Pulmonary HTN

Question 0

Prostacyclins

Epoprostenol, Iloprost, Treprostinil

Answer 0

Pulm HTN
-inhibits platelet aggregation and promotes vasodilation
MOA
-binds prostaglandin I2 (prostacyclin)
ADE
(Epoprostenol or Trepostinil)
-HA
-jaw pain
-diarrhea
-anorexia
-vomiting
(ilboprost)
-HA
-cough
-nausea
-syncope

Question 1

Calcium Channel Blockers

Nifedipine, Amlodipine, Diltiazem

Answer 1

Pulm HTN
-reduces PVR and BP
-used for pulmonary HTN in vasoreactive pts
ADE
-hypotension
-reflex tachycardia
-sympathetic stimulation
-right ventricular ischemia

Question 2

Sildenafil

Answer 2

Pulm HTN
-leads to relaxation of muscle cell and causes vasodilation
MOA
-inhibits phosphodiesterase 5 which degrades cGMP
ADE
-epistaxis
-HA
Contraindications
-ppl on nitrates

Question 3

Riociquat

Answer 3

Pulm HTN
MOA
-stimlates soluble guanylate cylcase
ADE
-embryo-fetal toxicity
-hypotension
-bleeding
Contraindications
-pregnancy
-nitrates and nitric oxide donors
-PDE inhibitors

Question 4

Endothelin Receptor Antagonist

Bosentan, Macitentan, Ambrisentan

Answer 4

Pulm HTN
MOA
-ET-1 receptor antagonist
ADE
-*fatal hepatotoxicity
-*monthly liver fx test required
-hypotension
-edema
-cold
-palpitations
-chest pain
Contraindications
-*negative pregnancy test
-pregnancy