Drugs for the treatment of pulmonary arterial hypertension

  1, calcium antagonists: mainly used in patients with positive vascular response to primary pulmonary hypertension.  2, Prostacyclin: Prostacyclin has long been used in the treatment of pulmonary hypertension. The new prostacyclin preparation, epoprostenol, has been developed successfully and has become the gold method for the treatment of pulmonary hypertension, especially for primary pulmonary hypertension, with significant effect, but for other causes of the effect is general. However, there are some problems with the clinical use of eprostacyclin, in addition to the necessity of central catheter administration and indwelling catheters, and some adverse drug reactions such as unmanageable diarrhea, jaw pain, thrombocytopenia, systemic hypertension, and flushing. In addition, the drug is also very expensive.  3, endothelin receptor blockers: endothelin receptor blockers: such as bosentan, its ability to improve pulmonary hypertension is not as good as prostacyclin, and also has some adverse reactions, such as 30% of patients with hepatotoxicity, anemia, etc.  4, sildenafil, NO, etc., can also be used in the treatment of selected pulmonary hypertension.  5.Anticoagulation therapy: If pulmonary hypertension is caused by recurrent pulmonary embolism, anticoagulation, lower limb venous filter placement, pulmonary artery thrombectomy and other treatment methods can be used. Among them, it is worth noting that the mortality rate of thrombectomy can be 5% to 15%.  6, gene therapy: some other newer therapeutic measures such as gene therapy is being studied, which depends on the identification, screening and regulation of the causative gene of pulmonary hypertension, although the prospect is bright, but if short-term application in the clinic is not possible.