Formulary implications of management of pulmonary arterial hypertension: Part I--An overview of existing and new pharmacological treatment options.
Pulmonary arterial hypertension (PAH) represents a significant challenge to physicians, particularly because of its etiology and nonspecific presentation. Unfortunately, the majority of patients are not diagnosed until the condition is at an advanced stage. In this two-part White Paper from The Pharmacy and Therapeutics Society, prostanoids, administered as continuous intravenous or subcutaneous infusions, are the most effective treatments but are inconvenient and costly, owing to complex parenteral administration. The endothelin-receptor antagonist bosentan and the phosphodiesterase-5 inhibitor sildenafil are currently the only oral therapies licensed for PAH; however, bosentan has an identified risk of liver toxicity. Newer PAH treatments may offer benefits over existing therapies in terms of less potential for liver damage and more favorable interaction profiles.
Feldman
Jeremy
J
Pulmonary Hypertension Program, St. Joseph's Hospital, Phoenix, USA. jpfeldman1@yahoo.com
Berenbeim
David
D
D005569:Formularies as Topic; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008329:Managed Care Programs; D004364:Pharmaceutical Preparations; D011651:Pulmonary Artery / Q000503:physiopathology*; D014481:United States
D004364:Pharmaceutical Preparations