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Pulmonary hypertension is a serious condition characterized by elevated blood pressure in the pulmonary arteries, leading to various complications if left untreated. Several classes of drugs are used to manage this condition, each with distinct mechanisms of action and clinical considerations.
Drug Class | Mechanism of Action | Clinical Notes | Examples |
---|---|---|---|
Endothelin Receptor Antagonists | Competitively antagonizes endothelin-1 receptors, reducing pulmonary vascular resistance. | Hepatotoxic; monitor liver function tests (LFTs). | Bosentan |
PDE-5 Inhibitors | It inhibits phosphodiesterase-5 (PDE-5), increases cyclic guanosine monophosphate (cGMP), and prolongs the vasodilatory effect of nitric oxide (NO). | Also used for erectile dysfunction. Contraindicated with nitroglycerin or other nitrates due to the risk of severe hypotension. | Sildenafil |
Prostacyclin Analogs | Mimics prostacyclin (PGI2), with direct vasodilatory effects on pulmonary and systemic arterial vascular beds. Inhibits platelet aggregation. | Side effects include flushing and jaw pain. | Epoprostenol, Iloprost |