Pulmonary HTN

Question 1

Calcium Channel blocker’s

Answer 1

Diltiazem, Nifedipine

Dilates smooth muscles and lower PAM(10-20) book says 12-16
Don’t use in RHF—>decreases HR

Question 2

Endothelin receptor antagonists

Answer 2

Bosentan, Anbisetan

Binds to ER1 receptors and blocks constriction of arteries (promotes relaxation/decrease PAM)

Consider LFT for hepatotoxic
ALT- 7-56
AST- 10-40

Question 3

Phosphodietrase (type 5) enzyme inhibitors (Vasodilation)

Answer 3

Sildenfil (viagra), tadalafil

Promotes relaxation in lung vascular
Monitor BP—> lowers BP

Do not give with nitroglycerin= refractory hypotension

Question 4

Vasodilators inhaled

Answer 4

Iloprost, trepostinil
Dilates systemic/pulmonary arterial vasculature

Given 6-9 times daily by nebulizer disk, cause orthostatic hypertension, withhold for BP <85; will have HA; give NSAIDS before

Question 5

Vasodilator IV

Answer 5

Given to pt who do not respond to calcium channel blockers or have RHF, central line or continuous SubQ, clinical deterioration of abrupt withdrawal

Question 6

Diuretics

Answer 6

Furosemide

Monitor I&Os
Electrolytes abnormalities
Therapeutic response

Question 7

Anticoagulants

Answer 7

Pulmonary complications
Heparin, enoxaprin (levonox), warfarin, apixaban, pradaxa, xarelto (rivaroxaban)

Heparin drip for A-fib/Flutter
PT/INR: 11-12.5/0.8-1.1
APTT:30-40
PTT:60-70

Question 8

Beta-blockers Selective

Ok if they have to have it

Answer 8

Metoprolol, Atenolol

Question 9

Beta blockers Non-selective
Don’t give!!

Answer 9

Propranolol, Sotalol, Timolol

Question 10

Decongestants
Don’t give

Answer 10

Phenylephrine (Sudafed PE)
Pseudoephedrine (Sudafed)
Oxymetazoline (Claritin)