Treatment Options for Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) can be managed with various medications aimed at reducing pressure in the pulmonary arteries and improving heart function. Diuretics are often prescribed to help alleviate fluid buildup and reduce strain on the right ventricle. In cases where right heart failure is present, inotropic agents such as milrinone or digoxin may be used to strengthen cardiac output.

Common Medications for Lowering Pulmonary Pressure

One of the primary approaches in PAH treatment involves the use of vasodilators to relax blood vessels in the lungs. Before initiating therapy with calcium channel blockers (CCBs), patients undergo an acute vasodilator test. If the test yields a positive result, medications such as nifedipine or diltiazem may be prescribed to lower pulmonary artery pressure effectively.

Targeted Therapies for Pulmonary Arterial Hypertension

Phosphodiesterase-5 Inhibitors

Targeted drug therapies have significantly advanced the management of PAH. Among these, phosphodiesterase-5 (PDE-5) inhibitors like sildenafil and tadalafil are commonly used. These medications help improve exercise capacity and delay disease progression by enhancing the effects of nitric oxide, a natural vasodilator.

Endothelin Receptor Antagonists

Another important class of drugs includes endothelin receptor antagonists such as bosentan and ambrisentan. These medications block the action of endothelin, a substance that narrows blood vessels, thereby helping to maintain open and relaxed pulmonary arteries.

Prostacyclin Analogues

Prostacyclin medications, including treprostinil and epoprostenol, are also widely used in PAH treatment. These drugs mimic the action of prostacyclin, a naturally occurring compound that dilates blood vessels and prevents blood clotting.

Inhaled Therapies and Other Approaches

In addition to oral and intravenous treatments, inhaled therapies such as nitric oxide are frequently used in clinical settings. These agents deliver medication directly to the lungs, offering rapid and targeted relief of pulmonary hypertension symptoms. When used in combination with other therapies, inhaled treatments can significantly improve patient outcomes.