6. Pulmonary Hypertension

Question 1

All of the following are what type of pulmonary HTN drug?
epoprostenol
treprostinil
iloprost
selexipag

Answer 1

Prostanoids

Question 2

All of the following are what type of pulmonary HTN drug?
bosentan
ambrisentan
macicentan

Answer 2

Endothelin Antagonists

Question 3

All of the following are what type of pulmonary HTN drug?
sildenafil
tadalafil

Answer 3

PDE 5 inhibitors

Question 4

All of the following are what type of pulmonary HTN drug?

Riociguat

Answer 4

Guanylate cyclase sensistizer

Question 5

If you have a positive vasopressor test, along with a pulmonary HTN durg you should give them?

Answer 5

CCB (nifedipine, diltiazem, Amlodipine)

Question 6

Pulmonary arterial hypertension is seen in young mothers most commonly, it is progressive increase in pulm vascular resistance which is due to changes in pulm arterioles like vasoconstriction, inflammation, obstructive remodeling of pulm vessel wall and?

Answer 6

localized thrombosis formation

Question 7

Drug:
Characteristics: mimics action of endogenous prostacyclin, for PAH, very short 6min half life, given IV and needs to be cold, toxicities include sepsis due to chornic catheter, flushing, jaw paine

Answer 7

Epoprostenol

Question 8

Drug:
Characteristics: mimics action of endogenous prostacyclin, for PAH, subcutaneous infusion but PAINFUL, longer half life 4hrs, doesnt require refrigeration, sepsis d/t catheter, jaw pain, PAIN

Answer 8

Treprostinil

Question 9

Drug:
Characteristics: mimics action of endogenous prostacyclin, for PAH, inhalation 6-9times per day, causes fainting d/t hypotension, flushing, jaw pain

Answer 9

Iloprost

Question 10

Drug:
Characteristics: mimics action of endogenous prostacyclin, for PAH, aministered orally BID, **expensive 350/dose, same side effects

Answer 10

selexipag

Question 11

Drug:
Characteristics: nonspecifically* blocks ETa and ETb endothelin receptors, improves excersize tolerance, for PAH, 50% bioavailbitly, hepatotoxicity, tertaogenesis, interacts with warfarin/oral contraception

Answer 11

Bosentan

Question 12

Drug:
Characteristics: selectively blocks ETa receptors, imporves excersice tolerance, oral drug, first choice, teratogenesis, does not damage liver, does not interact with warfarin/OC

Answer 12

Ambrisentan

Question 13

What is the difference between sildenafil and tadalafil?

Answer 13

tadalafil has a much longer 1/2 life

Question 14

Drug:
Characteristics: sensitizes soluble guanylate cyclase to NO, increases generation of cGMP causing increased vasodilation, PAH, oral drug-1/2 life 12 hours

Answer 14

Riociguat

Question 15

PAH FCII combination with ambrisentan/tadalafil no combination =

Answer 15

monotherapy with macitentan, ambisentan, riociguat, sildenafil/tadalafil

Question 16

PAH FCIII with out eveidence of rapid disease progression monotherapy with macitentan, ambisentan, riociguat, sildenafil/tadalafil or combo with

Answer 16

tadalafil and ambrisentan

Question 17

PAH FCIII WITH evidence of rapid disease progression tX: pts not willing to use parenteral prostanoids = inhaled/oral prostanoid if yes then IV epoprostenol, IV treprostinil or SC?

Answer 17

treporostinil