antihypertensivedrugs抗高血压药创新教程分析.pptVIP

* * * * * * * * * * * * ? * * * * * * Summary of major points Thank you ！ * * Pre-hypertension 高血压前期 * * * * * * * * Potassium-sparing diuretics Spironolactone，amiloride depletion natriuretic * Clinical uses All types hypertension，be united with β-R blockers and diuretics. Prostate hypertrophy Untoward reactions 1.First dose phenomenon 2. Retention of salt and fluid α and β-receptor antagonist Labetalol Carvedilol Blocking β1=β2＞α1 Blocking α1 and β-R，↓BP Light effect on heart rate and cardiac output Used for all types of hypertension Calcium channel blockers Nifedipine Amlodipine Verapamil Diltiazem Mechanism of antihypertension Calcium antagonists block the entry of calcium into the smooth muscle of the blood vessels，causing it to dilate Certain types such as verapamil and diltiazem can also slow the heart rate and inhibit cardiac contractility. Therapeutic uses Calcium channel blockers are useful in the treatment of hypertensive patients who also have asthma，diabetes，angina，and/or peripheral vascular disease. Nifedipine 1.Action of dilating vessel is stronger than other calcium antagonist. 2.Treatment of all types hypertension. 3.Reflex increase in sympathetic activity：tachycardia，↑CO，↑renin activity. 4.Short action，can increase mortality if used for long time. Amlodipine Amlodipine belongs to long-acting calcium channel blockers which are better than nifedipine. （1）It takes effect slowly （1-2w），lower BP steadily and continuously. （2）It does not affect heart obviously. （3）It can reverse myocardial hypertrophy. Inhibitors of RAS Angiotensin converting enzyme inhibitors（ACEI） Catopril Enalapril Cilazapril Benazapril Ramipril The mechanism of action 1.Inhibit ACE that cleaves Ang I to form the potent vasoconstrictor Ang ∥ both in circulating system and local tissue. 2.Diminish the degradation of bradykinin——increase bradykinin levels –increase the release of NO,PGI2 3.Inhibit NA release，inhibit RAS in CNS, and decrease central and per