PAH Flashcards
1
Q
What treatment should be used based on AVT results?
A
- Positive: CCB
- Negative, RV failure, or CCB contra: do not use CCB
2
Q
What is the purpose of AVT?
A
Predicts response to CCB
3
Q
Which CCB should be avoided?
A
Verapamil (negative inotropic effects)
4
Q
WHO FC I
Require therapy?
A
- At risk, but symptom free when active or at rest
- Not immediate therapy, but consider CCB if responder
5
Q
WHO FC II
Require therapy?
A
- comfortable at rest, slight limitation of physical ability (ordinary activity causes symptoms)
- Yes; CCB if positive, targeted therapy if neg/contra CCB
6
Q
WHO FC III
A
comfortable at rest, marked limitation in physical activity
7
Q
WHO FC IV
A
symtoms at rest & activity
8
Q
What are examples of worsening symptoms
A
- dyspnea on exertion
- fatigue
- weakness
9
Q
What is targeted therapy for PAH (FC II, FC III w/o rapid progression or poor prognosis)
A
- Combo: ambrisentan & tadalafil
- Mono: ERA, riociguat, or PDE5i
10
Q
What is the treatment for FC III with rapid progression or poor prognosis
A
- if candidate for parenteral prostanoids, SC treprostinil, IV treprostinil, or IV epoprostenol
- if not, inhaled or oral prostanoid
11
Q
What is the treatment for FC IV?
A
- if candidate for parenteral prostanoids, SC treprostinil, IV treprostinil, or IV epoprostenol
- if not, inhaled prostanoid & ERA + PDE5i
12
Q
ERA
A
- Drugs: ambrisentan, macitentan, bosentan
13
Q
PDE5i
A
- Drugs: sildenafil, tadalafil
14
Q
Riociguat
A
15
Q
A
