Sunday 2 May 2010

Primary Pulmonary Hypertension Treatment Choices

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Significant advances in the treatment of Primary Pulmonary Hypertension (PPH) have been made since the 1990s. While there is still no cure for this condition, there are now a variety of options that increase the quality of life and improve the long-term prognosis for people with this disease.

If you have been diagnosed with PPH as a result of Fen-Phen use, you have several options available for treatment depending on how far advanced your disease is and how healthy you are in other respects. Other considerations such as allergies are also an important factor in determining whether you will be treated with Flolan or another similar drug.

Primary Pulmonary Hypertension is caused by increased blood pressure in the lungs, which in turn has a variety of causes, one of which is known to be prolonged use of the diet drug Fen-Phen. The high blood pressure in the lungs puts extra strain on the heart of the affected individual, and causes shortness of breath, fatigue, fainting, dizziness, and cyanosis (a blue tinge to the skin of the feet, hands, and lips).

Drugs used for PPH treatment are, therefore, typically targeted to expanding lung blood vessels and increasing blood flow to the lungs in order to ease the strain on the heart and provide relief from the symptoms of the disease.

Determining which of these drugs is the best to use for PPH treatment can be a lengthy process. Individual reactions to each drug can vary quite widely, so a patient may have to try several different treatment options before an effective long-term treatment can be established.

Approximately 25% of patients can be treated effectively with oral medication using drugs called calcium channel blockers; however for those that do not respond to this medication, stronger oral medications or intravenously-administered drugs such as Flolan are needed to treat PPH effectively.

While Flolan is an effective medication for the treatment of Primary Pulmonary Hypertension, it does have some disadvantages. Flolan is administered intravenously directly into the patient's bloodstream, via a catheter which must be surgically implanted into a chest vein.

Once the drug is injected, it functions for only five minutes in the body, and this means that a patient being treated with Flolan must be continually injected with new doses of the drug (via the catheter) to maintain an optimum level of treatment. People receiving Flolan treatment wear a small battery-operated pump which injects Flolan into the catheter at a pre-determined rate.

All of this means that for people who have had and would like to maintain a very active lifestyle, Flolan may not be the best choice for PPH treatment. The preparation that is injected must be prepared daily, as the drug has a very short life-span, and the pump must be kept cold with mini ice packs if the supply of the drug is to last longer than eight hours without being renewed.

The pump itself can also interfere with daily life. Certain sporting activities, such as swimming and other water sports are made more difficult, and high impact activities such as contact sports are not recommended due to the possibility of the pump or catheter being displaced. The effects of sudden withdrawal of Flolan treatment, even if for a short time only, can be quite severe, and may cause breathing difficulties as well as dizziness and weakness.

Despite its disadvantages, Flolan treatment has some advantages when compared to treatment with other medications such as Tracleer. The side effects of Flolan are typically less severe than those of some other medications used for PPH treatment, particularly for long-term use. Tracleer, for example, can cause liver damage and is known to be harmful to unborn babies.

Flolan can improve the quality of life for people with PPH quite dramatically, and can improve the long term prognosis for the disease as well as enabling individuals to achieve a normal level of physical fitness and activity. Flolan treatment is also known to slow down the progress of scarring in lung tissue caused by Primary Pulmonary Hypertension, and it is now viewed as an effective alternative to lung transplantation (which was once used as a last resort for PPH treatment and carries its own set of risks).

By: Nick Johnson

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