钙通道阻滞药ppt课件.ppt

三.其它 1、雷诺病 硝苯地平等 2、支气管哮喘 3、急性胃肠痉挛性腹痛 4、痛经、动脉粥样硬化、偏头痛 【不良反应】 1、一般不良反应 扩血管---颜面潮红、头痛、眩晕等 胃肠平滑肌松驰----恶心、便秘等。 2、心脏抑制 维拉帕米＞地尔硫卓 3、低血压 二氢吡啶类 常用钙拮抗药 一、选择性作用于血管的钙拮抗药 代表药有硝苯地平、氨氯地平、尼莫地平等 二、减慢心率的钙拮抗药 维拉帕米（verapamil）及地尔硫卓（diltiazem 三、其它钙拮抗药 Thanks for Your attention 复习生理知识 钙通道阻滞药 ---定义（熟悉） ---分类（了解） -----作用方式（自学） -----作用及应用（掌握）★ 第21章 钙通道阻滞药  钙拮抗药 (calcium channel blockers/calcium antagonists) P201 Cellular Sites Regulating Intracellular Ca++ Concentration Ca++ 3Na+ 1Ca++ Ca++ Na+ Ca++ Ca++ VOC Ca++ ROC Ca++ Na+ Ca++ MTO SR Ca++ Ca++ ATP In principle, all these Ca++ sites are candidates for interactions with specific categories of drugs, but, in practice, the availability of therapeutically useful agents is thus far confined to blockers of voltage-gated Ca++ channels (VOC). Two question 1.钙通道阻滞药的定义？ 2.VOC阻断后会影响细胞的哪些功能? 21 Mediate Ca2+ influx in response to membrane depolarization Gene expression Neurotransmission Secretion Contraction Regulation of intracellular processes Function of Voltage-Gated Ca++ Channels Question 1.根据钙通道阻滞药的概念，能否推出其药理 效应包括哪些方面？ 2.VOC是否存在亚型？ L N T P Q R 根椐其电导值及动力学特性 电压依赖的钙通道 电压依赖的钙通道的亚型 不同亚型的 VOC分布的主要部位、功能存在一定差异 Cardiac action potential generation and propagation (AV-conduction) Excitation-contraction coupling in the heart Regulation of pacemaker activity Main Functions of L-Type Ca++ Channels in the CV System Vascular contraction Main Functions of T-type Ca++ Channels in the CV system Cardiac cells rely on L-type Ca2+ channels for contraction and for the upstroke of the AP in slow response cells Contractile Cells (atria, ventricle) L-Type Ca2+ Ca2+ Ca2+ Slow Response Cells (SA node, AV node) L-Type Ca2+ Ca2+ Vascular smooth muscle relies on Ca2+ influx through L-type Ca2+ channels for contraction (graded, Ca2+ dependent contraction) L-Type Ca2+ N-type and P-type Ca2+ channels mediate neurotransmitter release in neurons postsynaptic cell Ca2+