心血管药物 Cardiovascular drugs Heart Disease Facts Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men. About 600,000 Americans die from heart disease each year-that's 1 in every 4 deaths.I Coronary heart disease is the most common type of heart disease, killing more than 385,000 people annually. In the United States,someone has a heart attack every 34 seconds. Each minute,someone in the United States dies from a heart disease-related event. Heart disease is the leading cause of death for people of most racial/ethnic groups in the United States,including African Americans,Hispanics,and whites.For Asian Americans or Pacific Islanders and American Indians or Alaska Natives,heart disease is second only to cancer. Coronary heart disease alone costs the United States $108.9 billion each year.This total includes the cost of health care services, medications,and lost productivity
心血管药物 Cardiovascular drugs Heart Disease Facts • Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men. • About 600,000 Americans die from heart disease each year—that’s 1 in every 4 deaths. 1 • Coronary heart disease is the most common type of heart disease, killing more than 385,000 people annually. • In the United States, someone has a heart attack every 34 seconds. Each minute, someone in the United States dies from a heart disease-related event. • Heart disease is the leading cause of death for people of most racial/ethnic groups in the United States, including African Americans, Hispanics, and whites. For Asian Americans or Pacific Islanders and American Indians or Alaska Natives, heart disease is second only to cancer. • Coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and lost productivity
Risk Factors High blood pressure,high LDL cholesterol,and smoking are key heart disease risk factors for heart disease.About half of Americans(49%)have at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including: Diabetes Overweight and obesity Poor diet Physical inactivity Excessive alcohol use
High blood pressure, high LDL cholesterol, and smoking are key heart disease risk factors for heart disease. About half of Americans (49%) have at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including: Diabetes Overweight and obesity Poor diet Physical inactivity Excessive alcohol use Risk Factors
心血管药物 Cardiovascular drugs 1. 强心药Cardiotonic agents 2. 抗心绞痛药Antianginal drugs 3. 抗心率失常药Antiarrhythmic drugs 4. 抗高血压药Antihypertensive drugs 5. 抗高脂蛋白血症Antihyperlipoproteinemic drugs
心血管药物 Cardiovascular drugs 1. 强心药 Cardiotonic agents 2. 抗心绞痛药 Antianginal drugs 3. 抗心率失常药 Antiarrhythmic drugs 4. 抗高血压药 Antihypertensive drugs 5. 抗高脂蛋白血症 Antihyperlipoproteinemic drugs
心肌细胞膜电位与离子转运 O相：除极，Na*快速内流 +20 零电位 1相：快速复极初期，K*短暂外流 0 2相：Ca2+及少量Na*经慢通道内流， 膜 -20 去 复 K*外流 0 极 极 -40 3相：快速复极末期，K*外流 化 化 3 60 4相：静息期 …阙电位 -80 静息电位 复极过程膜电位恢复 -100 到-60-50mV时，细胞 动作电位(actionpotential duration) 才对刺激产生动作电 位。之前为Effective Na+Cr Ca++ KNa',K+-ATPase Refractory Period (ERP).ERP大：心肌不 细胞膜 起反应的时间长→不 易发生快速性心律失 常 药物：影响心肌细胞膜的离 子通道，改变离子流
_+_+ +_ +_ +_ _+ +_ + _ + _ + _ + _ + _ + _ + _ +_ _ +_ + Na + , K + -ATPase ATP Na + K+ Ca C ++ l N - a + K+ K+ 跨 膜 电 位 mv -100 -80 -60 -40 -20 0 +20 复 极 化 去 极 化 4 3 2 1 0 - - - - - - - 心肌细胞膜电位与离子转运 零电位 阈电位 静息电位 动作电位(actionpotential duration) 细胞膜 0相：除极，Na+快速内流 1相：快速复极初期，K +短暂外流 2相：Ca2+及少量Na+经慢通道内流， K +外流 3相：快速复极末期，K +外流 4相：静息期 复极过程膜电位恢复 到-60~-50mV时，细胞 才对刺激产生动作电 位。之前为Effective Refractory Period (ERP).ERP大：心肌不 起反应的时间长→不 易发生快速性心律失 常 药物：影响心肌细胞膜的离 子通道，改变离子流
I.强心药Cardiotonic agents/正性力药notropic agents 慢性或充血性心力衰竭(Congestive Heart Failure,CHF) 诱发因素：心肌局部缺血、高血压、非阻塞性心肌病变，先天性心脏病 *正性肌力药加强心肌收缩性 *血管扩张剂、利尿药、血管紧张素转化酶抑制剂降低前、后负荷 ·强心药 *抑制膜结合Na,K+-ATP酶活性的强心苷 *阝-受体激动剂 *PDE(磷酸二酯酶)抑制剂 *加强肌纤维丝对Ca2+敏感性的钙敏化药
I. 强心药 Cardiotonic agents / 正性肌力药 Inotropic agents • 慢性或充血性心力衰竭(Congestive Heart Failure, CHF) 诱发因素：心肌局部缺血、高血压、非阻塞性心肌病变，先天性心脏病 正性肌力药加强心肌收缩性 血管扩张剂、利尿药、血管紧张素转化酶抑制剂降低前、后负荷 • 强心药 抑制膜结合Na+ ，K +-ATP酶活性的强心苷 b-受体激动剂 PDE(磷酸二酯酶)抑制剂 加强肌纤维丝对Ca2+敏感性的钙敏化药