Bosentan therapy for pulmonary arterial hypertension

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Henry CohenRajat Mukherji

Abstract

The etiology, epidemiology, pathophysiology, diagnosis, and manifestations of pulmonary arterial hypertension (PAH) are described, and the role of bosentan in the management of PAH is reviewed. The incidence of primary pulmonary hypertension, a subcategory of PAH, is estimated to be one to two new cases per million people annually in the general population. PAH has definitively been linked with several appetite suppressants. Disease-induced causes of PAH include connective tissue diseases, portal hypertension or liver disease, and human immunodeficiency virus infection. The clinical diagnosis of early PAH is difficult because its symptoms are nonspecific. Exertional dyspnea, the most common symptom of PAH, occurs in 60% of patients and indicates a severely compromised cardiac output. Three dependent elements are integral to the development of elevated mean pulmonary arterial pressure and PAH: vascular wall remodeling, thrombosis in situ, and vasoconstriction. Bosentan undergoes extensive hepatic metabolism. Bosentan-induced hepatotoxicity is common and must be monitored carefully throughout therapy. Since PAH is common in women of childbearing age, the use of bosentan in these patients requires careful review. Limited data exis...Continue Reading

Citations

Feb 26, 2005·Circulation Journal : Official Journal of the Japanese Circulation Society·Kenya SajiKunio Shirato
Nov 17, 2004·The Journal of Pathology·Pascal de LagausieDominique Berrebi
Aug 8, 2006·ChemMedChem·Michael BrandsNagahiro H Yoshida
Jan 25, 2006·European Heart Journal·Steeve ProvencherGérald Simonneau
Nov 11, 2008·Journal of Molecular Biology·Henk SchulzChristian Oefner

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