Why are calcium-channel blockers not used in all patients with ...

[jparksx]

Why are calcium-channel blockers not used in all patients with idiopathic pulmonary artery hy-pertension?
 
  a. It causes severe side effects.
  b. Many of these patients have systemic hy-potension.
  c. Only a small percentage of IPAH patients respond.
  d. There is a high incidence of anaphylaxis.

Question 2

In what type of IPAH patient is lung transplantation indicated?
 
  a. All pulmonary artery hypertension patients with clinically significant disease
  b. Patients not responding to vasodilators with significant cardiac dysfunction
  c. Patients with class II, class III, or class IV disease
  d. Patients with refractory hypoxemia

[Expo]

Answer to Question 1

ANS: C
Patients with IPAH who respond to vasodilators in the short term have improved survival with long-term use of calcium-channel blockers. Thus, these agents should be considered in all patients who have significant and definite response to a short-acting vasodilator. Unfortunately, only a small fraction of IPAH patients qualify for and benefit from long-term therapy with oral calci-um-channel blockers.

Answer to Question 2

ANS: B
Single or double lung transplantation has been used successfully in the treatment of patients with IPAH. Lung transplantation is indicated in the care of patients who do not respond to vasodila-tors and have significant cardiac impairment.