APDERP阻断INa-河北大学.PPT

抗心律失常药分类 Class Drug example Actions Uses I类： 钠通道阻滞药 Ia Ib Ic 奎尼丁 普鲁卡因胺 利多卡因 美西律 氟卡尼 恩卡尼 阻断 INa, IK, and ICa, ?APD, ?ERP, ?Velocity, ?Contractility 阻断 INa (fast dissociation), ?APD, ?ERP 阻断 INa (slow dissociation), ?Velocity, ?Contractility VT, AF VP VT II类： β受体阻断药 普萘洛尔 美托洛尔 阻断 ?-adrenoceptor ?Contractility AT, VT III类： 延长APD药 胺碘酮 阻断 IKr, ?APD 阻断 INa (Inac), IKr, ?APD AF, AT IV类： 钙通道阻滞药 维拉帕米 阻断 Ca2+ channels ?APD, ?A-V velocity AF flutter gengxianyl@163.com 河北大学医学部 * 膜电位越负，0相最大上升速率越快， 动作电位振幅越大，传导速度越快 * * Different waves and intervals on the ECG reflect the excitation of differential area of the heart and the propagation of excitation impulse within the heart. The ECG is therefore used as a routine tool in diagnosing if a patient’s cardiac electrical activity is normal. The action potential morphology and duration differ from SA node to atrial muscle A-V node, His bundle, Purkinje fibers, and ventricular muscle. These differences are related to the differential distribution of ion channels on the cell membrane. * It is well know that there are four phases in ventricular action potentials, 0. 1, 2, 3 and 4. The depolarization stimulation makes sodium channel open, , carries inward sodium current, generates action during the phase 0. The fast phase 1 repolarization is contributed by the transient outward current Ito. The Ito is composed by Company Logo HBU 河北大学医学部 第二十三章  抗心律失常药Antiarrhythmic drugs GENG XIAN Ph.D Department of Pharmacology gengxianyl@163.com * Cardiac electrical activity and ECG gengxianyl@163.com 河北大学医学部 Cardiac electrical activity gengxianyl@163.com 河北大学医学部 Sinus arrhythmia gengxianyl@163.com 河北大学医学部 Atrial flutter gengxianyl@163.com Atrial fibrillation gengxianyl@163.com Ventricular fibrillation gengxianyl@163.com 河北大学医学部 心律失常分类 缓慢型心律失常 (bradyarrhythmia) 窦性心动过缓 （病窦综合征） 传导阻滞 快速型心律失常 （tachyarrhythmia） 房性期前收缩、心房纤颤 心房扑动 室性期前收缩 阵发性室上性心动过速 室性心动过速、心室颤动 ge