治疗充血性心网衰的药物药学1.pptVIP

心衰治疗模式的转变 长期的、修复性的策略 改变衰竭心脏的生物学特性 改善长期预后 短期血流动力学效应 Summary Pathophysiological mechanisms Neurohormonal response: sympathetic and RAAS activation Down-regulation of β1-Gs system Myocardial remodeling Cardiac glycosides Typical positive inotropic agents Inhibiting Na-K-ATPase RAAS inhibitors Neurohormonal, hemodynamics, remodeling ACEI the first line therapy of CHF AT1 blockers and spironolatone Summary Diuretics Reduce sodium and water retention Low efficacy diuretics: Counteract K+ loss β- receptor blockers Initiated with low doses Vasodilators, calcium channel blockers, untypical positive i