Hosam Mohamed-
if patients are able to be treated with CCBs
What does the Acute Vasoreactivity test tell us?
-
amlodipine, diltiazem, nifedipine
What are the CCBs of choice in PAH? (3)
-
a
No symptoms with exercise or at rest.
a) Class I
b) Class II
c) Class III
d) Class IV
-
b
No symptoms at rest; SOB with normal activity.
a) Class I
b) Class II
c) Class III
d) Class IV
-
c
May or may not have symptoms at rest; SOB, and fatigue limit normal
activities.
a) Class I
b) Class II
c) Class III
d) Class IV
-
d
Symptoms at rest and severe symptoms with any activity.
a) Class I
b) Class II
c) Class III
d) Class IV
-
none; monitor for disease progression
What is the treatment for WHO FC I?
-
ambrisentan + tadalafil
What is the combo therapy for treatment-naive patients?
-
ERAs, PDE5 inhibitors, Riociguat
What are the treatment options for WHO FC III-treatment naive who can't
tolerate combo therapy? (3)
-
bosentan, macitentan, riociguat, sildenafil
What are the treatment options for WHO FC II who can't tolerate combo therapy? (4)
-
continuous IV epoprostenol; treprostinil; titrate both
What are the treatment options for WHO FC III-Rapid disease progression? (2)
-
continuous IV epoprostenol
What is the 1st line therapy for WHO FC IV patients?
-
inhaled prostacyclin, oral ERA antagonist, PDE-5 inhibitor, Riociguat
What are the treatment options for WHO FC IV patients who can't tolerate
the 1st line option? (4)
-
lung transplant; palliative care (if patient is not a candidate)
If inadequate response to maximal therapy, what are the treatments? (2)
-
thrombocytopenia
The prostacyclin analogs have a class effect of ____________.
-
a
Which is contraindicated in hepatic impairment when taken orally?
a) treprostinil
b) epoprostenol
c) illoprost
d) selexipag
-
b
Which is contraindicated in HFrEF + decreased LV EF?
a) treprostinil
b) epoprostenol
c) illoprost
d) selexipag
-
c,d
Which have no contraindications?
a) treprostinil
b) epoprostenol
c) illoprost
d) selexipag
-
cyclosporine, glyburide, pregnancy
Bosentan Contraindications? (3)
-
negative pregnancy test monthly
What do the ERA require before prescribing?
-
pregnancy
Who are the ERAs contraindicated in?
-
pregnancy, idiothetic pulmonary fibrosis
Ambrisentan CIs? (2)
-
c
Which has to be taken with food?
a) ERA
b) PDE-5 inhibitors
c) Nintedanib
d) Pirfenidone
-
b
Which can cause hearing loss?
a) ERA
b) PDE-5 inhibitors
c) Nintedanib
d) Pirfenidone
-
drop in mAP >=10 mmHg; absolute mAP of <40mmHg
What confirms a positive Vasoreactivity test? (2)
-
riociguat, ERAs
Which drugs require REMS? (2)
