Pulm Htn Flashcards
5 ph groups
1, pah 2 leftsided 3 lung disease or hypoxia 4 cteph 5. Misc(sarcoid compression of pa etc).
Define pah
Mean > 25 pasp 35
Wedge <15 if primary
Drugs that cause Pulm Htn
Diet drugs, l tryptophan, rapeseed oil
Rate of ph in sickle cell
10-30%
Negative trial with sildenifil
Three pathways in ph
Prostacyclins, nitric oxide, endothelin pathway.
Define class iv in Pulm Htn
Same as HF or syncope
Predictors of poor prognosis in Pulm Htn
6 min walk less than 300, pericardial infarction, rap greater than 20, who class iv, rapid tempo of decline, high bnp
What are the pivotal tests in ph
Pe, Cxr, EKG Echo Vq scan Pft Overnight oximetry HIV, lfts, Ana 6mw, bnp Rh Cath
What is normal tapse
> 12
Define success of vasodilator testing
Treatment.
MPap drops by 10 or less than 40.
Use nifedipine, amlodopine or diltiazem
Warfarin, dig diuretics and birth control
Bosentan side effects?
Check lfts monthly Decreases efficacy of sildenifil. Lowers affect of contraceptives, increases hepatotoxicity of glyburide Teratogen Anemia Male infertility
Sildenefil dosing
20mg tid
Can cause blindness or deafness
Types of type 1 pah
Familial Idiopathic Ctd Liver disease Sickle cell Drugs
What groups benefit from ph drugs
Ipah, ctd, HIV, drugs, congenital
Benefits of flolab
Exercise capacity, qol, survival
