CVS常用药物概论文稿.pptVIP

CVS 常用藥物概論 Yeh Yu Chang 94.06.04. 分類 Inotropes: 強心 Chronotropic: 增快心律 Pressors: 升壓 Vasodilator: 降壓 Antiarrhytmic agents:抗心律不整 常用藥物 Bosmine (Epinephrine) Levophed (Norepinephrine) Dopamine Dobutamine Primacor (Milrinone) Isuprel NTG Nitroglyceride Perdipine Amiodarone PGE1 DDAVP Cardiovascular Anatomy Catecholamines Natural Norepinephrine: a , b1 Epinephrine: a, b Dopamine: D, a1, b1 (also some NE release) Synthetic Isoproterenol: b Dobutamine: b1 (and mix of b2 stimulation and a1 inhibition and stimulation) μg/kg/min 160 mg in 100 ml, 50 kg (mg/ml) 160*1000 : mg/ml → μg/ml 160 * 1000/100 : 100ml → 1ml 160 *1000/100/60 : μg/h → μg/min 160/6/50 = 0.533 μg/kg/min Thanks for your attention! Have a nice weekend! Thanks for your attention! Have a nice weekend! Thanks for your attention! Have a nice weekend! ALPHA-ADRENERGIC MEDICATIONS Can be divided into: Alpha1-adrenergic effects: Vascular smooth muscle contraction Alpha2-adrenergic effects: Vascular smooth muscle relaxation--this is a very mild effect only at low doses of an alpha-adrenergic agent like epinephrine. BETA-ADRENERGIC MEDICATIONS Can be divided into: Beta1-adrenergic effects: Direct cardiac effects Inotropy (improved cardiac contractility) Chronotropy (increased heart rate) Beta2-adrenergic effects: Vasodilation Bronchodilation Epinephrine ?1 –↑contractility and H.R → ↑C.O. and myocardial oxygen demand. ?1 –↓splanchnic and renal blood flow but↑coronary and cerebral perfusion pressure, SBP ? ?2 – vasodilation in skeletal muscle may lower diastolic pressure also relaxes bronchial smooth muscle Dopamine vs Dobutamine Dobutamine Indications Consider for pump problems (CHF) with systolic blood pressure of 70 to 100 mm Hg and no signs of shock Dobutamine Precautions Avoid with systolic blood pressure 100 mm Hg and signs of shock May cause tachyarrhythmias, fluctuations in blood pressure, headache, and nausea Contraindication: Suspected or known poison/drug-induced shock Do not mix with