Respiratory Conditions

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Pulmonary arterial hypertension (PAH) is a progressive, debilitating disorder associated with poor quality of life and shortened life span. For many years, medical therapy consisted of calcium channel blockers, warfarin, supplemental oxygen, and digitalis glycosides. A better understanding of the pathophysiology of PAH has led to the recent development of effective treatments for this disorder. Therapeutic agents target the pathophysiologic mechanisms of PAH: pulmonary vasoconstriction, pulmonary vascular remodeling, and in situ thrombosis. With better understanding of the pathogenesis of PAH, recent advances in pharmacotherapy have been introduced for the treatment of PAH. Data are presented on efficacy and safety of newer approved and investigational agents: prostacyclin analogues, oral endothelin antagonists, and phosphodiesterase 5 inhibitors.

Finding optional ways to manage patients with chronic obstructive pulmonary disease (COPD) - the fourth leading cause of death in the US became a priority for this large mid-western collaborative of health care organizations. This this end, a guideline was developed to help clinicians identify, evaluate and manage COPD. This article provides an overview of the guideline development process and implementation approach, key guideline components, and the step-by-step pharmacologic treatment strategy.