Pulmonary Hypertension (Drugs)

Question 1

Bosentan

Answer 1

Endothelin Receptor Antagonists
- Treats PAH

MOA:
- Blocks Endothelin A receptors on SMC
–> Vasodilation

Question 2

Epoprostenol

Answer 2

Prostacyclin
- Treats PAH (Largest reductions in pulmonary arterial pressure)

MOA:
- Binds SMC IP Receptors–> Increases cAMP Signaling
–> Vasodilation

Question 3

Riociguat

Answer 3

sGC Activator - Allosteric Activator
- Treats PAH

MOA:
- Binds to sGC (different binding area than NO)
–> Potentiates effects of NO converting GTP into cGMP
–> Vasodilation

Question 4

Sildenafil

Answer 4

Phosphodiesterase 5 Inhibitor (PDE5i)
- Treats PAH

MOA:
- Inhibit PDE5i
–> Prevents breakdown of cGMP
–> Increase cGMP Signaling
–> Vasodilation

Question 5

Tadarafil

Answer 5

Phosphodiesterase 5 Inhibitor (PDE5i)
- Treats PAH

MOA:
- Inhibit PDE5i
–> Prevents breakdown of cGMP
–> Increase cGMP Signaling
–> Vasodilation

Question 6

Nifedipine

Answer 6

Ca2+ Entry Antagonists
- Treats PAH

MOA:
Reduces Calcium entry into SMC
–> Arterial DIlation
–> Reduces BP

Question 7

Inhaled NO

Answer 7

Diagnosis of PAH
- Not used for treatment

MOA:
- PAH will cause high resistant state to remain in infant
–> NO forces a shift from high to low resistance

Question 8

Vasopressin

Answer 8

Treats Shock/Hypotensive State (AKA ADH)

MOA:
- Used with Noradrenaline
–> Increases Water Reabsorption
–> Increase Blood Volume
–> Increase Cardiac Output
–> Increase Arterial Pressure

Question 9

Adrenaline

Answer 9

Adrenergic Vasopressors:
- Treats Shock/Hypotensive State

MOA:
- Alpha 1 Effect
–> Vasoconstriction
–> Increases Cardiac Output
–> Increases Arterial Pressure

Question 10

Noradrenaline

Answer 10

Adrenergic Vasopressors:
- Treats Shock/Hypotensive State

MOA:
- Alpha 1 Effect
–> Vasoconstriction
–> Increases Cardiac Output
–> Increases Arterial Pressure

Question 11

Dobutamine

Answer 11

Adrenergic Vasopressors:
- Treats Shock/Hypotensive State

MOA:
- Beta 1 Effect (Cardiogenic Shock)
–> Vasoconstriction
–> Increase Cardiac Output
–> Increase Arterial Pressure