Features:
Antihypertensive effect is weak, by an average of 10% 2 ~ 3 weeks after the majority of patients in medical work Can be used for various high blood pressure (basic blood
Clinical application
Light, medium and severe hypertension treatment
Nitrendipine
Selectively ACTS on the peripheral vascular, blocking its internal flow of calcium ions, relaxing smooth muscle, the dilate blood vessels and step-down
- Nerve - fluid system on blood pressure
regulation 。
1.Nervous regulation: the sympathetic nervous
system
Periphe
The
main ganglion centre
ral neurotr ansmitt
Nifedipine
【 Step-down characteristics 】 1 Buck degree was positively correlated with the
original high blood pressure, with normal blood pressure has no obvious antihypertensive effect ； 2 Oral absorption is good, work fast: sublingual administering 1-5 minutes work - in the treatment of variant angina pectoris, hypertensive crisis. Oral 30 to 60 minutes work - treatment of mild and moderate hypertension ； 3 Can cause reflective heart rate ↑—share Receptor blockers.
hydralazine sodium nitroprusside
nifedipine minoxidil
Second, humoral regulation:
renin – angiotensin aldosterone system
-R blockers
Kidney adjacent
renin
invertase
Calcium antagonist medicine
Block L voltage dependent calcium channel - > left intracellular Ca2 + diastolic small artery Nifedipine group, horizon, lacidipine flat, amlodipine
Compound antihypertension tablet: give up ping, hydralazine, hydrochlorothiazide
Compound apocynum tablet: guanidine b organism, hydralazine, hydrochlorothiazide
Hydrochlorothiazide
Early antihypertensive mechanism With sodium diuresis, reduce the
extracellular fluid and blood volume
Long-term antihypertensive mechanism Diuretic row sodium to Na + left aortic
postsynap tic
membrane
Vascular smooth muscle
er
receptor
clonidine mecamylamine release
-methyldopa
Reserpine
Epll 1 prazosin
1 labetalol
ball Beside the
Angiotensi
machine n original
angiotensinⅠ angiotensin Ⅱ
ACEI
Small artery contraction losartan
Aldosterone secretion Water sodium retention diureti(cthiazides)
Mechanism: hyperthyroidism and
circulating catecholamines increased sympathetic nervous activity
Clinical application
A gleam of medication Application of the treatment for
Antihypertensive drugs
Reasonable application of antihypertensive drugs
Control of blood pressure
Delay the formation and developmen t of atheroscle rosis
Jane chrysanthemum antihypertension tablet: clonidine, hydrochlorothiazide
Compound captopril tablets, enalapril and hydrochlorothiazide
Constant dropping pills: clonidine, hydralazine, hydrochlorothiazide
Hypertensive crisis
Patients with high blood pressure in the short term, the blood pressure increased significantly, and appear have a headache, be agitated, palpitation, sweating, nausea, vomiting, or pale flush, blurred vision and other signs.
Cardiac output :heart rate, myocardial contraction force, change of blood volume, etc.;
Peripheral resistance: the length of the blood vessels and blood viscosity, blood vessels, radius, etc.
-↓ Blood K+、Na+、Mg2+ -↑ Blood total cholesterol, triglyceride, low density lipoprotein cholesterol (hdl-c) -↑ Blood uric acid -↑ Blood renin -↓ Glucose tolerance (disabled) for diabetes patients Effective diuretic (furosemide) used in hypertensive crisis and poor associated with chronic renal hypertension patients.
mild hypertension separately With other antihypertensive drug
treatment, severe hypertension
Effect of diuresis medicine of compound preparations with other drugs
Reduce the complicat ions such as brain, heart and kidney
Reduce the mortality rate, prolong life
Blood pressure
- The factors influencing blood
pressure ：
Classification
Diuretic The sympathetic nervous depressants (1) central blood pressure medication (2) the ganglion block (3) noradrenaline can nerve endings block (4) the adrenaline receptor blockers Affect the renin - angiotensin system medicine
Antihypertensive drugs
hypertension
Mean arterial blood pressure is higher than the normal range, in the case of not taking blood pressure drugs ： Systolic blood pressure ≥18.7kPa(140mmHg)and（or） Diastolic blood pressure ≥12.0kPa(90mmHg)