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1、VocabularyvHypertension 高血压高血压vHyperlipemia 高脂血症高脂血症vCoronary artery disease 冠心病冠心病Atherosclerosis 动脉粥样硬化动脉粥样硬化Angina pectoris 心绞痛心绞痛Myocardial infarction 心肌梗死心肌梗死vArrhythmia 心律失常心律失常vCongestive heart failure 充血性心力衰竭充血性心力衰竭vAcute heart failure 急性心力衰竭急性心力衰竭vCardiac hypertrophy 心肌肥厚心肌肥厚 valvular disea
2、se 心瓣心瓣膜病膜病 rheumatic heart disease风湿性心脏病风湿性心脏病Contentsv.Ion channels and calcium channel blocking drugsv. Anti-arrhythmic drugsv. Renin-angiotensin system drugsv. Diuretics and dehydrant agentsv. Anti-hypertensive drugsv. Drugs used in Congestive Heart Failurev. Antianginal Drugsv. Lipidemic-modula
3、ting drugs and antiatherosclerotic drugs (self-study)You need to understand these things:The classification of drugsMechanism of actionClinical indicationsToxicity/adverse reactionsCalcium channel blockersVerapmil and diltiazem are relatively cardioselective; nifedipine is relatively smooth muscle s
4、elective and dilate blood vessel.Drugs inhibiting RAASangiotensinogenangiotensinangiotensinACEAT2RReninBradykinininactivationKininogenAT1RChymase pathway1. Increase BP2. Cardiac remodelingRelease NO，partially anti AT1R NOPGI2 1. High efficacy (Loop) diuretics Furosemide 2. Moderate efficacy (Thiazid
5、e) diuretics Thiazides 3. Low efficacy diuretics Spironolactone, triamterene, amiloride 4. Carbonic anhydrase inhibitors Acetazolamide4 Classes of Diuretics4 Classes of DiureticsloopNa+2Cl-K+H2ONa+Mg2+Ca2+Na-ClNaClNaHCO3K+H+NaClCa2+H2OADHADHAldAldcortexcortexmedullamedulla1. Furosemide2. Thiazides3.
6、 Spironolactone4. AcetazolamideSummary of DiureticsSummary of DiureticsCACAClassifications of anti-HT drugs vDiuretics.vSympathetic nervous system depressants. Centrally acting sympathetic agents Ganglion-blocking agents Adrenergic nerve ending blocking agents Adrenoceptor antagonistvInhibitors of R
7、AS (ACEI and ARB).vCalcium antagonists.vVasodilators.Common used drugs in HypertensionA B C D 一一、 Neural regulation : sympathetic systemneural centerganglionsTransmitters of Adrenergic nerve ending Receptor of postynapticvascular smooth muscle二二、Humoral regulation：RAASwater and sodium retensioncloni
8、dine -methyldopaMoxonidinemecamylaminereserpine propranolol 1 prazosin 1 labetalol SNPnifedipine -R blockersACEI (captopril )losartandiuretics(thiazides) Targets and classes of antihypertensive drugskidneyangiotensinogenAng IreninAng IIACEvasoconstrictionCHF Treatment Cardiac function obstaclesystol
9、ediastoleCOneurohormoneWater and sodium retensionblood volumeVenous congestion 1-R of heartcontractility compliancemyocardial remodellingreturned blood volumevascular remodelingvasoconstrictionresistancecomplianceafterloadpreloadVasodilator -blockerACEI、ARB、Diuretics Aldosterone antagonistDigoxin in
10、otropicsACEI、ARB、-receptor blockersCalcium Calcium channel channel blockersblockersVessel dilationBlock Ca2+Dilate coronary-Dilate coronary Heart rateHeart rate Heart rate Oxygen demandOxygen demand Oxygen demand Nitroglycerinblock -receptorAll types of anginaNot for variant angninaVariant anginaAnt
11、ianginal DrugsClassification of antiarrhythmic drugsClass I agents: sodium channel blockers, include: IA: Potent; IB: the lowest potent; IC: the most potent.Class II agents: -adrenoceptor antagonists.Class III agents: Drugs delaying action potential period.Class IV agents: Calcium channel blockers.EndThank you !
