Questions and Answers
Which drug class, if taken during pregnancy, can increase the risk of pulmonary hypertension in a newborn? (Select all that apply)
What is the definition of pulmonary hypertension?
A mean pulmonary artery pressure (PAP) of 25 mmHg or greater.
What are 6 agents that can cause PAH?
Cocaine, Dasatinib, Diazoxide, Methamphetamines, SSRI use during pregnancy, Weight loss agents.
Which of the following statements are true regarding bosentan? (Select all that apply)
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Which of the following pulmonary vasodilator medications matches its mechanism of action? (Select all that apply)
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Which of the following describes the mechanism of action of epoprostenol?
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All of the following are warnings associated with Adcirca except:
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Which of the following are common side effects of epoprostenol? (Select all that apply)
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Patients diagnosed with pulmonary arterial hypertension should undergo acute vasoreactivity testing. Positive responders can be treated with: (Select all that apply)
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Which of the following is true regarding treprostinil?
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What is the generic name of Revatio?
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Study Notes
Pulmonary Arterial Hypertension (PAH) Overview
- Pulmonary hypertension is defined as a mean pulmonary artery pressure (PAP) of 25 mmHg or greater.
Drug Risks During Pregnancy
- Selective serotonin reuptake inhibitors (SSRIs) can increase the risk of pulmonary hypertension in newborns when taken during pregnancy.
Agents Associated with PAH
- Cocaine, Dasatinib (Sprycel), Diazoxide (Proglycem), methamphetamines, certain weight loss agents, and SSRIs used during pregnancy can cause pulmonary arterial hypertension (PAH).
Bosentan Information
- Bosentan (Tracleer) is an endothelin receptor antagonist with a boxed warning for hepatotoxicity and embryo-fetal toxicity (not safe in pregnancy).
- Common side effects include headache and anemia; it is a substrate and inducer of CYP 3A4 and 2C9.
Mechanisms of Action for Pulmonary Vasodilators
- Tadalafil increases cGMP levels and is classified as a PDE-5 inhibitor.
- Epoprostenol is a prostacyclin analogue that acts to stimulate vasodilation.
- Other medications, like riociguat, also work by increasing cGMP levels.
Warnings Associated with Adcirca (Tadalafil)
- Adcirca has warnings for hearing loss, vision loss, priapism, and hypotension; hair loss is not associated.
- It is commonly taken once daily compared to sildenafil, which is taken three times a day.
Side Effects of Epoprostenol
- Common side effects include jaw pain and flushing, attributed to its vasodilating properties.
- Other reactions include hypotension, headache, and gastrointestinal side effects (nausea/vomiting/diarrhea).
Acute Vasoreactivity Testing
- Positive responders to acute vasoreactivity testing can be treated with calcium channel blockers, specifically diltiazem and amlodipine.
- Non-responders are unlikely to benefit from calcium channel blockers.
Treprostinil Administration
- Subcutaneous administration of treprostinil can cause significant pain at the infusion site, affecting patient comfort.
- It has an administration schedule that varies based on the formulation, particularly for inhaled treprostinil.
Generic Names of Medications
- Revatio is the brand name for sildenafil.
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Description
This quiz provides an overview of pulmonary arterial hypertension (PAH) including its definition, risks during pregnancy, associated agents, and treatments like Bosentan. Test your knowledge on the implications of various drugs and their mechanisms of action related to PAH.
