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Flashcards in Drugs for Pulmonary HTN Deck (32)
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1

Who is the common demographic for pulmonary arterial HTN?

young women

2

What is the definition of pulmonary arterial HTN?

sustained elevation of mean pulmonary arterial pressure >25mmHg at rest 

3

What are the common s/s of pHTN?

DOE, fatigue, chest pain, tachycardia, 

syncope/near-syncope, edema, cyanosis 

4

What is the first gene linked to pHTN?

BMPR2

5

What common drug causes weight loss and pHTN?

fen/phen

6

What is the vasopressor test?

short acting vasodilator is administered

test is positive if PAP falls >10

MPAP <40

CO is unchanged or increased 

7

Some positive responders to the vasopressore test will achieve sustained functional improvement and prolonged suvival with what drug?

CCB 

but will be deleterious in non-responders 

8

What drugs do not help pHTN?

anticoagulants

diuretics 

O2 therapy 

9

What is the MOA of prostanoids?

promotes vascular relaxation 

increases cAMP 

10

What are the effects of prostanoids?

lowers pulmonary arterial resistance

decreases pulmonary arerial pressure 

increases exercise tolerance 

improves survival 

11

Epoprostenol has a (short or long) half life?

short half life 

must be given by IV continuously and kept cold 

12

What are some serious adverse effects of epoprostenol?

sepsis

life-threatening if pump problems ensue

13

What are the pharmokokinetics of treprostinil?

given SUBQ but caused too much pain, so given with IV pump 

longer half life, no refrigeration 

can do QID inhalation 

extended release oral form avaialble 

14

What are the adverse effects for Treprostinil?

sepsis

jaw pain

cough/throat irritation

15

How is iloprost administered?

 

What are some adverse effects?

inhalation 6-9x per day 

 

fainting from hyptension, jaw pain 

16

Selexipag is a prostanoid that can be administered (oral or IV)?

 

common adverse effect?

Orally, BID

is VERY expensive 

 

Jaw pain

17

Bosentan is an endothelin antagonist that blocks what?

blocks nonspecifically ETa and ETb receptors 

18

What are some toxicities of bosentan?

hepatotoxicity

teratogenesis 

accelerates warfarin metabolism and oral contraception

19

Ambrisentan is an endothelin antagonist that blocks what?

 

What are the main adverse reactions?

Eta selectively 

 

teratogenesis, no liver damage, does not interfere with warfarin, but still must use 2 forms of birth control (due to teratogenesis) 

20

Macitentan is an endothelin antagonist that has what benefit?

18hr half life allowing for once/day dosing 

21

Silidenafil blocks what?

 

what can it cause if combined with a-blockers or nitrates?

selectively blocks PDE 5 

 

can cuase significant hypotension

22

What is the MOA of Riociguat?

sensistizes sGC to endogenous NO by stabilizing the NO-sGC

increases cGMP to increase vasodilation 

23

If a pt with confirmed pHTN and has a positive vasoreactivty test, treat with what?

CCB

24

In patient with naive PHTN with WHO FC II and patient is able to tolerate combination therapy, treat with what?

If they are unable to tolerate combo therapy, treat with what?

Ambristentan and tadalafil 

 

Macitentan, ambisentan, riocguat, sildenafil, or tadalafil 

25

In pt with naive PAH with WHO FC III w/o evidence of rapid dz progression who is able to take combo theraoy, treat with what? 

 

If unable to take combo therapy?

Abrisentan an Tadalfil 

 

 

Monotherapy with macitentan, ambisentan, riociguat, sildenafil, or tadalafil 

26

In pt with naive PHTN with WHO FC III with evidence of rapid dz progression and able to take parenteral prostanoids, treat with 

 

IF unable to take parental prostanoids, take 

IV epoprosteonol, IV treprostinil, or SC treprostinil

 

 

 

inhlaed or oral prostanoid 

27

In pt with pHTN with WHO FC IV and able to take parenteral prostanoids, treat with waht?

If unable to take parentarel prostenoids, tx with 

IV epoprostenol, IV treprostinil, or SC treprostinil 

 

inhaled prostanoid  + oral PDE5 inhibitor and oral ET antagonist 

28

What is the most common pHTN drug combo?

Tadalafil + Ambrisentan 

29

What are the prostanoids?

Epoprostenol 

treprostinil

iloprost

selexipag 

30

What are the PDE5 inhibitors 

sildenafil

tadalafil