Dosing considerations in the use of intravenous prostanoids in pulmonary arterial hypertension: An experience-based review

Oudiz, Ronald J.; Farber, Harrison W.

doi:10.1016/j.ahj.2008.10.029

Cited by 41 publications

(38 citation statements)

References 46 publications

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“…The use of higher dosages of iv PGI 2 as applied in our observation, been reported in the long term treatment of PAH patients (21,22).…”

Section: Discussionmentioning

confidence: 92%

Intravenous epoprostenol versus high dose inhaled iloprost for long-term treatment of pulmonary hypertension

Reichenberger¹,

A²,

Morrell³

et al. 2011

Pulmonary Pharmacology & Therapeutics

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Background: Intravenous prostacyclin (iv PGI) and inhaled Iloprost (inh ilo) are established therapies in pulmonary arterial hypertension (PAH), however comparative data are lacking.Methods and Patients: We performed a long-term open label comparison trial of iv PGI or high dose inh ilo in 24 patients with severe PAH: 12 patients (9 female, 40 +/-14 years, 10 idiopathic PAH, 2 PAH in connective tissue disease CTD) received iv PGI, whereas 12 patients (7 female, 43 +/-12 years, 5 IPAH, 6 CTD, 1 porto-pulmonary hypertension) were commenced on inh ilo with a median dose of 120 µg / 24 hours. Hemodynamic parameters and 6 minute walking distance (6MWD) at baseline did not differ between both groups.Results: After 3 months therapy, patients on iv PGI showed a significant increase in 6 MWD from 220 to 280 meters (p<0.01), whereas patients on high dose inh ilo

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“…The use of higher dosages of iv PGI 2 as applied in our observation, been reported in the long term treatment of PAH patients (21,22).…”

Section: Discussionmentioning

confidence: 92%

Intravenous epoprostenol versus high dose inhaled iloprost for long-term treatment of pulmonary hypertension

Reichenberger¹,

A²,

Morrell³

et al. 2011

Pulmonary Pharmacology & Therapeutics

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“…Sulandırılmış ilaç oda ısısında 8 saat dayanır. İlacın stabilitesini arttırmak ve sık kaset değişimini önlemek için her kaset buz torbalarıyla soğutulmalı ve infüzyon sırasında ilacın sıcaklığının 2 ile 8 derece arasında olmasına dikkat edilmelidir (5). İnfüzyonun her 24 saatte tekrardan hazırlanmasını gerekir (4).…”

Section: Epoprostenolunclassified

“…Intravenöz uygulama için treprostinil infüzyon öncesi sulandırılmalıdır ve santral bir venöz kateterden yollanmalıdır. Sulandırılmış treprostinil oda ısısında 48 saate kadar stabildir ve buz torbalarına ihtiyaç yoktur (5). Cilt altı uygulanmasından sonra hızlıca ve tamamen emilir, mutlak biyoyararlınımı %100'dür.…”

Section: Treprostinilunclassified

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Prostanoids in the treatment of pulmonary arterial hypertension

Başkurt¹,

Küçükoğlu²

2010

Anadolu Kardiyol Derg

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Prostacyclin, endothelin-1, and nitric oxide pathways are involved in the pathogenesis of pulmonary arterial hypertension. This devastating disease of the pulmonary vasculature is associated with vasoconstriction, thrombosis and proliferation, and this may be partly due to lack of endogenous prostacyclin secondary to prostacyclin synthase downregulation. Prostanoids (prostacycin analogues) are potent vasodilators and possess antiaggregant, antiinflammatory and antiproliferative properties. The first agent to be approved for the treatment of pulmonary arterial hypertension was epoprostenol. In the last decade other prostanoids (treprostinil, iloprost) has been approved for the treatment of pulmonary arterial hypertension.

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“…Oudiz and Farber reported mean maintenance dose of epoprostenol being 30-39 ng/kg/min in PAH patients [20]. Sitbon et al utilized even smaller doses of epoprostenol (mean 19.6 ng/kg/min) as a part of the triple-combination strategy [21] and recommended dose of epoprostenol according to Mc Laughlin et al was 25-40 ng/kg/ min [22].…”

Section: Epoprostenol As the Key Drug To Decrease Pulmonary Artery Prmentioning

confidence: 99%

Pulmonary artery pressure matters – how to efficiently improve survival in pulmonary arterial hypertension (RCD code: II‐1A.1)

Matsubara

Błaszczak

Podolec

et al. 2017

Journal of Rare Cardiovascular Diseases

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Please cite this article: Matsubara H, Blaszczak P, Podolec P, et al. Pulmonary artery pressure matters -how to efficiently improve survival in pulmonary arterial hypertension. AbstractPulmonary arterial hypertension is a disease characterized by poor prognosis despite treatment. Even in a modern era of pharmacotherapy there is a strong need to further improve survival of patients. The current therapeutic strategies do not offer a real break-through in terms of reducing mortality. In a search for better efficacy of treatment we discuss a strategy based on lowering pulmonary artery pressure as much as possible with epoprostenol in monotherapy or in combination. Epoprostenol with bosentan is an effective tool in achieving this goal. A rapid up-titration regardless of maximum epoprostenol dose achieved gives additional long-term benefit. Practical issues related to such modality of treatment are also discussed. JRCD 2017; 3 (4): 110-115

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Dosing considerations in the use of intravenous prostanoids in pulmonary arterial hypertension: An experience-based review

Cited by 41 publications

References 46 publications

Intravenous epoprostenol versus high dose inhaled iloprost for long-term treatment of pulmonary hypertension

Intravenous epoprostenol versus high dose inhaled iloprost for long-term treatment of pulmonary hypertension

Prostanoids in the treatment of pulmonary arterial hypertension

Pulmonary artery pressure matters – how to efficiently improve survival in pulmonary arterial hypertension (RCD code: II‐1A.1)

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