Sildenafil use in pulmonary hypertension

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  1. Stoun Well-Known Member

    Sildenafil use in pulmonary hypertension


    Background When a baby is born, pressure in the blood vessels of the lungs is high, and when normal breathing is established, this pressure starts to fall. In some babies, this transition does not occur and pressure remains high; this does not allow blood to go to the lungs to get adequate oxygen. This situation is called persistent of the neonate (PPHN). Other events can lead to development of high pressure in lung blood vessels that can manifest within a few days after birth. Persistent high pressure in these vessels leads to delivery of less oxygen to all organs of the body. A medication called sildenafil may cause lung blood vessels to relax, allowing improved blood flow and improved delivery of oxygen to all organs. Study characteristics We identified five studies that evaluated effects of sildenafil: three studies that compared sildenafil with (no sildenafil); one that compared sildenafil with other medication (magnesium sulphate); and one that used sildenafil in combination with another medicine (nitric oxide). Madrid, Spain—The prescribing of sildenafil to treat residual hypertension in patients with valvular heart disease should raise a red flag for pharmacists. That warning came from late-breaking results of the SIOVAC trial that were presented at the European Society of Cardiology meeting in Barcelona, Spain. At a Hot Line LBCT Session at the ESC Congress, Hospital General Universitario Gregorio Marañon–led researchers reported that off-label use of the drug led to worse clinical outcomes, including twice the risk of hospitalization, compared with placebo.“Valvular disease is considered the next cardiac epidemic because of its strong association with age and the rapid aging of the population worldwide,” said principal investigator Javier Bermejo, MD, Ph D. “The only established treatment is repair or replacement of the valve surgically or percutaneously. But symptoms often remain or reappear in the long-term. Residual pulmonary hypertension is the most important risk factor for death and disability after successful correction of the valvular lesion.”Increased blood pressure in the pulmonary artery might persist after valve treatment, according to the study, which points out that sildenafil—which usually is used to treat erectile dysfunction—is frequently prescribed off-label in patients with retrograde pulmonary hypertension. Conducted in 17 public hospitals and coordinated by the Spanish Network Centre for Cardiovascular Research (CIBERCV), the SIOVAC trial looked at whether sildenafil can improve long-term outcomes in patients with residual pulmonary hypertension after correction of a valvular lesion.

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    Study design. A retrospective cohort study of children with pulmonary hypertension PH treated with sildenafil at a single institution between 20. Sildenafil Use In Pulmonary Hypertension CanadianPharmacyOnline. Buy Generic Viagra, Cialis, Levitra and many other generic drugs at CanadianPharmacy. Lowest prices. Guidelines for the treatment of pulmonary hypertension stress the importance. Description of the use of sildenafil in childhood is limited to a single case report.

    Severe, chronic pulmonary hypertension in childhood is uncommon, difficult to treat, and carries a poor prognosis. Sildenafil (Viagra, Pfizer) has been used successfully in adults with pulmonary hypertension as monotherapy or in combination with inhaled prostacyclin. Severe pulmonary hypertension is characterised by extensive remodelling of the pulmonary vasculature, with consequent deleterious hypertrophic changes in the right ventricle. Before the advent of prostacyclin therapy, the prognosis in childhood was bleak, with a median survival of 10 months. Treatment with continuous intravenous infusions is particularly difficult in childhood and beset with potential complications, hence an effective oral treatment would be particularly attractive. Until recently, effective oral therapy has been limited to relatively unselective agents such as nifedipine. This is only useful in patients who respond acutely to vasodilator testing at cardiac catheterisation ( Sildenafil is a more selective agent, which relaxes pulmonary vascular smooth muscle by inhibiting cyclic guanosine monophosphate (c GMP) binding, c GMP specific phosphodiesterase, which is concentrated in the lungs. Patient 1 presented with transposition of the great arteries shortly after birth. uses cookies to improve performance by remembering your session ID when you navigate from page to page. Please set your browser to accept cookies to continue. This cookie stores just a session ID; no other information is captured. Accepting the NEJM cookie is necessary to use the website.

    Sildenafil use in pulmonary hypertension

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  7. High concentrations of phosphodiesterases in the pulmonary vasculature have led to the use of. Ohlsson A, Shah PS. Sildenafil for pulmonary hypertension in.

    • Sildenafil for pulmonary hypertension in neonates Cochrane.
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    Sildenafil Dangerous for Certain Pulmonary-Hypertension Patients. reported that off-label use of the drug led to worse clinical outcomes. For the Sildenafil Use in Pulmonary Arterial Hypertension SUPER Study Group. All sildenafil doses reduced the mean pulmonary-artery pressure P=0.04. Efficacy, Safety, and Tolerability Study of Pirfenidone in Combination With Sildenafil in Participants With Advanced Idiopathic Pulmonary Fibrosis IPF and Risk of.

     
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