کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
10129900 | 1645295 | 2018 | 38 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Titration of pulmonary arterial hypertension therapeutics: Experience-based recommendations
ترجمه فارسی عنوان
تداخل درمان های فشار خون شریان ریوی: توصیه های مبتنی بر تجربه
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کلمات کلیدی
PAHSBPET-1mPAPULNREMSSGCPAWP - AWPendothelin receptor antagonist - آنتاگونیست گیرنده اندوتلینRisk Evaluation and Mitigation Strategy - ارزیابی ریسک و کاهش استراتژیDose titration - اندازه گیری دوزendothelin 1 - اندوتلین 1Upper limit of normal - حد بالای طبیعیSoluble guanylate cyclase - سیکلاس گوانیلات حل کنندهPVR - ضبط و پخشERA - عصرsystolic blood pressure - فشار خون سیستولیکPulmonary arterial hypertension - فشار خون شریانی ریویmean pulmonary artery pressure - فشار متوسط شریانی ریویPulmonary artery wedge pressure - فشار گوه شریان ریهPulmonary vascular resistance - مقاومت عروقی ریویNitric oxide - نیتریک اکسیدwood units - واحد چوبPulmonary hypertension - پرفشاری خون ریویprostacyclin - پروستاسیکلین
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
پزشکی ریوی و تنفسی
چکیده انگلیسی
The availability of new medications has improved exercise capacity, enhanced quality of life, and extended time to clinical worsening in patients with pulmonary arterial hypertension (PAH). For many of these medications, careful individualized dose titration is required to maximize therapeutic effectiveness while minimizing side effects. In addition, specific routes of administration, including intravenous (IV), subcutaneous (SC), and inhaled administration may present additional challenges for patients and healthcare providers. These challenges include the possibility of catheter-related infections (IV), infusion site pain (SC), and adherence to frequent dosing schedules (inhaled). Temporary discontinuations may require re-titration and, in some cases, may even be life threatening. Here, based on our clinical experience, we provide our recommendations for dose titration schemes for PAH medications that require individualized dosing in adult patients, including agents acting on the endothelin-1 pathway (bosentan and ambrisentan), the prostacyclin pathway (epoprostenol, treprostinil, and selexipag), and the nitric oxide pathway (tadalafil and the soluble guanylate cyclase stimulator riociguat). A case study that illustrates the application of best practices for PAH medication dose titration in a real-world setting is presented. Good two-way communication between specialty pharmacies and other healthcare providers promotes optimal medication usage and patient health. Experience has shown that slow, cautious up-titration is generally associated with better long-term outcomes. In all cases, patient education, frequent monitoring and careful management of side effects, and treatment adherence are critical.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Respiratory Medicine - Volume 143, October 2018, Pages 139-146
Journal: Respiratory Medicine - Volume 143, October 2018, Pages 139-146
نویسندگان
Sandra Lombardi, Martha Kingman, Maribeth Duncan, Samuel Clark Berngard, Timothy Fernandes,