抗心绞痛药和降血脂药(精品)

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Antianginal,drugs,Angina pectoris is the severe chest pain that occurs when coronary blood flow is inadequate to supply the oxygen required by the heart.,The primary cause of angina pectoris is an imbalance between the oxygen requirement of the heart and the oxygen supplied to it.,Backgrounds of angina pectoris,Classification:,stable;unstable;variant,Mechanism:,Methods for treatment:,To improve perfusion:,To reduce metabolic demand,Drugs,organic nitrates;,calcium antagonists,-Receptor blockers,Organic nitrates,Pharmacological effects and mechanism:,dilate peripheral vein,preload,dilate peripheral artery,afterload,Dilate coronary artery,perfusion,of,ischemic,myocardium,Oxygen,consumption,Mechanism of action in VSM,NO(EDRF),activate GC increase c-GMP activate,cGMP,-dependent,kinase,decrease Ca induce de-,phosphorylation,of the myosin light chain relaxation,Pharmacokinetics,:,very low,bioavailability,per,os,Subligual,Rapid onset(25min),Acute adverse effects:,postural,hypotensiom,throbbing headache,Tolerance:,because of depletion of free SH groups,Clinic use:,to treat and prevent all of the angina,-Receptor blockers,Pharmacological effects:,Myocardial constriction,Heart rate,Clinic use:stable and unstable angina,Propranolol,not for variant angina because of coronary artery contraction due to its-receptor blocked and,-receptor relatively activated.,Propranolol,+,nitroglycerin,Oxygen,consumption,Calcium channel blockers,Pharmacological effects,:,Cardiac contractility,heart rate,Peripheral vessels dilation,afterload,dilate coronary artery,release its,spasm,Ca,2+,overload apoptosis,necrosis,Clinic use,:,variant angina,Nifedipine,not for unstable angina,+,-Receptor blockers,Myocardial oxygen,consumption,Other drugs for angina,Anti-platelet drugs:,aspirin,persantin,Chinese medicine:,salvia,miltiorrhiza,panax notogenseng,ATP sensitive potassium channel openers,