Management of the patient with pulmonary arterial hypertension receiving intravenous prostacyclin: an expert nurse practical guide.
Pulmonary arterial hypertension (PAH) is a severely disabling disorder characterized by elevated pulmonary artery pressure ultimately leading to right heart failure and death. Treatment options have significantly increased over the past decade. Intravenous prostacyclins remain the treatment of choice for advanced PAH, leading to long-term clinical benefits and improved survival. Their administration requires a high level of nursing competency and presents considerable challenges for patients and caregivers. This article reviews the characteristics of currently available intravenous prostacyclins and provides a practical guide for nurses who may have had limited exposure to intravenous prostacyclins and their unique dosing, side effects, and titration characteristics.
Heart and Lung Center, University of Texas Southwestern Medical Center, Dallas, Texas (Dr Kingman); and Pulmonary Division, University of California San Diego, San Diego, California (Ms Lombardi). Martha S. Kingman, DNP, FNP-C, is a family nurse practitioner in the pulmonary hypertension clinic at the University of Texas Southwestern Medical Center at Dallas. She is presently serving as subinvestigator in numerous ongoing pulmonary hypertension clinical trials and recently served on the editorial board of Advances in Pulmonary Hypertension, the journal of the Pulmonary Hypertension Association. Sandra Lombardi, RN, is a nurse coordinator in the pulmonary hypertension clinic at the University of California San Diego. She has managed patients with pulmonary hypertension in the clinic setting and has participated in clinical trials for the past 10 years. Prior to this role, she educated patients on the use of intravenous prostacyclins.
Martha S
MS
Kingman
Sandra
S
Lombardi
D006801:Humans; D006976:Hypertension, Pulmonary / Q000451:nursing / Q000628:therapy*; D007262:Infusions, Intravenous; D044062:Prostaglandins I / Q000008:administration & dosage*
D044062:Prostaglandins I