Details of Drug Interaction | MecDDI

Drug General Information (ID: DDIW0VHD4B)
Drug Name			Tolazoline		Drug Info		Nesiritide		Drug Info
Drug Type		Small molecule				Hormones
Therapeutic Class		Vasodilator Agents				Recombinant Natriuretic Peptide
Structure

Mechanism of Tolazoline-Nesiritide Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph

Drug Name		Tolazoline				Nesiritide
Mechanism		Antihypertensive agent Alpha-1 adrenergic receptor Antagonist				Antihypertensive agent Guanylate cyclase Agonist
Key Mechanism Factor 1
		Factor Name		Adrenergic receptor alpha-1				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		This alpha-adrenergic receptor mediates its action by association with G proteins that activate a phosphatidylinositol-calcium second messenger system. Its effect is mediated by G(q) and G(11) proteins. Nuclear ADRA1A-ADRA1B heterooligomers regulate phenylephrine(PE)-stimulated ERK signaling in cardiac myocytes. Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions. Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Tolazoline and Nesiritide

Recommended Action
Management		Whether used alone or with other agents, nesiritide should be administered only in settings where blood pressure can be closely monitored. The dosage should be reduced or the drug discontinued in patients who develop hypotension.

References
1	Product Information. Natrecore (nesiritide) Scios Inc, Sunnyvale, CA.