抗心绞痛药与利尿脱水药.ppt

Review
1. What is the purpose of using anti-hypertensives?
2. Which drugs are the anti-hypertensives used usually? And which are belong to the first-line drugs in anti-hypertensives?
3. What is the link and mechanism of action of each kind of anti-hypertensives?
Department of pharmacology: 辛志伟
Chapter 27antianginal drugs(抗心绞痛药)Chapter 24diuretics and dehydrants(利尿药与脱水药)
PROBLEMS
Which drugs are there in anti-anginal agents used usually? What is the mechanism of action of each kind of these drugs?
How do diuretics educe their effects? What relationship are there between their site and mechanism of action and result of action?
Which similar and different are there in effects and usage and adverse effects of diuretics and dehydrants?
Purpose and Requirement
Master:effects and usage and adverse effects of nitrates and high efficacy and moderate efficacy diuretics.
Be familiar with:effects and usage and adverse effects of low efficacy diuretics and dehydrants.
Know:features and usage of other antianginal agents.
English words:
硝酸甘油 nitroglycerin;甘露醇 mannitol
呋噻米,速尿 furosemide;
氢氯噻嗪 hydrochlorothiazide;
Emphasis for learning
、用途、不良反应。
、作用机理与利尿效应之间的关系。主要不良反应。
、作用、用途、不良反应。
Ground and nodus for learning
一、抗心绞痛药
:

劳力型:稳定型(有明确诱因)
不稳定型(可能与血栓形成有关)
变异型:与冠脉痉挛有关
二、利尿药
:
1)肾小球滤过
2)肾小管重吸收与分泌
、机理与作用间的关系
Fig.
Tab.
Tab.
一、概述
(一)概念:
心绞痛(angina pectoris)是一种心肌急剧而短暂的缺血、缺氧所引起的临床综合症。是冠心病的常见症状。其典型的发作表现为:左前胸或胸骨后出现强烈的压榨性、窒息性闷胀痛,并可向左肩及左上肢放射,历时数秒到数分钟,一般不超过30分钟。
室内压


心肌缺血、缺氧
(供不应求)
代谢物(乳酸、腺苷、缓激肽、丙酮酸等)
刺激感觉神经
疼痛
心肌收缩力
室壁张力
心率
心室容积
局部扩冠
射血时间
基本代谢
(二)病理:
稳定型(其发作与劳累、情绪激动有关)
劳力型
不稳定型(其发作与冠脉粥样斑的变化及血
栓形成有关)
变异型(其发作与冠脉痉挛有关)
(四)治则:
增加冠脉供血,减少心肌耗氧,防止血栓形成。
(三)临床类型
二、常用药物
(一)硝酸酯类与亚硝酸酯类
[作用、用途]
基本作用:松驰平滑肌
特点:
对血管作用>支气管、胃肠、膀胱;
对小静脉>小动脉;
对冠脉输送血管和侧支血管﹥小血管(阻力血管)。