Cardiopulmonary hypertension

[Eekman]

I found this on the Robb Report. The claim is from UCLA Health:


New Therapies Offer Hope for Patients with Pulmonary Arterial Hypertension

January 1, 2014

Two decades ago, patients suffering from pulmonary arterial hypertension (PAH) had no medical treatment options and death was frequently imminent. Today, there is an arsenal of FDA-approved and experimental medications for the different types of the progressively severe condition.


“While there is still no cure, we can offer significant improvement in patients’ symptoms and life expectancy if we treat them early with these new medications,” says David Ross, MD, medical director of the UCLA Lung and Heart-Lung Transplant Program.

Unfortunately, says Dr. Ross, the earliest signs of PAH, are often mistaken for other conditions, such as asthma or a lack of physical conditioning. Patients who fall into a higher-risk category for potential development of PAH should have symptoms evaluated immediately. Higher-risk groups may include individuals with chronic liver disease, HIV, collagen-vascular diseases such as scleroderma and systemic lupus erythematosus or mixed connective-tissue disease.

Since the mid-1990s, eight drugs have been approved for use in patients with PAH, bringing the median survival up to more than five years. The medications, which are designed to improve the blood flow through the abnormal vessels in the lungs, work in a variety of ways and come in oral, inhaled, intravenous and subcutaneous forms. Several promising experimental treatments are also available, increasing the likelihood that with proper treatment, patients with PAH can return to a satisfactory quality of life or survive with a “bridge” to lung transplantation. “We now have a broad spectrum of therapies, and the investigational drugs will further complement our options for effective threapy,” says Dr. Ross.

For patients who have PAH that is so severe that it requires hospitalization, the parenteral (intravenous or subcutaneous infusion) therapies can often enable specialists to take patients from the brink of death to being able to leave the hospital and thrive at home. “These therapies allow us to attack the disease in an
acute fashion with titratable medications — drugs that can be increased and decreased in real time — to optimize a particular patient’s response,” explains Rajan Saggar, MD, a pulmonary and critical-care physician and director of the medical intensive care unit at Ronald Reagan UCLA Medical Center.

Parenteral therapies are increasingly being used outside the hospital. “Some patients with this condition are extremely ill with progressive pulmonary vascular disease but may not require hospitalization,” Dr. Saggar says. “We no longer wait for a hospitalization to consider initiation of more aggressive drug regimens.” Similarly, patients with the forms of pulmonary hypertension known to have the worst survival rates are being treated more aggressively in the outpatient setting. These include patients with liver disease, parenchymal lung disease and connective-tissue disease.

What Is Pulmonary Arterial Hypertension?
Pulmonary arterial hypertension is high blood pressure in the arteries leading from the heart to the lungs. Pulmonary arterial hypertension is a different condition than ordinary high blood pressure (hypertension).

Symptoms Include:

• Shortness of breath (usually starts slowly and gets worse over time)
• Chest pain
• Fatigue
• Lethargy
• Passing out suddenly
• Swelling of the legs (edema)

Causes Include:

• Congestive heart failure
• Venous thromboembolic disease (blood clots in the lungs)
• HIV infection
• Illegal drug use (cocaine, methamphetamine)
• Cirrhosis of the liver
• Appetite-suppressant medications (fenfluramine, dexfenfluramine, diethylpropion)
• Autoimmune diseases (lupus, scleroderma and rheumatoid arthritis)
• Heart shunts (abnormal blood flow between heart chambers)
• Chronic lung disease (emphysema, chronic bronchitis and pulmonary fibrosis)
• Obstructive sleep apnea

http://robbreport.com/health-and-we...hope-patients-pulmonary-arterial-hypertension

 

[Eekman]

Maybe not the disease itself, but pain management goals may be helpful with cannabis. Stopping the opiod abuse hopefully.

This is from Cardiopulmonary Hypertension News.com

It is called "In Life with PH" by Serena Lawrence.

For my last column, Is There a Hidden Drug Abuse Problem Among Pulmonary Hypertension Patients?, I spoke to several pulmonary hypertension patients who use prescribed pain killers to help manage pain. Sarah and Lindsay shared that they began to abuse their prescribed painkillers within the last year. Both admitted that they knew other patients who were also abusing prescribed opioids. However, Jessica said that her use of prescribed pain killers, taken as directed, helps her with mobility and her ability to maintain her career.

Even when prescribed, painkiller abuse can pose a threat to many patients. Users can build a tolerance to their current dose, causing them to need more in order to get the same effect. Those with a history of addition or depression may also be prone to abuse the medications. Pulmonary hypertension is a very difficult diagnosis to cope with, sometimes causing depression. With all these things considered, it is possible that some pulmonary hypertension patients may be vulnerable.

In the previous column installment, all of the patients said they favor having medical cannabis available to them and other PH patients manage chronic pain. While the inhalation of smoke is not recommended, there are other methods to consume medical cannabis, such as oils and edibles.

A study conducted across seven pain management centers in Canada concluded that the use of medical cannabis for the treatment of chronic pain is mostly safe. Medical cannabis for chronic pain showed no difference in terms of serious side-effects between test patients and those in the control group who were not using cannabis. That includes the need for hospitalization, or even death. Researches also measured changes in pain, mood, and quality of life. Although both of the groups (that included patients with arthritis, fibromyalgia, multiple sclerosis, and spinal cord injury) improved over time, the cannabis users improved much more. Conventional pain therapies had not been effective in either control groups.

Neurological assessments showed that cannabis users had no adverse effects in cognitive function. Patients also showed no signs of damage to kidney, liver, or hormone function. Pulmonary function tests did show that those in the cannabis group had some restriction in lung function after a year, but it was difficult for researches to separate the effects of tobacco use from medical use in patients who used both.

If proven safe in pulmonary hypertension patients, medical cannabis could provide a less addictive pain management option for patients. Medical cannabis might also cause fewer side effects and long-term damage, such as kidney failure which is associated with opioid use. There have been few direct studies on the effects of medical cannabis for pulmonary hypertension patients. Some pulmonary hypertension patients have access to medical cannabis, depending on the laws where they live and choices that are made between the patient and their medical team.

I spoke to two patients who currently use, or have used, medical cannabis and typically prescribed drugs for chronic pain. They shared their experiences.

Patient Interviews

Kelly

Kelly is a young adult living with pulmonary hypertension in Canada, where medical cannabis is legal. Kelly has used Percocet for four years, which she says is fast acting to help manage her pain. Unfortunately, she found that the pain-killer makes her depressed. She also noticed that it caused brain fog, is addictive, and that she was able to build a tolerance to the dosing quickly. She also uses a cannabidiol (CBD) pill for pain management, which is non-psychoactive because of its low THC content. Although Kelly says that the CBD pill isn’t as strong as pain killers like Percocet, it doesn’t cause the brain fog or depression that she experiences with Percocet. As someone who has benefited from using CBD for pain, Kelly believes that everyone should have access to it as needed.

Kelly has a history of addiction, which is one of the reasons she received access to medical cannabis. To help avoid finding herself in a situation where she could become addicted to opiates, she turned to medical cannabis, which is believed to be non-addictive. Kelly said it is easy to imagine why some pulmonary hypertension patients abuse prescribed pain killers. She says, “it’s a slippery slope when dealing with something as devastating as PH.”

Beth

Beth* is a pulmonary hypertension patient in her 30s who used to have access to medical cannabis to help treat her pain until she moved to a state where medical cannabis is not legal. She credits medical cannabis for allowing her to function with less pain. Beth tries to avoid using pain killers unless she finds them necessary, such as for a medical procedure. Traditional pain killers made Beth feel sluggish, nauseous, and unmotivated. She shared that a member of her family is addicted to drugs, which is another reason she tries not to become drug dependent. Beth says: “unlike medications such as fentanyl and dilaudid, marijuana has allowed me to function with less pain.”

Closing Thoughts

While there is little literature available about medical cannabis for pulmonary hypertension patients, we had the chance to hear from two patients who benefited from it. If proven safe for pulmonary hypertension patients, medical cannabis could be a less potentially addictive option with fewer side effects. However, it is important to note that inhaling smoke is not recommended for patients with lung diseases and that there are other options for consuming medical cannabis, such as pills, oils, and edibles. Different strains cause little to no high, and manage pain differently. We do not suggest the use of cannabis, unless it has been legally prescribed by your doctor. It is important to treat medical cannabis with the same amount of caution used in other prescribed medications. Please be sure to discuss your options with your specialist and pain management team.

 

[strakey]

Great read, this sums this up in a great way. I just wanted this member to get the proper idea here. Its very important to treat this condition correctly. This article does just that.