药理学重点（Pharmacological emphasis）.docVIP

药理学重点（Pharmacological emphasis） The mechanism of propranolol and nitroglycerin in the treatment of angina pectoris and the advantages of its combination (10 points) are briefly described Propranolol is a beta blocker, by slowing down the heart rate, decreased myocardial contractility and systolic velocity, decreasing blood pressure and reduce myocardial oxygen consumption (2 points); increase the blood supply, improve myocardial metabolism in ischemic area (1 points). Nitroglycerin is not endothelium-dependent NO donor can increase the concentration of NO, through the expansion of peripheral blood vessels, reduce heart load and reduce myocardial oxygen consumption (2 points); diastolic coronary artery, improve collateral circulation, the coronary blood flow redistribution, so as to improve the blood supply of ischemic area (1 points). The combination of propranolol and nitroglycerin can reduce the myocardial oxygen consumption and compensate for each other. The expansion of intravenous nitroglycerin, reduce blood volume, reduce the load, which can offset the disadvantage of propranolol ventricular volume expansion (2 points); propranolol can antagonize the nitroglycerin due to decreased blood pressure caused by reflex tachycardia (2 points). To summarize the clinical application of adrenergic receptor blocker. (1) arrhythmia (1 points): can be used for a variety of causes of ventricular and supraventricular arrhythmias (1 points); (2) hypertension (2 points); (3) angina pectoris and myocardial infarction (2 points); (4) chronic cardiac insufficiency (2 points); (5) other auxiliary treatment such as hyperthyroidism, migraine, etc (2 points). The mechanism of morphine in the treatment of cardiogenic asthma was reviewed. (1) expanding peripheral blood vessels, reducing back blood volume, and reducing cardiac load (4 points); (2) calm, relieve tension, anxiety, fear, and reduce myocardial oxygen consumption (4 points); (3) reduce the sensitivity of the respiratory cente