药理学课件__27抗心绞痛药.pptVIP

抗心绞痛药Antianginal Drugs Factors affecting myocardial oxygen demand and oxygen supply * * Oxygen demand Oxygen supply = Coronary blood flow Regional myocardial distribution Ventricular volume LV pressure Wall tension Heart rate Contractile state Aortic pressure Coronary vascular resistance Chemical structures of two nitrates Nitroglycerine Isosorbide dinitrate -O-NO2 Reflex increase in contractility Decreased myocardial perfusion Decreased diastolic perfusion time due to tachycardia Increased myocardial oxygen requirement Potential deleterious effects Reflex tachycardia Improved