Pulmonary Arterial Hypertension (PAH) belong to group 1 in the classification of Pulmonary Hypertension (PH). It is a chronic progressive disease caused by narrowing of the minor pulmonary arteries due to vascular proliferation and remodeling.
Figure 1: Changes occur in blood vessels in PAH.
The estimated prevalence for PAH is 15-50 cases per million although it is a rare disease. The female to male ratio is 1.7:1 with higher prevalence between 30-40 years old. To date there are 52 cases per million population of Scotland diagnosed with PAH. (1)
The current treatments available for PAH are prostaglandin (PG), calcium channel blocker (CCB), Endothelin Receptor Antagonist (ERA), and Phosphodiesterase-5-inhibitors (PDE-5-I). The need for new drug therapy is due to the drawbacks of the current treatment as shown in the tables below. (3) This has led to the development of Opsumit (Macitentan), a new drug therapy for PAH.
Table 1: Drawbacks of using Calcium Channel Blocker (CCB) in PAH
Calcium Channel Blocker (Nifedipine, Diltiazem) The proportion of patient benefited from this drug is too little.(2)
Table 2: Drawbacks of using Prostaglandins (PGs) in PAH
Epoprostenol I.V Iloprost nebulized Treprostinil S.C
- Inconvenience administration through IV route which requires hospitalization
- Unpresentable body image
- Administration of the drug might be associated with high risk of infection (need to be given through continuous I.V infusion due to short half-life)
The closing of the ductus arteriosus increases blood flow to the lungs since the breathing is focused mainly on liquid to air gas exchange in the lungs, as opposed to the placenta in the fetus. Where PPHN takes its toll is that it inhibits the bodies’ ability to lower pulmonary resistance, therefor keeping blood flow at a minimum and blood pressure to remain high for the lungs and not allowing enough gas exchange for the child to function properly (Glanville, 2011).
Pulmonary hypertension is a lung disorder. The arteries that carry blood from the heart to the lungs become narrowed, making it very hard for the blood to get through the vessels, this then causes the pressure in the arteries to increase more than usual (high blood pressure). Scientists think that the procedure starts with injury to the layer of cells that line the small blood vessels of the lungs.
The dosage was to high for the patient because the chart started going over the regular normal level
3.3. A pharmacist should verify the ordering provider is appropriate as noted in section 2.
However, per AbbVie citing CIPO, the mere presence of a fixed dosage and fixed dosing schedule cannot always be sufficient “to avoid the method of medical treatment prohibition” (AbbVie at [18]).
Patients may shy away from an injectable formulation, despite its value in providing a full month of protection from relapse.
et al. 2017). Pulmonary hypertensions occurs in about 8-23% of premature infants (Vyas-Read S et. al. 2017). One method of determine if a patient has pulmonary arterial hypertension is by lung function test (Davis R and Mychaliska G, 2013). One current method used to help treat pulmonary arterial hypertension is assisted ventilation, the method helps lower blood pressure (Davis R and Mychaliska G, 2013). However assisted ventilation can not be used in all preterm infants some extracorporeal life support which will provide respiratory and veno-arterial support (Davis R and Mychaliska G, 2013).
With the growing reliance on medication therapy as the primary intervention for most illnesses, patients receiving medication interventions are exposed to potential harm as well as benefits. Medicines have proven to be very beneficial for treating illness and preventing disease. This success has resulted in a dramatic increase in medication use in recent times. Unfortunately, this increase in use and expansion of the pharmaceutical industry has also brought with it an increase in hazards, error and adverse events associated with medication use.
The act of not informing the patient about this can cause several errors in taking the medication. An example
The purpose of this report is two discuss the Pharmacodynamics, pharmacokinetics, proposed benefits, research method, results of research, and possible-nursing implications of newly approved drugs for the treatment of hypertension. These drugs include Atacand HCT and Diltiazem HCL. All newly approved drugs from the FDA are either new drugs or new formulations of older drugs. The information contained in this report was derived from various web pages and online search engines.
Changing the name of Concomitant Medication to be Pre and Concomitant Medication to reflect medication used before the IP given. However, the caution was given for the medication with long half-life. This kind of medication may interfere IP uneven given several days before administration of IP. Hence, such kind of medication should be handled with care.
Pulmonary vascular disease is used to identify any disorder that may affect blood flow through the vessels between the heart and lungs. Blood flow begins at the right side of the heart and makes its way to the lungs in the process of oxygenation. Deoxygenated blood from the tissue travels to the right side of the heart through the veins and is eventually pumped towards the lungs through pulmonary arteries. The lungs oxygenate the blood and send it towards the left side of the heart through the pulmonary vein in order to pump it throughout the body. Any disruption of this process would be labeled a Pulmonary Vascular Disease. There are several kinds of PVD, the two main types are Pulmonary Embolism and Pulmonary Hypertension. Pulmonary Embolism
There used to be two types of Pulmonary Hypertension. Primary Pulmonary Hypertension is when there is no other disease or illness accompanying it. Secondary Pulmonary Hypertension is when there is a pre-existing disease that triggers the Pulmonary Hypertension.
For this review, the Kettering College library online database was used to find peer reviewed articles as references. Beginning on February 22, 2015, the search “treatment of pulmonary hypertension” was used to narrow the results for the study. To shorten the results further, the year limit was set from 2005
No matter how it is administered when used on a long-term basis, the complications become very abundant. Adequate nutrition is often not provided due to problems with diarrhea, tube clogging, and aspiration.