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1、心内科常用药小结（Summary of commonly used drugs in Department of Cardiology）Source of commonly used medicine in Department of Cardiology: Tao Yus DiaryPhentolamine mesylate 1.Function and useThis product is a blocker of alpha - blockers, which can rapidly dilate peripheral blood vessels by blocking the acti
2、vation of alpha - adrenoceptor and indirectly activating beta - receptor. It can significantly reduce peripheral vascular resistance, increase peripheral blood volume and improve microcirculation. This product has an exciting effect on the heart, increases the contractility of the myocardium, increa
3、ses the heart rate and increases the cardiac output. The main clinical treatment for acute heart failure, pulmonary congestion or pulmonary edema, vascular spasm, acrocyanosis, perceptual toxic shock and test in the diagnosis of pheochromocytoma. It is also used for ventricular premature beat.Dosage
4、 and usage1 treatment of vascular spasm of intramuscular injection or intravenous infusion, 5mg/ times, 12 times / day.2 intravenous infusion of 0.3mg per minute can increase the cardiac output.3 the diagnosis of pheochromocytoma by intravenous injection of 5mg, 1 blood pressure measurement every 30
5、 seconds after injection, can be continuously measured for 10 minutes, such as in 24 minutes the blood pressure decreased by 4.67/3.33kPa (35/25mmHg) above and maintained for 35 minutes as the positive results.2. dopamineFunction and useThis product is a precursor of norepinephrine in vivo. It has t
6、he function of the activation of the beta receptor and the activation of the alpha receptor. Can enhance myocardial contractility, increased cardiac output, heart rate effects are slight (as isoproterenol significantly); mild contraction of peripheral vessels, increased arterial pressure on the spla
7、nchnic vascular (kidney, mesentery, coronary artery) to expand, increase blood flow; the renal blood flow and glomerular filtration rate to increase the urine volume and sodium excretion. For various types of shock, including toxic shock, cardiogenic shock, hemorrhagic shock, central shock, especial
8、ly for patients with renal insufficiency, reduced cardiac output, peripheral vascular resistance and low blood volume of patients has been up more meaningful. There are three variants of the DARPP-32 gene: TT, TC, and CC, which determine the level of dopamine in the brain.IndicationApplicable caused
9、 by myocardial infarction, trauma and endotoxin sepsis, cardiac surgery, renal failure, congestive heart failure and shock syndrome; supplement the blood volume after the shock is still not correct, especially shock oliguria and peripheral vascular resistance is normal or low. Because this product c
10、an increase cardiac output, it is also used for digitalis and diuretic ineffective cardiac dysfunction.3. Isosorbide Mononitrate TabletsIndicationLong term treatment of coronary heart disease; prevention of angina pectoris; treatment of persistent angina pectoris after myocardial infarction; combine
11、d with digitalis and / or diuretics in the treatment of chronic congestive heart failure.Adverse reactionAt the initial stage of the medication, there may be a vasodilator headache caused by nitrates, which usually disappear after a few days of continuous administration. Facial flushing, vertigo, or
12、thostatic hypotension and reflex tachycardia may also occur. Occasionally, the blood pressure decreased significantly, bradycardia, angina aggravated and syncope.Contraindications: acute circulatory failure (shock, circulatory collapse); severe hypotension (systolic blood pressure 90 mmHg); acute my
13、ocardial infarction with low filling pressure (unless there is continuous hemodynamic monitoring conditions); hypertrophic cardiomyopathy; constrictive pericarditis or cardiac tamponade; severe anemia; glaucoma; intracranial hypertension; allergy of nitro compounds4. sodium nitroprussideAdaptive sym
14、ptomsAs for hypertensive emergencies, such as before and after hypertensive crisis, hypertensive encephalopathy, hypertension, malignant pheochromocytoma and paroxysmal hypertension emergency lowering blood pressure, but also for surgical anesthesia during controlled hypotension;(2) for acute heart
15、failure, including acute pulmonary edema. It should be used for acute myocardial infarction or valveAcute heart failure in patients with mitral regurgitation or mitral regurgitation.Pharmacodynamic theoryThis product is a quick acting and short acting vasodilator. The arteries and veins smooth muscl
16、e expansion, but does not affect the uterus, duodenum or myocardial contraction; change the local blood flow distribution is not much. Vasodilation reduces the resistance of peripheral blood vessels, thereby reducing blood pressure. Vasodilation can reduce the preload and afterload of the heart and improve the cardiac output, so it is beneficial to heart failure. Afterload reduces the impe
