Izard Drugs for DVT & PE Flashcards
What are the prostanoids used for Pulmonary Htn?
- Epoprostenol
- Treprostinin
- Iloprost
- Selexipag
What are the Endothlein antagonists used for puplmonary htn?
- Bosentan
- Ambrisentan
- Macicentan
What are the PDE 5 inhibitors used for pulmonary htn?
- Sildenafil
- Tadalafil
What are the guanylate cyclase sensitizers used for pulmonary htn?
riociguat
What do you use if you have a positive vasopressor test in a patient with PAH?
CCB
What treatments are routinely sued with little impact on PAH progression?
- Anticoagulants
- Diuretics
- Oxygen therapy
Epoprostenol effects and MOA?
- Mimics prostacyclin compound
- lowers pulmonary arterial resistance and decreases pulmonary artery pressure
Epoprostenol toxicities?
- Sepsis due to chronic catheter
- Life threat if pump lines clogged
- N/V
- HA
- Jaw pain
- Flushing
Treprostinil MOA and effects?
- Mimics prostacyclin
- Lowers pulm art pressure & resistance
Pharmacokinetcs of treprostinil?
- SubQ infusion
- longer half life doesn’t require refrigeration
- qid inhalation is available
AE of Treprostinil?
- Sepsis due to chronic catheter
- site pain
- jaw pain
- diarrhea
- edema
- nausea
- If inhaled:
- Cough
- HA
- Throat irritation
Iloprost pharmacokinetics?
Inhale 6-9x daily
Iloprost AE?
- fainting due to hypotension
- cough
- HA
- flushing
- jaw pain
Selexipag pharmacokinetics and AE?
- BID po, Expensive
- HA
- Flushing
- Diarrhea N/V
- Jaw limb and muscle pain
- skin rash
Bosentan MOA and effects?
- Nonspecifically blocks ETa and ETB endothelin receptors
- improves exercise tolerance and slows progression
Bosetan toxicities?
- Serious:
- hepatotoxicity
- teratogen
- Flushing
- Headache
- Peripheral edema
- Nasal congestion
- reduced sperm
Bosetan drug interactions?
- accelerates metabolism of
- warfarin
- Oral contraceptives
- need 2 forms
- increases cyclosporine or glyburide
Ambrisentan MOA?
- Selectively blocks endothelin receptors that cause vasoconstriction and promote cell proliferation
Ambrisentan AE and drug interactions?
- Teratogen
- does not damage liver like Bosetan
- peripheral edema, nasal congestion, anemia, reduced sperm
-
doesn’t accelerate warfarin like Bosetan or OC’s but still need two forms
*
Sildenafil MOA and AE? (viagra for ED, Revatio for PAH)
- Selectively blocks PDE5
- well tolerated flushing and dyspepsia most common AE
Riociguat MOA & AE?
- Guanyl cyclase stimulator
- Hypotensioin
- HA
- Dizziness
- dyspepsia
- Fetal harm
- Not given with NO or type 5 PDEI
Common PAH drug combinations?
Tadalafil + Ambrisentan
