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超靠北CV洪老師藥理 - Coggle Diagram

- - - - MOA
        
        Inhibition of Na+, K+ATPase
        
        增加sensitivity of baroreceptor
        
        增加vegal tone，降低renin釋出
        
        減低av node conduction，減低動作電位，不反應期縮短
      - 效果
        
        increase CO, EF
        
        降低 filling pressure
        
        降低renin, NE
      - 可治療
        
        systolic dysfunction
        
        paroxysmal AT
        
        atrial flutter, AF
      - side effect
        
        Gynecomastia (女樣乳房)
        
        GI
        
        Neurologic complaints
        
        Ventricular tachycardia or fibrillation
        
        高血鈣、低血鉀或低血鎂時易引起毛地黃中毒
        
        不能給WPW吃
        
        therapeutic index 窄，可能引發arrhythmia
    - - Dobutamine,
      - dopamine
      - β1 or 2 agonist
    - - Amrinone
      - Inamrinone
      - milrinone
      - 有可能引發thrombocytopenia、arrhythmia
  - - - hydralazine and nitrate
    - - sinoatrial modulator
      - funny current blocker
    - - Tolvaptan
      - Conivaptan
      - MOA
        
        阻止水分回收
- - - - furosemide
      - bumetanide
    - - trichlormethiazide
      - chlorothiazide
      - hydrochlorothiazide
      - 本身有痛風或曾有嚴重的低血鈉病患應小心使用
    - - spironolactone
        
        aldosterone blocker抑制留鈉排鉀, 男性女乳症性功能不正常
      - amiloride
        
        抑制ENaC (epithelium sodium channel)
      - triamterene
        
        抑制sodium-proton exchanger
      - eplerenone
        
        aldosterone blocker
    - - Black patient, hypertension in the elderly
    - - Potassium depletion
      - impairment of glucose tolerance
      - increase in plasma lipid concentration
  - - - MOA
        
        刺激中樞神經的α2接受體，抑制NE釋放
      - 長期高劑量(1 mg/d)將產生嚴重戒斷症(hypertension crisis).
      - t 抗高血壓（重症），嗎啡戒斷症
    - - side effect
        
        思睡、姿勢性低血壓,肝疾病病人避免服用
      - MOA
        
        false transmitter
        
        α2 agonist
  - - - 影響CNS
  - - - prazosin
      - terazosin
      - doxazosin
      - phentolamine
        
        Pheochromocytoma treatment 開刀前給藥 nonselective
      - phenoxybenzamine
        
        Pheochromocytoma treatment 開刀前給藥 nonselective
      - side effect
        
        first-dose syncope
      - Tamsulosin
        
        阻斷α1
    - - propranolol, timolol, nadolol
        
        nonselective
      - atenolol, metoprolol
        
        selective
      - pindolol, acebutolol (ISA
      - labetalol, carvedilol
        
        α1β
      - side effect
        
        blockers不但會延長胰島素所誘發的低血糖現象外，還會遮掩糖尿病患的低血糖症狀。
        
        氣喘的病患、 reactive airways disease或二、三級心臟阻斷性疾病，應避免給予beta-blocker
  - - - hydralazine
        
        干擾IP3
        
        長期使用可能有 rheumatoid arthritis及lupus erythematosus-like syndrome產生
      - minoxidil
        
        鉀離子管道活化劑
        
        作用時間更久，更強，副作用亦大
        
        生髮
      - diazoxide
        
        也治療血液中胰島素過多所引起的低血糖
        
        抑制atp sensitive potassium channel的關閉
        
        鈣離子通道阻斷
    - - sodium nitroprusside
        
        降壓作用是血管擴張劑中最強的
        用於短時間內，必須馬上降低血壓的病人
        
        side effect
        
        姿勢性低血壓
        
        thiosulfate解毒
      - Bosentan
        
        non-selective ET-1 receptor antagonist
    - - 心臟專一
        
        dipheylalkylamine
        
        verapamil
        
        不能給heart block的病人吃
      - 中間
        
        benzothiazepines
        
        diltiazem
      - 血管專一 SVT不會用
        
        dihydropyridine
        
        第一代
        
        nifedipine
        
        第二代
        
        amlodipine, felodipine, isradipine, nicardipine
  - - - Captopril, Enalapril, Lisinopril, Fosinopril, ramipril, quinapril, benazepril, perindopril, moexipril, trandolapril
      - 抑制 Angiotensin I轉為II
      - t 腎臟性高血壓
      - side effect
        
        乾咳(bradykinin堆積)、氣喘易發作
        
        angioedema的病患不建議使用ACEIs
    - - Saralasin, Losartan, Valsartan, Candesartan, Irbesartan, eprosartan, olmesartan, telmisartan
      - MOA
        
        Angiotensin II (AT1)接受體的拮抗劑
- - - - quinidine
      - procainamide
      - disopyramide
    - - lidocaine
      - tocainide
      - mexiletine
    - - Flecainide
      - propafenone
- - - - 吸入，急救
    - - 舌下急救，皮膚預防
      - 降低preload
      - nitrate tolerance
    - - 長效