????? Antianginal Drugs

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?????Antianginal Drugs
?27?

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???????? 1.?????? 2.?????? 3.??????
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From the coronary arteries
The right and left coronary arteries, the first
branches of the aorta, carry blood to most of
the myocardium.
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lt
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Arrhythmias
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LV Dysfunction
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1. ?????????????????????
2. ????,??????/????????????????
3. ???????????????????

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Classification of Antianginal Drugs

1. Nitrate esters???????????
2. ?-adrenergic blockers ????
3. Calcium channel blockers???????????????

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???????(nitroglycerin)

• ????? ????????????????????
• ??????
• 1.????,???????????????80(??8),????????
• 2.1-2min??,??20-30min
• 3.??????????????

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• ??????V??????????????????????
• ??????A ????????????????
• 2.??????,???????
• ?????,???????????,???,????,???????
• 3. ??????,??????,???????
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• 4.???????????????
• ??NO?PGI2?CGRP??,????,?????,?????

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NO
SMC or EC???????(GC)
cGMP
cGMP???PK
Ca2
PGI2? CGRP ? PLT?
MLCK- MLCK
P
???????
MLCK????????
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???? Nitroglycerin

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• ????????(??),????,??
• ??????????
• CHF??(????),??(???????)
• ??????????

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???????,????????NO????SH,???SH??,?SH??????????
,??????
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???ß?????

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• ???ßR????????????? ???????????????????
  ????(??)?????
• 2. ???????
• ??????????????,??????????????????
• ??????????,????????????????
• 3. ?????????????????
• 4. ???????FFA,????,???

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• ?????,????????????,
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• ??/?????

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??? CCB???????

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• ????,??????,????
• ???,????
• ???????????????????????????????????
• ?????? ?Ca2 ?????ATP??,???????
• ???????

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CCB???????

1. ????????????????,??????????????
2. ??????????????
3. ??????????
4. ?????????????CCB,???-R blockers

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• ????????A??A
• ???????????????
• ?????????????/?????
• ???????????????????

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• ?????ßR??????????,ßR?????????????????????????
  ??????ßR??????????????????????,??,????

?????CCB????????,????????V,CCB?????A,????????????
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ß??????CCB????????? ?????,ßR??????CCB???????CCB
??ßR?????????
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?27-1 ?????ß???????????????
?? ???? ßR ??? CCB
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???? ? ? -/?
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1. ???????????????????????
2. ????????????????

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THANK YOU!