Sunday, November 17, 2019

Pharmacologic treatment of pulmonary hypertension (notes and mnemonics)


Vasodilator response: A favorable vasodilator response is defined as a fall in mPAP of 10 mm Hg or greater to less than 40 mm Hg with an unchanged or improved cardiac output, in response to an agent such as inhaled NO or IV epoprostenol.

Patients demonstrating a positive vasoreactivity response are initially treated with an oral calcium channel antagonist, such as long-acting nifedipine, amlodipine, or diltiazem.

Oral endothelin receptor antagonists:
Mnemonic: BAM!

Oral phosphodiesterase type 5 (PDE5) inhibitors:
Mnemonic: PTSD

Oral soluble guanylyl cyclase agonists:
Mnemonic: SgCAR

Prostacyclin analogues:
Mnemonic: ProstaTIE

Epoprostenol remains the only approved agent with a documented survival benefit in PAH and the drug of choice in patients with class IV PAH.


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