留学生心绞痛.pptx

留学生心绞痛

§1BriefIntroduction

Coronaryheartdisease

TeatmentofAnginaPectoris:1、Dilationofbloodvessels2、Reducingbloodlipidlevel3、Reducingbloodglucoselevel4、Antithrombosis5、Anti-pain

大家有疑问的，可以询问和交流可以互相讨论下，但要小声点

ContractilityHeartRateCardiacWallTensionPreloadandAfterload1.Beta-Blockers2.Glyceryltrinitrate3.L-CBAnti-anginapectorisAgentsCoronaryheartdiseaseprescription:NitrateestersAntihypertensiveagentsAntilipemicagents

§2NitrateVasodilatorInbloodvesselwall,GTNproduceNOwiththehelpofmitochondrialaldehydedehydrogenase(mtALDH)NOinducedilationofbloodvesselsOverdose/longtimeadministrationofGTNalsocaninduceactiveoxygenandinducetolerance.Bloodvesseldilationmechanism

GTN:GlycerylNitratePETN:pentaerythrityltetranitrateISDN:isosorbidedinitrateISMN:isosorbide-5-mononitrate

Solubleguanylylcyclase(sGC)istheonlyknownreceptorforNO、Itissoluble,i、e、pletelyintracellular、Itismostnotablyinvolvedinvasodilation、Inhumans,itisencodedbythegenesGUCY1A2,GUCY1A3,andGUCY1B3

EffectsofGTNTolowertheoxygendemandoftheheart2.Todilatecoronaryarteryandincreasetheischemiaareabloodirrigation3.Todecreasetheleftventricularendocardialpressure,increasetheendocardialbloodsupplyandimprovetheadaptabilityoftheleftventricle4.Toprotectischemiccardiaccells：NO-inducedPGI2andcalcitoningene-relatedpeptides(CGRP)5.Anti-arrythmiaandInhibitionofplateletaggregation

BeforeGTNAfterGTNIschemiczoneNormalzone

PharmacokineticsofGTNHighlipophilicpropertyExtensivefirst-passeffectsforP.O.:Ifsublingualroute,Fis80%,theonsetofactionis1to2minutes,andthedurationofactionis20to30minutes.

INDICATIONSOFGTN1.Acuteanginapectorisattack2.ProphylaxisofanginapectorisGTNpatches,ointment3.Acutemyocardialinfarction4.Congestiveheartfailure

IsosorbideDinitrate(消心痛）IsosorbideMononitrate（异乐定）AnginaPr