噛むアイソソルビド・ディニートレートとニトログリセリンの血液動力学的効果を,結血性心不全の患者で比較した
Circulation
|September 1, 1975
まとめ
チューアブルイソソorbide dinitrate (CHIS) は,心不全患者の左心室充填圧 (LVFP) の持続的な低下を提供します. この長期間作用する血管拡張剤は,慢性心不全の管理に有益である可能性があります.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
背景:
- 血管拡張剤は,心臓の出力を増加させ,左心室の充填圧 (LVFP) を減少させることで,閉塞性心不全の血液動力学を改善します.
- 長期作用の血管拡張剤は,実用的で慢性的な心不全の治療に不可欠です.
研究 の 目的:
- 心不全によりLVFPが上昇した患者で,噛むアイソソorbide dinitrate (CHIS), sublingual nitroglycerin (NTG),およびプラセボ (P) の血管への効果を比較するために.
主な方法:
- LVFP>14mmHgの8人の心不全患者は,ランダムな順序でCHIS (10 mg),NTG (0.6 mg) またはプラセボを受けた.
- 心拍数 (HR),血圧 (BP),およびLVFPを含む血液動力学的パラメータは,投与後3時間監視されました.
主要な成果:
- NTGはBPとLVFPの一時的な減少を引き起こし,効果は20分未満に続いた.
- CHISは迅速な作用を示し,5分以内にLVFPを大幅に減らし,15分後にピーク減少を示しました.
- CHISは,LVFPの有意な減少を3時間維持し,持続的な血管拡張効果を示しました.
結論:
- チューアブルイソソorbide dinitrate (CHIS) は,LVFPの迅速かつ持続的な減少をもたらし,慢性血管拡張療法における心臓不全における潜在的に価値のある選択肢となっています.
関連する概念動画
Heart Failure Drugs: Inotropic Agents
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure Drugs: β-Blockers
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation, vasodilation, and...
Antianginal Drugs: Nitrates and β-Blockers
In cardiovascular health, antianginal drugs combat angina pectoris — a condition marked by chest pain owing to diminished blood flow to the heart.
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Organic nitrates, such as nitroglycerin, play a pivotal role. Once metabolized, they liberate nitric oxide, a molecular marvel. Nitric oxide triggers guanylyl cyclase and augments cGMP production. This biochemical cascade orchestrates the relaxation of vascular smooth muscles, ushering in vasodilation and enhancing coronary blood flow. Administered...
Drug Delivery: Enteral Route
The enteral drug administration involves three primary routes: oral, sublingual, and buccal. Oral ingestion is the most prevalent, safe, economical, and convenient method for drug administration. However, it has certain drawbacks, including limited absorption due to the drug's low water solubility or poor membrane permeability, possible emesis from GI mucosa irritation, destruction of drugs by digestive enzymes or low gastric pH, and irregular absorption along with food or other drugs.
Drugs in...
Drugs in...
Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...


