交感缩血管纤维舒血管神经纤维_ 浙江大学课件.ppt

血管活性药物概述 浙江大学医学院药理学系 卢韵碧 yunbi@zju.edu.cn 影响血管舒张收缩的因素 神经调节 心血管中枢（延髓心血管中枢） 心血管反射（baroreceptor reflex） 交感神经系统 副交感神经系统 体液调节 肾素-血管紧张素系统 局部具血管舒缩活性的多肽等活性物质 Clinical uses Hypertension: mild to moderate hypertension that has not responded adequately to treatment with diuretics alone.minimal changes in renal blood flow and glomerular filtration, inhibit gastrointestinal secretion and mobility. Toxicity Central and atropine-like side effects Long-term uses: water and sodium retention rebound phenomenon Drug actions and classification Adrenoceptor agonists ?, ? receptor agonists epinephrine (adrenaline)，dopamine, ephedrine (2) ? receptor agonists ?1?2 receptor agonists: norepinephrine （升压药） ?1 receptor agonists: phenylephrine （升压药） ?2 receptor agonists: clonidine（抗高血压） (3) ? receptor agonists： ?1?2 receptor agonists: isoproterenol ?1 receptor agonists: dobutamine ?2 receptor agonists: salbutenol Drug actions and classification Adrenoceptor antagonists （1）? receptor antagonists ?1?2 receptor antagonists: short-acting: phentolamine long-acting: phenoxybenzamine （用于外周血管痉挛性疾病） ?1 receptor antagonists: prazosin（抗高血压） ?2 receptor antagonists: yohimbine Drug actions and classification Adrenoceptor antagonists （2）? receptor antagonists ?1?2 receptor antagonists: propranolol ?1 receptor antagonists: atenolol ?2 receptor antagonists: butoxamine （3）?, ? receptor antagonists labetalol （临床应用：抗高血压…） (2) Clinical uses Hypertension: all kinds of hypertension Other uses: angina pectoris; arrhythmias (3) Side effects Bradycardia or cardiac conduction disease (over inhibition); Asthma (Why); Peripheral vascular insufficiency Diabetes Withdrawal syndrome after prolonged regular use: nervousness, tachycardia, increased intensity of angina (even myocardial infarction), or increase of blood pressure; 影响血管舒张收缩的因素 神经调节 心血管中枢（延髓心血管中枢） 心血管反射（baroreceptor reflex） 交感神经系统 副交感神经系统 体