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Overview of Noteworthy Drugs for Various Medical Conditions

This chapter highlights significant drugs used to treat conditions such as pulmonary arterial hypertension, sepsis, neonatal respiratory distress syndrome, cystic fibrosis, sickle cell anemia, hyperuricemia from chemotherapy, narcolepsy, ALS, and hyperphosphatemia in dialysis patients. Key drug classes include prostacyclin analogs like Epoprostenol, endothelin receptor antagonists such as Bosentan, corticosteroids like Dexamethasone, and phosphate binders. Additionally, it covers important side effects, monitoring requirements, and treatment goals to provide a comprehensive reference for healthcare professionals.

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Overview of Noteworthy Drugs for Various Medical Conditions

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  1. Chapter 106 Miscellaneous Noteworthy Drugs

  2. Drugs for Pulmonary Arterial Hypertension • Prostacyclin analogs • Epoprostenol (Flolan) • Treprostinil (Remodulin) • Iloprost (Ventavis) • Endothelin-1 receptor antagonists • Bosentan (Tracleer) • Ambrisentan (Letairis) • Sitaxsentan (Thelin) – available in Canada • Sildenafil (Revatio)

  3. Sepsis and Treatment • Sepsis • Life-threatening condition triggered by systemic microbial infection • End result – diffuse endovascular injury, MODS, and often death • Drotrecogin alfa (activated) (Xigris) • Adverse effects • Bleeding • Use with caution for patients at risk for bleeding

  4. Drugs for Neonatal Respiratory Distress Syndrome • Prenatal and postnatal glucocorticoids • Accelerate fetal lung maturation • Dexamethasone • Betamethasone • Lung surfactant • Direct intratracheal instillation • Poractant alfa (Curosurf), calfactant (Infasurf), and beractant (Survanta)

  5. Drugs for Cystic Fibrosis • Inherited disorder resulting in damage to lungs, pancreas, and other organs • Drugs used to alleviate symptoms • Pancreatic enzymes • Fat-soluble vitamins • Antibiotics • Inhaled dornase alfa (Pulmozyme) • Oral ibuprofen • Inhaled beta2-adrenergic agonists • Salmeterol (Serevent diskus)

  6. Drugs for Sickle Cell Anemia • Inherited blood disorder characterized by abnormal hemoglobin, chronic anemia, painful episodes • Analgesics and glucocorticoids • Hydroxyurea • Adverse effects • Myelosuppression • Monitor hematologic state every 2 weeks

  7. Drugs for Hyperuricemia Caused by Cancer Chemotherapy • Rasburicase (Elitek) • Adverse effects • Fever • GI effects

  8. Gamma-Hydroxybutyrate (Xyrem) • GHB – used for cataplexy in patients with narcolepsy • Adverse effects • Confusion • Depression • Headache • Dizziness • Sleepwalking

  9. Riluzole (Rilutek) • Used to treat amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease • Adverse effects • Asthenia • GI effects • CNS effects • Decreased lung function

  10. Phosphate Binders for Patients on Dialysis • Used to treat hyperphosphatemia • Calcium-based phosphate binders • Calcium carbonate • Increase risk of hypercalcemia • Calcium-free phosphate binders • Sevelamer carbonate • Do not increase risk of hypercalcemia but are more costly

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