Which medication is most appropriate for a patient with decompensated right ventricular (RV) failure caused by PAH?

Study for the Board Certified Cardiology Pharmacist Exam. Utilize flashcards and answer multiple-choice questions with detailed explanations. Prepare efficiently for your certification!

In the context of treating decompensated right ventricular (RV) failure associated with pulmonary arterial hypertension (PAH), the most appropriate medication is a potent vasodilator that specifically targets pulmonary vascular resistance and improves cardiac output, particularly in the right heart where it is most affected by the increased pressures characteristic of PAH.

Epoprostenol, a prostacyclin analog, plays a vital role in this scenario. It has vasodilatory effects on both pulmonary and systemic arterial vascular beds and is crucial in managing patients with severe PAH, especially when they are experiencing acute decompensation. The use of epoprostenol can lead to significant improvements in hemodynamic parameters, including lowering pulmonary artery pressure and improving right ventricular function, thereby helping to stabilize patients in this critical state.

In comparison, while other options such as sildenafil, a phosphodiesterase-5 inhibitor, and treprostinil, another prostacyclin analog similar to epoprostenol, do have roles in the long-term management of PAH, they are generally not the first-line choices during acute decompensation. Vasopressin serves primarily as a vasoconstrictor and does not specifically address the underlying issues of RV failure in PAH. Therefore

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