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Chapter 106

Chapter 106. Miscellaneous Noteworthy Drugs. Drugs for Pulmonary Arterial Hypertension. Prostacyclin analogs Epoprostenol (Flolan) Treprostinil (Remodulin) Iloprost (Ventavis) Endothelin-1 receptor antagonists Bosentan (Tracleer) Ambrisentan (Letairis)

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Chapter 106

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  1. Chapter 106 Miscellaneous Noteworthy Drugs

  2. Drugs for Pulmonary Arterial Hypertension • Prostacyclin analogs • Epoprostenol (Flolan) • Treprostinil (Remodulin) • Iloprost (Ventavis) • Endothelin-1 receptor antagonists • Bosentan (Tracleer) • Ambrisentan (Letairis) • Sitaxsentan (Thelin) – available in Canada • Sildenafil (Revatio)

  3. Sepsis and Treatment • Sepsis • Life-threatening condition triggered by systemic microbial infection • End result – diffuse endovascular injury, MODS, and often death • Drotrecogin alfa (activated) (Xigris) • Adverse effects • Bleeding • Use with caution for patients at risk for bleeding

  4. Drugs for Neonatal Respiratory Distress Syndrome • Prenatal and postnatal glucocorticoids • Accelerate fetal lung maturation • Dexamethasone • Betamethasone • Lung surfactant • Direct intratracheal instillation • Poractant alfa (Curosurf), calfactant (Infasurf), and beractant (Survanta)

  5. Drugs for Cystic Fibrosis • Inherited disorder resulting in damage to lungs, pancreas, and other organs • Drugs used to alleviate symptoms • Pancreatic enzymes • Fat-soluble vitamins • Antibiotics • Inhaled dornase alfa (Pulmozyme) • Oral ibuprofen • Inhaled beta2-adrenergic agonists • Salmeterol (Serevent diskus)

  6. Drugs for Sickle Cell Anemia • Inherited blood disorder characterized by abnormal hemoglobin, chronic anemia, painful episodes • Analgesics and glucocorticoids • Hydroxyurea • Adverse effects • Myelosuppression • Monitor hematologic state every 2 weeks

  7. Drugs for Hyperuricemia Caused by Cancer Chemotherapy • Rasburicase (Elitek) • Adverse effects • Fever • GI effects

  8. Gamma-Hydroxybutyrate (Xyrem) • GHB – used for cataplexy in patients with narcolepsy • Adverse effects • Confusion • Depression • Headache • Dizziness • Sleepwalking

  9. Riluzole (Rilutek) • Used to treat amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease • Adverse effects • Asthenia • GI effects • CNS effects • Decreased lung function

  10. Phosphate Binders for Patients on Dialysis • Used to treat hyperphosphatemia • Calcium-based phosphate binders • Calcium carbonate • Increase risk of hypercalcemia • Calcium-free phosphate binders • Sevelamer carbonate • Do not increase risk of hypercalcemia but are more costly

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