Exam 2: PAH Flashcards

1
Q

Sildenafil: Drug Class

A

PDE5 inhibitor

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2
Q

Sildenafil brand name

A

Revatio

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3
Q

Revatio generic name

A

Sildenafil

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4
Q

Sildenafil dosing

A

20mg TID

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5
Q

Tadalafil drug class

A

PDE5 inhibitor

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6
Q

Tadalafil brand name

A

Adcirca

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7
Q

Adcirca generic name

A

Tadalafil

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8
Q

Tadalafil dosing

A

40mg daily

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9
Q

Bosentan drug class

A

ET1-RA

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10
Q

Bosentan brand name

A

Traceleer

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11
Q

Bosentan Dosing

A

62.5mg BID

Max 250mg BID

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12
Q

Traceleer generic name

A

Bosentan

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13
Q

Amrbisentan brand name

A

Letairis

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14
Q

Amrbisentan drug class

A

ET1-RA

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15
Q

Ambrisentan Dosing

A

2.5mg daily

Max 10mg daily

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16
Q

Bosentan MOA

A

Dual ET-A and ET-B antagonist

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17
Q

Ambrisentan MOA

A

Selective ET-A antagonist

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18
Q

Effects of increased ET-1

A

Proliferation (Vascular smooth muscle and fibroblast)
Vasoconstriction
Hypertrophy (cardiac/vascular)
Inflammation
Fibrosis (fibroblast proliferation, extracellular matrix proteins, collagenase production)

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19
Q

Bosentan pregnancy risk

A

Category X

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20
Q

Ambrisentant pregnancy risk

A

Category X

21
Q

Which has higher hepatotoxicity: Bosentan or Ambrisentan

A

Bosentan 11% (vs amrbisentan 1%)

22
Q

Which drug has NOT been shown to benefit WHO-E group 2 patients?

A

Bosentan

23
Q

Epoprostenol brand name

A

Flolan

24
Q

Epoprostenol Drug Calss

A

Prostacyclin analog

25
Q

Epoprostenol dosing

A

IV ONLY
3ng/kg/mg
Target: 30ng/kg/mg

Titrate up every hour, down q15min for side effects

Half life 3min

26
Q

Treprostinil brand name (IV/SC)

A

Remodulin

27
Q

Treprostinil brand name (inhaled)

A

Tyvaso

28
Q

Remodulin generic name

A

Treprostinil (IV/SC)

29
Q

Tyvaso generic name

A

Treprostinil (inhaled)

30
Q

Treprostinil dosing

A

1.25ng/kg/min
Target 12.5ng/kg/min
Titrate: every 3 days, down every 1 day for side effects

Half life: 20 min

31
Q

Conversion: 1 mg = ___ mcg = ____ ng

A

1000mcg = 1,000,000 ng

32
Q

Epoporstenol dose limiting effects

A

headache, musculoskeletal pain, hypotension, bradycardia, diarrhea, flushing

33
Q

Epoprostenol: both bottle and IV tubing must be changed every ____

A

8 hours

34
Q

Which drugs have NOT been shown to benefit WHO-E group 1 patients?

A

Prostacyclin analogs

35
Q

Give diltiazem when right heart cath and vasodilation resting with inhaled nitric oxide with ≥ __ decrease in mean PAP and ≤ ____

A

10mmHg decrease in mean PAP

≤40mmHg

36
Q

HTN in your pulmonary artery when mean pulmonary artery pressure ≥ ___ at rest

A

25mmHg

37
Q

PAH often leads to _____-sided HF

A

Right sided

38
Q

WHO E group 1 def

A
Idiopathic (IPAH) -- genetic 
Associated with (APAH): collagen vascular disease (lupus), portal hypertension secondary to liver failure, HIV, drugs (stimulants)
39
Q

WHO E group 2 def

A

Left-HF

**most common cause of PAH

40
Q

WHO E Group 3 def

A

Associated with lung disease or chronic hypoxemia

COPD, ILD, ONA, high altitudes

41
Q

WHO E group 4 def

A

Chronic thromboembolic disease, pulmonary embolism

42
Q

WHO E Group 5

A

Unclear or multifactorial causes

43
Q

WHO F Class 1

A

No dyspnea or fatigue with usual physical activity

44
Q

WHO F Class II

A

SOB or fatigue when doing usual physical activity

45
Q

WHO F Class III

A

SOB or fatigue when doing simple activities

46
Q

WHO F Class IV

A

SOB/fatigue at rest

47
Q

PCWP > ____ means left sided heart failure likely

A

PCWP >15

48
Q

Normal 6MWT results in healthy elderly adults is ___

A

600m