Another alternative to treating Pulmonary arterial hypertension (PAH), in the Unified Health System (SUS). This is the combined use of sildenafil and bosentan. Both drugs can be used together or alone in treating the disease.
For the National Committee for the Integration of Technologies into the Unified Health System (Conitec), this ruling could contribute to a reduction in clinical decline and, in turn, to an increase in patients’ quality of life, as well as an increase in cost-effectiveness for SUS when compared to other medicines already listed, such as the use of In monotherapy or in combination with each other.
Pulmonary arterial hypertension
The diagnosis of pulmonary arterial hypertension should be based on the anamnesis and the results of detailed clinical examinations, and it is necessary to address the patient’s entire life history since childhood.
In general, there are difficulties in identifying PAHs, and they are recognized at a relatively advanced stage. For diagnosis, in addition to evaluating symptoms, tests such as transthoracic echocardiography, arterial blood gas analysis, pulmonary scintigraphy, physical activity tests and tests of peak oxygen consumption, right heart catheterization, and others should be performed.
The most common symptoms of the disease are shortness of breath, fatigue, crusting of breath, paroxysmal nocturnal dyspnea, palpitations, syncope or syncope, and hemoptysis or haemorrhage.
Thus, to select the most appropriate drug for the patient, the patient’s response to the specific vasodilator test should be evaluated in the hemodynamic evaluation and clinical characteristics presented.
The causes may be related to the presence of underlying diseases, the use of certain drugs or other toxic substances, or to having a genetic background.
The Clinical Protocol and Therapeutic Guidelines (PCDT) for HAP provide for treatment with medications, such as nifedipine, amlodipine, sildenafil, iloprost, ambrisentan, and bosentan, which are freely available at SUS.
In addition, the PCDT directs non-pharmacological measures, such as dietary salt reduction, physical activities with specialized monitoring and oxygen therapy.
It is also recommended that women with PAH be avoided, as the disease increases the risk of death in pregnancy.
*This article has been reviewed by the PEBMED portal medical team.
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