Pulmonary Arterial HTN (PAH) Flashcards Preview

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Flashcards in Pulmonary Arterial HTN (PAH) Deck (24):
0

List clinical classification of Pulmonary HTN

Pulmonary arterial HTN (PAH)

Pulmonary HTN owing to a left heart dx

Pulmonary HTN owing to lung dx and/or hypoxia

Chronic thromboembolic pulmonary HTN (CTEPH)

Pulmonary HTN with unclear multifactorial mechanisms

1

What's the INR goal in pt with PAH using warfarin?

INR 1.5-2.5

2

MOA of prostacyclin analogues (or Prostanoids)?

Potent vasodilators on pulmonary and systemic vascular beds.

They also inhibit platelet aggregation.

3

List prostacyclin analogues (or Prostanoids) agents.

Epoprostenol (Flolan, Veletri)

Treprostinil (Remodulin - SC/IV; Tyvaso - inhaled)

Iloprost (Ventavis)

4

SEs that may occur during dose titration of prostacyclin analogues (or Prostanoids)?

VD (hypotension, HA, flushing)
Nausea/v/d
Anxiety
Chest pains/palpitations
Tachycardia
Edema
Jaw claudication

5

SEs that may occur during chronic use of prostacyclin analogues (or Prostanoids)?

Anxiety

Flu-like sx

Jaw pain

Thrombocytopeni

Neuropathy

6

Best to avoid interruption to Prostacyclin analogues (or Prostanoids) therapy?

Yes

7

Best to avoid large, sudden reduction to Prostacyclin analogues (or Prostanoids) dose?

T

8

Howz Flolan pump stored?

Needs to be on ice packs for proper cooling

9

Which agents are most potent of all PAH meds?

Parenteral Prostacyclin analogues (or Prostanoids) agents?

10

MOA of Endothelin Receptor Anatagonists (ERAs)?

Blocks Endothelin (VC with cellular proliferation)

11

Endothelin Receptor Anatagonists (ERAs) agents?

Bosentan (Tracleer) - REMS drug

Ambrisentan (Letairis) - REMS drug

Macitentan (Opsumit) - REMS drug

12

BBW of Bosentan (Tracleer) - REMS drug and Ambrisentan (Letairis) - REMS drug and Macitentan (Opsumit) - REMS drug?

Preg cat X

Hepatoxicity (Bosentan (Tracleer) - REMS drug)

13

SEs of Bosentan (Tracleer)

HA

High hemoglobin

High LFTs

14

SEs of Ambrisentan (Letairis) - REMS drug

Peripheral edema

HA

Reduced hemoglobin

15

SEs of Macitentan (Opsumit) - REMS drug

Reduced hemoglobin

HA

16

List PDE-5 used in PAH?

Sildenafil (Revatio)

Tadalafil (Adcirca)

17

CI to PDE-5 agents use?

Concurrent use of nitrates

18

SE to PDE-5 agents use?

Dizziness

Sudden drop in BP

HA

Priapism

19

MOA of Soluble Guanylate Cyclase (sGC) stimulator?

Increasing conversion of GTP to cGMP leads to increased relaxation and antiproliferative effects in the pulmonary artery smooth muscle cells

20

Agents under Soluble Guanylate Cyclase (sGC) stimulator? What's unique about it?

Riociguat (Adempas) - REMS drugs

Only 1 approved for both PAH and CTEPH (all others are only used for PAH)

21

BBW of Riociguat (Adempas) - REMS drugs?

Cat x

22

CI of Riociguat (Adempas) - REMS drugs?

Pregnancy

Concomitant use of PDE-5 inh or Nitrates

23

SE of Riociguat (Adempas) - REMS drugs

HA

Dyspepsia

Dizziness

Hypotension

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