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pulmonary hypertension and drugs Flashcards

1
Q

Normal mean pulmonary pressure

A

10-14 mmHg

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2
Q

pulmonary hypertension: (value)

A

more than 25 mmHg at rest

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3
Q

pulmonary hypertension results in …. (Histology)

A
  1. arteriosclerosis 2. medial hypertrophy 3. intimal fibrosis
    OF PULMONARY ARTERIES
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4
Q

pulmonary hypertension - course

A

severe respiratory distress –> cyanosis and RVH –>

death from decompensated cor pulmonale

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5
Q

classification group of pulmonary hypertension - number

A

5

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6
Q

classicfication group of pulmonary hypertension - based on

A

cause and treatment options

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7
Q

PH

A

pulmonary hypertension

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8
Q

which are the classicfication group of pulmonary hypertension

A
  1. pulmonary arterial hypertension (PAH)
  2. PH due to left heart disease
  3. PH due to lung disease or hypoxia
  4. chronic thromboembolic PH
  5. multifactorial PH
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9
Q

multifactorial pulmonary hypertensions - causes

A
  1. hematologic disorders
  2. systemic disorders
  3. metabolic disorders
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10
Q

chronic thromboembolic pulmonary hypertensions - pathophysiology

A

recurrent microthrombi –> decreased sectional area of pulmonary vascular bed

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11
Q

pulmonary hypertensions due to lung disease or hypoxia - pathophysiology

A
  1. destruction of lung parenchyma

2. hypoxemic vasoconstriction

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12
Q

pulmonary hypertensions due to lung disease or hypoxia - destruction of lung parenchyma example

A

COPD

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13
Q

pulmonary hypertensions due to lung disease or hypoxia - hypoxemic vasoconstriction

A
  1. obstructive sleep apnea

2. living in high altitude

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14
Q

pulmonary hypertensions due to left heart disease - is often due to

A
  1. systolic dysfunction
  2. diastolic dysfunction
  3. valvular disease such as mitral stenosis
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15
Q

pulmonary arterial hypertension (PAH) - idiopathic - prognosis

A

poor

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16
Q

pulmonary arterial hypertension (PAH) - causes

A
  1. idiopathic
  2. drugs
  3. connective tissue disease
  4. HIV infection
  5. portal hypertension
  6. congenital heart disease
  7. schistosomiasis
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17
Q

pulmonary arterial hypertension (PAH) - idiopathic - pathophysiology

A

often due to inactivation mitation in BMPR2 gene

18
Q

BMPR2 gene - normal action

A

inhibits vascular SMCs proliferation

19
Q

pulmonary arterial hypertension (PAH) also includes

A
  1. pulmonary venous occlusive disease

2. persistent PH of newborn

20
Q

pulmonary arterial hypertension (PAH) - drugs that cause it

A
  1. amphetamines

2. cocaine

21
Q

idiopathic pulmonary arterial hypertension (PAH) - special feature

22
Q

pulmonary hypertension drugs - categories

A
  1. endothelin receptor antagonists
  2. PDE-5 inhibitors
  3. Prostacyclin analogs
23
Q

pulmonary hypertension drugs - categories and drugs

A
  1. endothelin receptor antagonists –> BOSENTAN
  2. PDE-5 inhibitors –> SILDENAFIL
  3. Prostacyclin analogs –> EPOPROSTENOL, ILOPROST
24
Q

pulmonary hypertension drugs - endothelin receptor antagonists - drug and toxicity

A

bosentan

hepatotoxicity

25
Q

pulmonary hypertension drugs - endothelin receptor antagonists - monitor

A

monitor LFTs

26
Q

pulmonary hypertension drugs - endothelin receptor antagonists - drug and mechanism of action

A

Bosentan: competitively antagonize endothelin-1 receptors –> decreases pulmonary vascular resistance

27
Q

pulmonary hypertension drugs - PDE-5 inhibitors - drugs

A

sildenafil (viagra)

28
Q

pulmonary hypertension drugs - PDE-5 inhibitors - mechanism of action

A

inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide

29
Q

pulmonary hypertension drugs - PDE-5 inhibitors - they also used for

A

erectile dysfunction

30
Q

sildenafil - used for

A
  1. pulmonary hypertension

2. erectile dysfunction

31
Q

prostacyclin analogs side effects

A
  1. flushing

2. jaw pain

32
Q

prostacyclin analogs for pulmonary hypertension - drugs

A
  1. epoprostenol

2. iloprost

33
Q

prostacyclin analogs for pulmonary hypertension - mechanism of action

A

prostacyclins (PGI2) with direct vasodilatory effects on pulmonary and systemic arterial vascular beds
inhibit platelet aggregation

34
Q

pulmonary hypertension treatment - categories

A
  1. endothelin receptor antagonists –> BOSENTAN
  2. PDE-5 inhibitors –> SILDENAFIL
  3. Prostacyclin analogs –> EPOPROSTENOL, ILOPROST
35
Q

pulmonary hypertension treatment - drug with hepatotoxicity

36
Q

hiv infection - type of pulmonary hypertension

A

pulmonary arterial hypertension

37
Q

type of pulmonary hypertension with poor prognosis

A

pulmonary arterial hypertension

38
Q

obstructive sleep apnea - type of pulmonary hypertension

A

PH due to lung disease or hypoxia

39
Q

portal hypertension - type of pulmonary hypertension

A

pulmonary arterial hypertension

40
Q

pulmonary hypertension treatment - categories

A
  1. endothelin receptor antagonists –> BOSENTAN
  2. PDE-5 inhibitors –> SILDENAFIL
  3. Prostacyclin analogs –> EPOPROSTENOL, ILOPROST

respiratory (27 decks)

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