Oxygen Therapeutic Agents

Oxygen Therapeutic Agents

Hemoglobin-Based Oxygen Carriers

  • Cell-free solutions of hemoglobin extracted from RBC’s.
  • Unstable, short ½ life, removed by reticuloendothelial system, less effective oxygen transporter, vasoconstrictor.

Perfluorochemical Solutions (Fluosol)

  • Low concentration (10%), short ½ life, instability required frozen storage, FDA approved for distal perfusion during PTCA only. Production stopped late 1990’s due to low demand.
  • Perflubron: New 90% concentration, but emulsion is cleared in 24-36 hours. Repeat dosing results in hepatosplenomegaly and 15-25% reduction in platelet count.
  • Optison: Ultrasound contrast agent.

Allosteric Modifiers of Hemoglobin

  • Two lipid lowering drugs, clofibrate and benzofibrate, decrease hemoglobin’s affinity for oxygen in vitro; potentially increasing oxygen release to tissues. This allosteric effect is inhibited by serum albumin in vivo.
  • RSR13: Drug designed to affect the allosteric modification of hemoglobin without inhibition by albumin. By shifting the oxygen dissociation curve to the right, it necessitates the use of supplemental oxygen to maximize the arterial hemoglobin oxygen saturation. Transient increase in serum creatinine was noted in early human studies.

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