pulmonary hypertention

8 terms by honeygobears 

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Epoprostenol (Flolan®)

Prostacyclin Analogues for class III and first line class IV and catheter
SE: Nausea, vomiting, headache, jaw pain, flushing, hypotension, bradycardia, reflex tachycardia (at higher doses), flu-like symptoms
Antiplatelet effect Line infections, sepsis, catheter obstruction

CI: Development of pulmonary edema, CHF due to severe L ventricular systolic dysfunction

Portable infusion pump --- pump failure ordislodging can result in rebound pulmonary hypertension and possible death medical emergency unstable at room temperature a

Treprostinil

SQ or IV no oral class 2-4

SE: Nausea, vomiting, headache, jaw pain, flushing, hypotension, bradycardia, reflex tachycardia (at higher doses), flu-like symptoms
Antiplatelet effect Line infections, sepsis, catheter obstruction (with IV formulation), infusion-site pain/swelling (with SQ formulation)

Safer, more convenient, and less temperature-labile than epoprostenol Portable pump

inhaled treprostini

class 3
SE same as others, pro throat irritation cough

lloprost

protable neubulizer /inhale
class 3 and 4
syncope SBP<85mmHg
cough,flusing,flu-like syndrome,jaw pain, bronchospasms, antiplatlet effects
neb adaptive aerosol delivery system

sildenafil/tadalafil

act like NO sustain cGMP
class 1,2,3
cause flushing, HA, heartburn, muscle aches, vision (rare). vasorelaxation

Bosentan 2C9 3A4

endotherial receptotr antagonist

2-4
FDA black box warning for hepatic toxicity, monthly LFTs
Pregnancy category X monthly pregnancy test, two methods of contraception (except IUD) during and one month after stopping bosentan therapy in females of childbearing potential
Headache, flushing, peripheral edema, decreased sperm count, angioedema
Anemia: monitor hematocrit every 3 months

ambrisentan 3A4 2C19

endptherial receptor antgaonist

adjunct therapies

treatment of HF digoxin diuretics oxygen chronic anticoagulation warfarin
limit Na intake and get immunized

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