（医学各论课件）17抗高血压药.pptVIP

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（医学各论课件）17抗高血压药.ppt

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C. Antihypertensive Drugs Sympathetic system inhibitors Centrally acting adrenergic drugs Ganglion blockers Noradrenergic nerve ending blockers Adrenoreceptor blockers ? receptor blockers ? receptor blockers ? and ? receptor blockers C. Antihypertensive Drugs Adrenoreceptor blockers ? Receptor blockers 1. Pharmacological effects (1) Decreasing cardiac output (2) Decreasing sympathetic outflow from CNS and releasing of noradrenalin from peripheral nerve endings (3) Inhibiting the release of renin from kidney (formation of angiotension and secretion of aldosterone) (4) Increasing production of PGs (5) Increasing sensitivity of baroreceptor C. Antihypertensive Drugs Main actions of β receptor antagonists on blood pressure 3. Clinical uses (1) Hypertension: all kinds of hypertension more effective in young patients than elderly useful in treating coexisting conditions such as supraventricular tachycardia, previous myocardial infarction, angina pectoris, glaucoma and migraine headache (2) Other uses: angina pectoris; arrhythmias C. Antihypertensive Drugs 3. Adverse effects alterations in serum lipid patterns drug withdrawal Cardiac depression C. Antihypertensive Drugs C. Antihypertensive Drugs ?1 Receptor blockers C. Antihypertensive Drugs Prazosin 哌唑嗪 Terazosin 特拉唑嗪 Doxazosin 多沙唑嗪 Trimazosin 曲马唑嗪 ?1 Receptor blockers 1. Pharmacological effects Relaxing arterial and venous smooth muscles Decreasing peripheral resistance 2. Clinical uses Hypertension: mild to moderate (single) and severe hypertension (combined with diuretics and ? blockers) minimal changes in cardiac output, renal blood flow renin release and glomerular filtration regulation of blood lipid C. Antihypertensive Drugs 3. Adverse effects first dose phenomenon (postural hypotension) water and sodium retention C. Antihy