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Inhaled nitric oxide is a gas that is inhaled. [1] It was initially described in 1987 as an "endothelial-derived relaxing factor" and has since been used to treat pulmonary disorders. [3] It works by relaxing smooth muscle to widen (dilate) blood vessels, especially in the lungs. [1] Inhaled nitric oxide selects only pulmonary smooth muscles.
When used in combination with other anesthetics gases, nitrous oxide causes a dose dependent increased respiratory rate and decreased tidal volumes, the net effect is a lower minute ventilation. Like volatile anesthetics, it increases cerebral blood flow and intracranial pressure.
Common side effects when taken by mouth include nausea and itchiness. [2] When applied to the skin, common side effects include redness and a burning sensation. [2] In pregnancy, use on the skin or in the vagina is believed to be safe. [2] There is no evidence of harm when used by mouth during pregnancy but this has been less well studied. [2]
Nitric oxide dilates blood vessels, raising blood supply and lowering blood pressure. Conversely, it helps protect tissues from damage due to low blood supply . [ 8 ] Also a neurotransmitter , nitric oxide acts in the nitrergic neurons active on smooth muscle , abundant in the gastrointestinal tract and erectile tissue . [ 49 ]
Until the 1980s, nitric oxide, a product of fossil fuel combustion, was thought only to play a role the detrimental effects of air pollution on the respiratory tract. [17] In 1987, experiments with coronary arteries showed that nitric oxide was the long sought endothelium-derived relaxing factor .
Inhalation of pure nitrous oxide causes oxygen deprivation, resulting in low blood pressure, fainting, and even heart attacks. This can occur if the user inhales large quantities continuously, as with a strap-on mask connected to a gas canister or other inhalation system, or prolonged breath-holding. [citation needed]
Inhaled nitric oxide (iNO) acts on vascular smooth muscle causing selective pulmonary vasodilation. This is ideal in the treatment of PPHN as it causes vasodilation within ventilated areas of the lung thus, decreasing the ventilation-perfusion mismatch and thereby, improves oxygenation.
Once nitric oxide is converted to nitrates and nitrites by oxygen and water, cell signaling is deactivated. [31] The endothelium (inner lining) of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, resulting in vasodilation and increasing blood flow. [30] Sildenafil (Viagra) is a drug that uses the nitric oxide ...
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