(医学各论课件）17、抗高血压药知识介绍.pptVIP

Chapter 34 Antihypertensive Drugs;Overview Classification of antihypertensive drugs Antihypertensive drugs Rational application of antihypertensive drugs;A. Overview;Major factors influencing blood pressure;Peripheral resistance and vascular tone and elasticity ; Diuretics 1. Pharmacological effects (1) Reducing plasma volume (cardiac output ?) (2) Reducing Na+-Ca2+ exchange in vascular smooth muscle cells (Ca2+i ?, peripheral resistance ? );Na+-Ca2+ exchange ?, Ca2+i ? in vascular smooth muscle cells ;2. Clinical uses (1) Hypertension single or combined with other drugs mild to moderate hypertension particularly useful in the treatment of elderly patients, pure systolic hypertension, hypertension with heart failure (2) Other uses: diuretic, etc.;3. Adverse effects plasma levels of renin ? hypokalemia hyperuricemia hyperglycemia hyperlipidemia;C. Antihypertensive Drugs;Calcium channel blockers 1. Pharmacological effects Relaxing vascular smooth muscles 2. Clinical uses Mild to severe hypertension (usually combined with ? receptor blockers );3. Adverse effects Peripheral edema Reflex sympathetic activation Renin activity ? Other calcium channel blockers: amlodipine, etc.;C. Antihypertensive Drugs;Renin-angiotensin system inhibitors ACEIs: captopril 卡托普利, enalapril 依那普利 AT1 receptor antagonists：losartan 氯沙坦 Renin inhibitors: enalkiren 依那吉仑;;Angiotensin converting enzyme;Constricting vessels, increase peripheral resistance and returned blood volume. Increasing sympathetic tension, promote release of sympathetic transmitter. Stimulating release of aldosterone. Inducing expression of c-fos、c-myc、c-jun rapidly.;ACEIs;ACEIs 1. Pharmacological effects Inhibiting the production of Ang II Inhibiting the degradation of bradykinin Increasing ANP and scavenge free radicals;Angiotensin II;2. Clinical uses Hypertension without reflexly increasing the activity of sympathe