第二十二单元抗高血压药.pptVIP

22章 抗高血压药 Antihypertensive drugs Objective 掌握 氢氯噻嗪、普萘洛尔、硝苯地平、卡托普利、硝普钠的降压作用、机制、临床应用。 熟悉 抗高血压药的分类，其它常用药的作用特点，抗高血压药的应用原则。 了解 其它药物的降压作用特点。 §1 introduction 1. Hypertension Bp＞140/90mmHg(18.7/12kPa) The condition can be fatal if untreated, as it greatly increases the risk of thrombosis （血栓症）, stroke （卒中） and renal failure. §1 introduction §1 introduction pathophysiology(病生理) of hypertension 1). sympathetic nervous system dysfunction (交感神经系统功能紊乱) 2). RAAS ㈩ §1 introduction Antihypertensive drugs 【definition】 The agents can lower blood pressure, clinical used to treat hypertension and to prevent damages in kidney, heart and brain. 【significance】 ↓ morbidity and mortality ( 发病率） （死亡率） §1 introduction Classification of antihypertensive drugs 1.?Diuretics: DCT氢氯噻嗪, furosemide呋塞米 2. RAAS inhibitors ⑴ ACEI captopril, enalapril ⑵ AT1 blockers losartan氯沙坦, valsartan缬沙坦 ⑶ Renin inhibitors enalkiren依那吉仑, remikiren雷米克林 §1 introduction 3. Adrenergic receptor blockers: 1) ?1-R blockers: prazosin terazosin… 2) ?-R blockers: propranolol 3) ?、 ?-R blockers: labetalol 4. Calcium channel blockers: nifedipine, amlodipine §1 introduction 5. Sympathetic nervous inhibitors: clonidine, methyldopa, reserpine…. 6. Vasodilators: hydralazine , sodium nitroprusside minoxidil, diazoxide…. 7. others §2 usual drugs---- Diuretic agents I. Diuretic agents 【antihypertensive mechanism】 early hypotensive effect diuretic effect →blood volume ↓ long-term effect PVR（外周血管阻力） ↓→ Bp ↓ §2 usual drugs---- Diuretic agents Excretion of sodium ↑ → intracellular [Na+] ↓ intracellular [Ca2+] ↓； the sensitivity of blood vessel responses