Instantly from the ACCP Pulmonary drugs Board assessment 2009 direction, this article covers each subject in a concise, easy-to-use structure. Use as a self-study source to organize for the pulmonary medication subspecialty board exam.
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Additional resources for ACCP Pulmonary Medicine Board Review: 25th Edition
Unfortunately, calciumchannel blockers have no antiproliferative effect, and thus, only a small subset of patients will benefit from long-term use. In patients who do not show a reduction in PAP (with the administration of vasodilators) during right-heart catheterization, it is not beneficial and is potentially dangerous to initiate therapy with calcium-channel blockers. Significant adverse effects include systemic hypotension, pulmonary edema, and right ventricular failure. Current US Food and Drug Administrationapproved and investigational therapies aimed at reducing endothelial and smooth-muscle cell proliferation target the following three major pathways involved in the pathogenesis of PAH: prostacyclin, NO, and endothelin.
Control of these risk factors could decrease the risk of PE among women. Hayashino Y, Goto M, Noguchi Y, et al. Ventilation-perfusion scanning and helical CT in suspected pulmonary embolism: meta-analysis of diagnostic performance. Radiology 2005; 234:740−748 Helical CT scanning has better discriminatory power than . V/Q scanning for excluding PE, but the two tests have a similar discriminatory power in the diagnosis of PE when . ” Heit JA, Kobbervig CE, James AH, et al. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study.
Few studies have been published that directly compare individual medications or classes of medications. Multidrug treatment is appealing because the three classes of medications approved by the Food and Drug Administration exert their effects by different mechanisms. The use of two or more drugs may allow for dosing below the levels that cause important side effects. A few small studies have confirmed this theory, but more data are needed before firm recommendations can be made. Authors of the American College of Chest Physicians evidence-based guideline published updated guidance for medical therapy for PH in June 2007.
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