第21章 抗心绞痛与抗动脉粥样硬化药英文.pptVIP

Hypertension Complications of untreated hypertension Hypertensive cardiovascular disease Hypertensive cerebrovascular disease and dementia Hypertensive renal disease Aortic dissection Atherosclerotic complication Myocardial infarction ( MI ) is one of the most common diagnoses occurring in the world. Its mortality is approximately 30%. Although the survival following treatment has improved in the last two decades, the morbidity and mortality of MI still remain high. LEADING CAUSES OF MORTALITY IN WHO REPORT MYOCARDIAL INFARCTION Myocardial Infarction generally occurs with the abrupt decrease in coronary blood flow that follows a thrombotic occlusion of a coronary artery leads to irreversible myocardial cells damage and necrosis. Angina pectoris Is the most common condition involving in tissue ischemia Vasodilators Calcium channels blockers: arteriodilator (e.g. Nifedipine硝苯地平, verapamil异搏定, diltiazem硫氮卓酮) Cause Atheromatous obstruction—most frequent Primary cause: imbalance between the oxygen required by the heart and oxygen supplied to it by the coronary artery. Drugs used to treat Angina Nitrates: Nitroglycerin (glyceryl trinitrate) Nitrites: Amyl Nitrite Indications Short-acting nitrates for acute effort angina: sublingual nitroglycerin (0.3 to 0.6 mg) every 5 minutes until pain goes or a max. of 4 to 5 tablets to be taken. Nitroglycerin spray is an alternative mode of oral administration. Side-effects of Nitrates Headache--most common side-effect Other drugs used to treat angina Calcium channel blockers Indications: chronic stable angina, unstable angina Hypertension Superaventricular Arrhythmias Others: hypertrophic cardiomyopathy, migraine and atherosclerosis. Side-effects Headache, facial flushing, dizziness, and constipation (but Nifedipine not ) Indications: Ischemic heart disease Hypertension Cardiac arrhythmias Others cardiovascular disorders: increasing stroke volume (in patients with obstructive cardiomyopathy), congestive hea