Medications for Pulmonary Hypertension
Although there is no cure for pulmonary hypertension, the condition that causes high blood pressure in the lungs, a variety of drug treatments can help reduce symptoms and lengthen life for people diagnosed with the possibly deadly cardiovascular disease.
The best treatment for pulmonary hypertension varies from person to person. Additionally, one course of treatment may only be effective for a short amount of time, requiring a physician to select another treatment option. Factors including age, type of pulmonary hypertension and overall health help determine what medication is best for each individual. Medications and treatments for pulmonary hypertension include: blood vessel dilators, endothelin receptor antagonists, high-dose calcium channel blockers, anticoagulants, diuretics, oxygen and transplantation.
Blood vessel dilators, or vasodilators, improve the function of the pulmonary blood vessels and improve related symptoms, such as shortness of breath and chest pain. Two examples of these drugs are prostacyclin, which acts like a hormone and an anti-clogging agent, and epoprostenol (Flolan), which is infused through an intravenous catheter. While epoprostenol has shown to be beneficial in preventing fainting spells, improving stamina and reducing risk of blood clots, and has proven more effective than any other treatment, it is also a complex therapy that requires the patient to mix his own medication, operate an intravenous pump and maintain the catheter. Its side effects include jaw pain, nausea, diarrhea, leg cramps and pain and infection at the intravenous site.
Endothelin receptor antagonists are pills that are used to counteract the effects of endothelin, a substance in the blood vessel walls that causes constriction and narrowing of the blood vessels. One type of this medication is called bocentan (Tracleer), which has been found to improve stamina and relieve other symptoms of pulmonary hypertension. A drawback of this pulmonary hypertension medication is that it is not suitable for pregnant women. Additionally, people taking bocentan require monthly liver monitoring.
High-dose calcium channel blockers relax the muscles in the walls of the blood vessels. There are a number of different types of calcium channel blockers, including amlodipine (Norvasc), diltiazem (Cardizem, Tiazac) and nifedipine (Adalat, Procardia), however, this type of medication has only proven successful for one in five pulmonary hypertension patients. These drugs also may produce a number of serious side effects.
Anticoagulants, such as warfarin (Coumadin), are often prescribed to reduce the likelihood of blood clots. These work for that purpose, but also may cause bleeding complications. Therefore, routine blood tests are necessary for people taking anticoagulants. These drugs also have a negative interaction with more than 100 other drugs, requiring diligent attention to even over-the-counter medications.
Diuretics, or water pills, help release excess fluid from the body. This helps lessen the work for the heart in pulmonary hypertension patients and also limits the amount of fluid that may form in the lungs.
In addition to medications, oxygen therapy is often used to help treat symptoms of pulmonary hypertension. In rare cases, a heart or heart-lung transplant is a method of treatment for pulmonary hypertension patients.
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