《钙离子阻滞剂》ppt课件.ppt

具有较强的扩张冠状动脉作用，在增加冠状动脉血流量的同时，通过使末梢血管阻力降低，从而减轻后负荷降低心肌耗氧量，增加心搏出量。 * 心脏作用：短效二氢吡啶类钙拮抗剂由于外周血管的扩张作用减低了心脏后负荷以及反射性的交感反射增强心肌收缩力，从而抵消了其负性肌力作用 血管平滑肌作用：第二代钙离子拮抗剂有较好的血管选择性，扩张冠状动脉，并改善侧支循环，对脑、肾、肠系膜及肢体血管也有舒张作用，在降压的同时还可改善重要脏器血流量 * * The benefits of a systolic blood pressure (BP) below 150-160 mmHg are well established; whether a systolic BP of less than 140 mmHg provides additional benefits remains controversial. This study was designed to compare the 2-year effect of a strict treatment to maintain systolic BP below 140 mmHg (group A) and that of a mild treatment to maintain systolic BP at between 140 and below 160 mmHg (group B). The subjects were elderly patients (65-85 years old) who consistently had a systolic BP of 160 mmHg or higher. The baseline drug was efonidipine hydrochloride (efonidipine), a long-acting dihydropiridine calcium antagonist. The primary endpoints were stroke, cardiac disease, vascular disease, and renal failure. After a run-in period of 2 to 4 weeks, 2,165 patients were assigned to group A and 2,155 patients to group B Hypertens Res. 2005 Jun;28(6):513-20. PMID:[PubMed - indexed for MEDLINE] * * * * 合贝爽抗心律失常作用：房颤心室率控制，终止室上速 * * 基于以上证据， 2006年ACC/AHA/ESC的房颤治疗指南，地尔硫卓的口服剂型（最好应用缓释制剂）控制心率的证据级别最高为I B类证据，β受体阻断剂仅为I C类证据 * * * * * Diltiazem was administered at an initial bolus injection of 0.25 mg/kg over 2 minutes followed by a second bolus of 0.35 mg/kg if VR remained 90 bpm 15 minutes later, and then a maintenance infusion at 10 mg/hr for 24 hours. Digoxin was given at a bolus dose of 0.5mg, then 0.25 mg every 8 hours (i.e., 1.25 mg over 24 hours). This dosage is lower than the maximal recommended dose (1.5 mg over 24 hours) to adjust for the lower body weight (range, 40–60 kg) in our cohort of Chinese patients. Amiodarone was administrated at a loading infusion of 300 mg over the first hour followed by 10 mg/kg over 24 hours. This dosage is also lower than the maximal recommended dose (20 mg/kg over 24 hours) used for pharmacologic conversion