医学课件-期末考试临床执业医药理学考试大纲课件.ppt

了解酚苄明、哌唑嗪及育享宾的作用特点及应用 熟悉阻断α受体及β受体所产生的基本药理作用。 学习要点： 基本要求： 掌握β受体阻断药普萘洛尔、α受体阻断药酚妥拉明的作用、用途、与主要不良反应。熟悉阻断α受体及β受体所产生的基本药理作用。 延伸要求：将所学各章节以及各学科知识进行整合。例如beta受体阻断药为何可以治疗高血压、 心绞痛及心律失常？ beta受体阻断药的膜稳定作用与beta受体阻断作用产生的效应是一致的吗？知识整合 Alpha alpha-1 alpha-2 受体阻断药对血压与心率的影响？为什么？ Beta 受体阻断药用于治疗高血压，心绞痛，心律失常以及甲亢的生理学基础。 学习方法：理解各种概念的明确定义与相互联系。理解高血压、 心绞痛及心律失常的发病主要机理，与药物的针对性。理解beta受体阻断后产生兴奋还是抑制作用与膜稳定之间的关系。 Acute myocardial infarction (AMI,急性心肌梗死), results from the interruption of blood supply to a part of the heart, causing heart cells to die. This is most commonly due to blockage of a coronary artery following the rupture of a vulnerable atherosclerotic plaque, which is an unstable collection of lipids and white blood cells in the wall of an artery. The resulting ischemia and ensuing oxygen shortage, if left untreated for a sufficient period of time, can cause damage or death (infarction) of myocardium. Ischemic heart disease (which includes myocardial infarction, angina pectoris and heart failure when preceded by myocardial infarction) was the leading cause of death for both men and women worldwide. In the context of acute myocardial infarction (AMI), which represents a state of reduced oxygen supply to the affected portion of the heart. Blockade of beta-1 receptors results in slowing of heart rate, reduction in myocardial contractility, and lowering of systemic blood pressure. These effects may be beneficial as they result in reduced myocardial workload and oxygen demand. Furthermore, beta-blockers may reduce the risk of ventricular arrhythmias, which are an important cause of death following AMI. Sympathetic activation leading to raised levels of catecholamines is one of the earliest responses to the fall in cardiac output that occurs in chronic heart failure (CHF). Raised catecholamine levels have numerous adverse effects that can be counteracted by beta-blockers. For example, the increased heart rate associated with sympathetic activation is associated with a poor prognosis in CHF. In