Pulmonary Arterial HTN (PAH) Flashcards

0
Q

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

A

INR 1.5-2.5

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1
Q

List clinical classification of Pulmonary HTN

A

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

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2
Q

MOA of prostacyclin analogues (or Prostanoids)?

A

Potent vasodilators on pulmonary and systemic vascular beds.

They also inhibit platelet aggregation.

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3
Q

List prostacyclin analogues (or Prostanoids) agents.

A

Epoprostenol (Flolan, Veletri)

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

Iloprost (Ventavis)

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4
Q

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

A
VD (hypotension, HA, flushing)
Nausea/v/d
Anxiety
Chest pains/palpitations
Tachycardia
Edema
Jaw claudication
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5
Q

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

A

Anxiety

Flu-like sx

Jaw pain

Thrombocytopeni

Neuropathy

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6
Q

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

A

Yes

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7
Q

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

A

T

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8
Q

Howz Flolan pump stored?

A

Needs to be on ice packs for proper cooling

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9
Q

Which agents are most potent of all PAH meds?

A

Parenteral Prostacyclin analogues (or Prostanoids) agents?

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10
Q

MOA of Endothelin Receptor Anatagonists (ERAs)?

A

Blocks Endothelin (VC with cellular proliferation)

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11
Q

Endothelin Receptor Anatagonists (ERAs) agents?

A

Bosentan (Tracleer) - REMS drug

Ambrisentan (Letairis) - REMS drug

Macitentan (Opsumit) - REMS drug

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12
Q

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

A

Preg cat X

Hepatoxicity (Bosentan (Tracleer) - REMS drug)

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13
Q

SEs of Bosentan (Tracleer)

A

HA

High hemoglobin

High LFTs

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14
Q

SEs of Ambrisentan (Letairis) - REMS drug

A

Peripheral edema

HA

Reduced hemoglobin

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15
Q

SEs of Macitentan (Opsumit) - REMS drug

A

Reduced hemoglobin

HA

16
Q

List PDE-5 used in PAH?

A

Sildenafil (Revatio)

Tadalafil (Adcirca)

17
Q

CI to PDE-5 agents use?

A

Concurrent use of nitrates

18
Q

SE to PDE-5 agents use?

A

Dizziness

Sudden drop in BP

HA

Priapism

19
Q

MOA of Soluble Guanylate Cyclase (sGC) stimulator?

A

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

20
Q

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

A

Riociguat (Adempas) - REMS drugs

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

21
Q

BBW of Riociguat (Adempas) - REMS drugs?

A

Cat x

22
Q

CI of Riociguat (Adempas) - REMS drugs?

A

Pregnancy

Concomitant use of PDE-5 inh or Nitrates

23
Q

SE of Riociguat (Adempas) - REMS drugs

A

HA

Dyspepsia

Dizziness

Hypotension