A premature infant is born with a patent ductus arteriosus. Its closure can be stimulated by administration of –
**Core Concept**
The patent ductus arteriosus (PDA) is a congenital heart defect characterized by the failure of the ductus arteriosus to close after birth, leading to abnormal blood flow between the pulmonary artery and the aorta. Prostaglandins, particularly prostaglandin E2 (PGE2), play a crucial role in maintaining the patency of the ductus arteriosus.
**Why the Correct Answer is Right**
The administration of indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), can stimulate the closure of the patent ductus arteriosus. Indomethacin inhibits the production of prostaglandins, specifically PGE2, which are responsible for maintaining the patency of the ductus arteriosus. By reducing prostaglandin levels, indomethacin promotes the closure of the ductus arteriosus, which is essential for normal fetal circulation and postnatal adaptation.
**Why Each Wrong Option is Incorrect**
**Option A:** Furosemide, a loop diuretic, is used to treat fluid overload in patients with heart failure but does not have a role in stimulating the closure of the patent ductus arteriosus.
**Option B:** Dopamine, a catecholamine, is used to support blood pressure and cardiac output in critically ill patients but does not affect ductus arteriosus closure.
**Option C:** Atropine, an anticholinergic agent, is used to treat bradycardia and has no effect on ductus arteriosus closure.
**Clinical Pearl / High-Yield Fact**
The closure of the patent ductus arteriosus is often delayed or incomplete in premature infants, leading to persistent pulmonary hypertension and increased risk of respiratory distress syndrome. Early detection and treatment of PDA are crucial to prevent long-term complications.
**Correct Answer:** C. Indomethacin is a commonly used medication to stimulate the closure of the patent ductus arteriosus in premature infants.