Ladan Panahi

By Ladan Panahi, George Udeani, Michael Horseman, Jaye Weston, Nephy Samuel, Merlyn Joseph, Andrea Mora, Daniela Bazan and Pooja Patel

Pulmonary embolism management has typically been accomplished with anticoagulant treatment that includes parenteral heparins and oral vitamin K antagonists. Even though heparins and oral vitamin K antagonists continue to play a role in pulmonary embolism management, other newer available options have somewhat reduced the role of heparins and vitamin K antagonists in pulmonary embolism management. This reduction in utilization involves their toxicity profile, clearance limitations, and many drug and nutrient interactions. New direct oral anticoagulation therapies have led to more available options in the management of pulmonary embolism in the inpatient and outpatient settings. More evidence and research are now available about reversal agents and monitoring parameters regarding these newer agents, leading to more interest in administering them for safe and effective pulmonary embolism management. Current research and literature have also helped direct the selection of appropriate use of pharmacological management of pulmonary embolism based on the specific population such as patients with liver failure, renal failure, malignancy, and COVID-19.

Part of the book: New Knowledge about Pulmonary Thromoboembolism

By Ladan Panahi, George Udeani, Andrew Scott Tenpas, Theresa Ofili, Elizabeth Marie Aguilar, Sarah Burchard, Alexandra Ruth Ritenour, April Jacob Chennat, Nehal Ahmed, Chairat Atphaisit, Crystal Chi, Jesus Cruz III, Monica D. Deleon, Samantha Lee, Zack Mayo, Mackenzie Mcbeth, Mariel Morales, Jennifer N. Nwosu, Kelly Palacios, Jaycob M. Pena and Nitza Vara

Idiopathic pulmonary fibrosis (IPF) is a common interstitial lung disease (ILD) caused by environmental exposures, infections, or traumatic injuries and subsequent epithelial damage. Since IPF is a progressively fatal disease without remission, treatment is both urgent and necessary. The two medications indicated solely for treatment include the tyrosine kinase inhibitor nintedanib (Ofev®) and the anti-fibrotic agent pirfenidone (Esbriet®). This chapter discusses in detail the current treatment options for clinical management of IPF, specifically the mentioned two pharmacotherapeutic agents that decrease physiological progression and likely improve progression-free survival. The chapter also discusses the evolution of drug therapy in IPF management and the drawbacks and limitations learned throughout historical trials and observational studies.

Part of the book: Idiopathic Pulmonary Fibrosis

By Anthony Wilks, Ladan Panahi, George Udeani and Salim Surani

Acid suppressive therapy (AST) has been the primary mechanism to provide gastroesophageal reflux disease (GERD) symptomatic relief and prevent complications in many individuals with GERD. Many AST options exist, but proton pump inhibitors (PPIs) have developed popularity in symptomatic relief for refractory GERD patients. To help reduce persistent symptoms, the use of AST therapy optimization is imperative and involves timing doses appropriately and increasing the dose and dosing frequency. Recently, more data has become available regarding the safety profile of AST, specifically PPI use. This data has raised awareness about its potential for toxicity with long-term use. This chapter focuses on the pharmacological management of GERD with a focus on the current updates regarding AST safety and efficacy.

Part of the book: Gastroesophageal Reflux Disease

By Andrew Tenpas, Ladan Panahi, George Udeani, Chioma Ogbodo, Joy Alonzo, Anne-Cecile Mingle, Pooja Patel, Frank North, Merlyn Joseph, Sara Rogers and Chinonso Paul

Pulmonary hypertension is a condition characterized by elevated blood pressure in pulmonary arteries due to increased muscle mass of vessel walls, leading to arterial constriction and reduced blood oxygenation. Commonly classified into five major groups, pulmonary hypertension is often viewed as quite rare when, in fact, it is far more common than traditionally advertised. It is also an extremely debilitating disease with far-reaching economic, societal, personal, and psychosocial impacts, especially in underserved populations. Though 10 FDA-approved medications—targeting four different biological pathways—have come to market over the last 20 years, more recent research has focused on complex signaling pathways regulating hypoxic and metabolic signaling, proliferation, apoptosis, senescence, and inflammation. In this chapter, we provide an overview of pulmonary hypertension’s prevalence and widespread impact, its underlying pathophysiology and clinical presentations, currently recognized treatment strategies, recommended regimens in special populations, and emerging therapeutic options and fields of research.

Part of the book: New Insights on Pulmonary Hypertension [Working title]