcutaneous infusion methods.

In intravenous method, the pump has a long intravascular catheter tube inserted directly to veins at the region between the superior vena cava and the heart. Only skilled surgeon can do this process and the pump is placed under the skin in abdominal region. The pump is referred as implantable system, which has reservoir i.e. 20 ml or 40 ml of drug can be stored. In addition, it has silicone septum on the top of the device. If the reservoir runs low volume of drug, with the help of physicians it can be refilled using simple injection via silicone septum. The IV infusion of Remodulin has been associated with the risk of blood stream infections, arm swelling, tingling sensations, bruising, and pain. Other common side effects seen with IV Remodulin were headache, diarrhea, jaw pain, nausea, vasodilatation (widening of the blood vessels), and edema (swelling). In subcutaneous method, the catheter is small, instead of insertion in heart it is inserted under the skin, generally in the abdominal (stomach) area. The pump for subcutaneous method usually is worn outside the body like a cell phone and delivers medicine.

In many advanced devices, pumping comes with programmer and alarm system. Alarm helps in refilling the Remodulin and programmer helps in flow rate control. Every once in 15 or 28 days, refilling process is done. The pump remains permanently implanted and the health care provider uses a needle and syringe refill kit to refill the pump with Remodulin as needed.

Remodulin (Treprostinil) must be diluted with either sterile water or a 0.9% sodium chloride solution earlier to infusion. In case new patient, Remodulin is administered at 1.25 ng/kg/min and if any adverse effect is noted in the patient it may be reduced to 0.625 ng/kg/min. A compact and lightweight pump is available to both those using Remodulin intravenous and Remodulin subcutaneous.

Remodulin should not be used in the patient who has NYHA Class IV heart failure condition. It is not recommended for patients, who unable to tolerate a sudden cessation of Remodulin therapy or suspected infection like bacteremia. Doctors’ wont implant the device if the patients has poor would heal ability, or susceptible to infection. It is also a tedious procedure in patients whose body size is not sufficient to accept pump bulk and weight. Remodulin is risk associated drug, it may cause excess bleeding and reduce the function of the anti-coagulant. So, the precaution is necessary for heart patients who take blood thinners. Pregnant, breast-feeding, or women who planning to become pregnant must consult doctor before taking Remodulin. Precaution is required when administering Remodulin to patients who have weakened kidney or extreme liver dysfunction.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 5, 2018

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