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21 Cards in this Set

  • Front
  • Back
what is pulmonary HTN?
increases in PA pressures w/o demonstrated cause
common underlying pathologic causes of pulmonary HTN (5)
1.pulmonary vasoconstriction
2.vascular remodeling
3.thrombosis
4.smooth muscle hypertrophy
5.intimal proliferation
normal mean PAP
a.at rest
b.during exercise
a.at rest - PAP > 25 mmHg
b.during exercise - PAP > 30
median length of survival after diagnosis? from what?
2.5 yrs

from right sided-heart failure
some non-pulmonary differential diagnoses for pulmon HTN (4)
1.portal HTN

2.AIDS

3.cocaine abuse

4.appetite suppressant usage (serotonin uptake inhibitors, amphetamines)
why is it so hard to diagnose pulm HTN
b/c of subtle, nonspecific symptoms
most common first 2 early signs of pulm HTN
1.dyspnea
2.fatigue
5 categories of pulm HTN
1.resp diseases
2.pulm venous HTN
3.pulm arterial HTN
4.chronic thrombotic and/or embolic disease
5.pulm vasculature disorders
what easy way can healthcare provider and pt measure severity of disease?
6 minute walk test
key goal of pharm tx for pulm HTN
vasodilation
most common therapy for pulm HTN/cor pulmonale?
vasodilator Ca2+ channel blockers
when Ca2+ channel blockers don't work would could be used next?
epoprostenol (Prostacyclin)
side effects of prostacyclin (4)
1.decreases SVR
2.arterial hypoxemia
3.platelet inhibition & bleeding
4.complication of delivery system
what are some pharm tx options for pulm HTN/co pulmonale
1.supplemental O2
2.Ca2+ channel blockers (vasodilator)
3.prostacyclin (vasodilator)
4.nitric oxide (vasodilator)
5.bronchodilators

6.anticoags
7.diuretics
8.digitalis (inotrope)
9.antibiotics
10.heart-lung transplant
side effecs of nitric oxide
1.platelet inhibition & bleeding
2.methemoglobinemia
3.toxic nitrate metabolites
4.technical difficulties of delivery
most freqent cause of cor pulmonale
COPD
what can abrupt increases in right atrial pressure signal in cor pulmonale pt? cause?
right ventricular dysfunction 2nd to increased PVR

arterial hypoxemia, hypoventilation, use of N2O
why do aminophylline levels require close monitoring w/ cor pulmonale?
decreased hepatic clearance 2nd to CHF
benefit of digoxin in cor pulmonale.
improved right & left ventricular fxn
what physiologic states common in cor pulmonale can increase toxicity of dig (3)
1.arterial hypoxemia
2.acidosis
3.electrolyte imbalance
examples of Ca2+ channel blockers (6)
1.amlodipine
2.diltiazem
3.felodipine
4.nicardipine
5.nifedipine
6.verapamil

*note: they all end in -pine except for diltiazem & verapamil