Drugs for Pulmonary Artery Hypertension

Question 1

What are 4 Prostanoids?

Answer 1

Epoprostenol
Treprostinil
Iloprost
Selexipag

Question 2

What are 4 Prostanoids?

Answer 2

Epoprostenol
Treprostinil
Iloprost
Selexipag

Question 3

What are 3 Endothelin Antagonists?

Answer 3

Bosentan
Ambrisentan
Macicentan

Question 4

What are 3 Endothelin Antagonists?

Answer 4

Bosentan
Ambrisentan
Macicentan

Question 5

What are 2 Phosphodiesterase 5 Inhibitors?

Answer 5

Sildenafil

Tadalafil

Question 6

What are 2 PDE5 (-)’s?

Answer 6

Sildenafil

Tadalafil

Question 7

What is 1 Guanylate Cyclase Sensitizer?

Answer 7

Riociguat

Question 8

What is 1 Guanylate Cyclase Sensitizer?

Answer 8

Riociguat

Question 9

If a (+) vasopressor test is present, what should you add?

Answer 9

CCB

Question 10

Is there a cure for PAH?

Answer 10

No - treat symptoms and slow disease progression

Question 11

What is the MOA for Prostanoids?

Answer 11

Prostacyclin analogs that increase cAMP
= vascular relaxation and
(-) smooth m. growth/platelet aggregation

Question 12

How is Epoprostenol given and what is its half life?

Answer 12

Continuous IV pump and must be cold

- Half life = 6 mins

Question 13

What are the common side effects of Epoprostenol?

Answer 13

N/V, headache, flushing and jaw pain

Question 14

Treprostinil can be given many ways. When it is given via subcutaneous infusion, what side effect results?

Answer 14

Pain

Question 15

When Treprostinil is given via continuous IV pump, what is its half life and temperature compared to Epoprostenol?

Answer 15

Half life is longer = 4 hours
DOES NOT have to be cold!!
– Epoprostenol: 6 min half life and must be cold

Question 16

In what other 2 forms besides infusions is Treprostinil available?

Answer 16

QID inhalation

Extended release oral form

Question 17

What are the side effects of the QID inhalation form of Treprostinil?

Answer 17

Cough, throat irritation and headache

Question 18

What are the side effects of Treprostinil?

Answer 18

Jaw pain, diarrhea, edema, N/V

Question 19

With the Prostanoids that are given via infusion, what adverse effect can occur due to the chronic catheter?

Answer 19

Sepsis or other life threatening events if catheter clogs

Question 20

How is Iloprost given?

Answer 20

Inhaled 6-9 times a day

Question 21

What are the common side effects with Iloprost?

Answer 21

Hypotension fainting, cough, flushing, jaw pain, headache

Question 22

How is Selexipag given?

Answer 22

ORAL twice a day

Question 23

What is the con about Selexipag?

Answer 23

It is oral in form but is EXPENSIVE

Question 24

What are the common side effects of Selexipag?

Answer 24

N/V, flushing, jaw/limb pain and rash

Question 25

MOA for Bosentan?

Answer 25

Blocks ETa and ETb endothelin receptors

Question 26

Serious adverse effects of Bosentan?

Answer 26

Hepatotoxicity and Teratogenesis

Question 27

Bosentan accelerates the metabolism of what things?

Answer 27

Warfarin | Oral contraceptives

Question 28

MOA for Ambrisentan?

Answer 28

Blocks ETa endothelin receptors only

Question 29

Serious adverse effect of Ambrisentan?

Answer 29

Teratogenesis

Question 30

Does Ambrisentan accelerate the metabolism of warfarin and oral contraceptives like Bosentan?

Answer 30

NO

Question 31

With Bosentan and Ambrisentan, what should the patient make sure that they do with their significant other?

Answer 31

Use 2 forms of birth control

Question 32

MOA and half life time for Macitentan

Answer 32

Blocks ETa and ETb | -- Half life is 18 hours

Question 33

MOA for PDE5 inhibitors?

Answer 33

(-) PDE-5 to (-) cGMP breakdown and prolong smooth muscle relaxation

Question 34

Which PDE-5 inhibitor has a longer half life?

Answer 34

Tadalafil

Question 35

Adverse effects of Sildenafil?

Answer 35

Headache, dyspepsia, flushing and extended erections

Question 36

Sildenafil is what advertised drug?

Answer 36

Viagra

Question 37

MOA for Riociguat?

Answer 37

Increases NO and cGMP = vasodilation

Question 38

What are the adverse effects of Riociguat?

Answer 38

Fetal harm, hypotension, dyspepsia and headache

Question 39

What is a common drug combination for PAH?

Answer 39

Tadalafil + Ambrisentan

Question 40

What is a common drug combination for PAH?

Answer 40

Tadalafil + Ambrisentan