Treatment for a patent ductus arteriosus in neonates?

• A. Lisinopril
• B. Indomethacin
• C. Propranolol
• D. Digoxin

Answer: (B)

Indomethacin closes a patent ductus arteriosus by lowering prostaglandin levels. It inhibits cyclooxygenase, reducing prostaglandin E2, which normally keeps the ductus arteriosus open after birth. With less PGE2, the smooth muscle of the ductus constricts and the vessel closes—an effect that is especially reliable in premature neonates. This medical approach is typically preferred for closing PDA and can be started IV in the NICU; ibuprofen is another NSAID used similarly. Watch for side effects like reduced renal perfusion and feeding intolerance.

The other drugs don’t close the PDA. Lisinopril (an ACE inhibitor) lowers blood pressure but doesn’t promote ductal constriction. Propranolol, a beta-blocker, does not induce closure. Digoxin improves cardiac contractility for congestion but does not close the ductus.