Inhibidores de fosfodiesterasa-5 para el tratamiento de la hipertensión arterial pulmonar

摘要: In experimental and clinical cardiology, phosphodiesterase type 5 (PDE-5) inhibitors have brought scientific interest as a therapeutic tool in pulmonary arterial hypertension (PAH) management recent years. Phosphodiesterases are superfamily of enzymes that inactivate cyclic adenosine monophosphate guanosine monophosphate, the second messengers prostacyclin nitric oxide. The rationale for use PDE-5 PAH is based on their capacity to overexpresss oxide pathway pursued inhibition hydrolysis. By increasing levels it promotes vasodilation, antiproliferative pro-apoptotic effects may reverse vascular remodeling. There also evidence these drugs directly enhance right ventricular contractility through an increase mediated by -sensitive PDE-3. Sildenafil, tadalafil vardenafil 3 specific current use, which share similar mechanisms action but present some significant differences regarding potency, selectivity pharmacokinetic properties. Sildenafil received approval 2005 Food Drug Administration European Medicines Agency 2009 treatment patients classified NYHA/WHO functional class II III. Mexico, sildenafil were approved Comision Federal de Proteccion contra Riesgos Sanitarios this indication 2010 2011, respectively.