calcium channel blocker文章.pptVIP

 Calcium Channel Blockers(CCBs) － Calcium Antagonists The role of Ca2+ Action?potential of excitable cells Contraction of muscle?cells Neurotransmitter?release As a second messenger As a cofactor of enzymes Blood-clotting? Bone formation. Types of calcium channels voltage-dependent calcium channels High-voltage gated: L-type, N-type and P/Q-type Intermediate voltage gated: R-type Low-voltage gated: T-type ligand-gated calcium channels (receptor-operated calcium channels ) Main Subtypes of Voltage-Dependent Calcium Channels Main Subtypes of Voltage-Dependent Calcium Channels T-type calcium channel: Most often found in neurons, and cells that have pacemaker activity N-type and P/Q-type calcium channel: Most often found in the brain and peripheral nervous system, responsible for the release of neurotransmitters. Calcium channel blockers (CCBs) Alpha-1 Subunit Structure Actions Heart negative inotropic effect负性肌力作用 negative frequency负性频率 negative conduction负性传导作用： obvious in sino-atrial node and atrioventricular node rationale for treating supraventricular arrhythmia Smooth muscle blood vessel：dilate AV; obvious for spasmodic vessels; dilate coronary vessels冠状血管 other smooth muscle: relax Anti-artherosclerosis抗动脉粥样硬化作用 relieve vessel wall injury caused by calcium overload increase compliance of vessel wall inhibit lipid peroxidation and protect endothelial cell nifedipine increases intracellular cAMP, leading to a decrease of intracellular cholesterin胆固醇 Relieve injury of RBC caused by calcium overload Inhibition of platelet activation Kidney: exclude sodium and diuresis利尿 Therapeutic uses 1. Angina: effective for all kinds Angina is a chest pain that occurs when coronary blood flow is inadequate to supply the oxygen required by heart Classic angina is caused by atherosclerosis Angiospastic or variant angina is caused by vasospasm Therapeutic uses 2. Arrhythmia：especially caused by supraventricular and after-depolarization triggered activi