- 300年前的人大概活到30歲,今日的平均壽命大大延長,有90%的人會得高血壓 。
- 目標:140/90(/80沒有evidence)
定義[]
治療Hypertension的藥物
分類[]
- diuretics
- Sympathoplegic agents and related drugs
- centrally acting sympathoplegic drugs
- clonidine
- guanidines
- methyldopa
- peripherally acting sympathoplegic drugs
- autonomic ganglion blockers
- adrenergic neuron-blocking agent
- adrenoceptor anatagonist
- centrally acting sympathoplegic drugs
- direct vasodilators
- agents blocking production or action of angiotensin
- 平肝息風藥:治療肝陽上亢造成的高血壓
JAMA把DM用高血壓藥分成五類[]
ADR[]
- ADR以以下藥物族群分類,並以此選擇配伍對象
- diuretics
- centrally acting sympathoplegic drugs
- autonomic ganglion blockers
- adrenergic neuron-blocking agent
- adrenoceptor antagonist: alpha-blocker
- adrenoceptor antagonist: beta-blocker
- direct vasodilators
- agents blocking production or action of angiotensin
療程[]
- 國際guildline:JNC7
- RxT
- pregnancy-induced hypertension
- 但是妊娠高血壓第一線用藥是methyldopa
- preclapsia和eclapsia第一線用藥是hydralazine
延伸學習[]
- 高血壓
- diuretics
- centrally acting sympathoplegic drugs
- autonomic ganglion blockers
- adrenergic neuron-blocking agent
- adrenoceptor anatagonist: alpha-blocker
- adrenoceptor anatagonist: beta-blocker
- direct vasodilators
- agents blocking production or action of angiotensin
- 抗心絞痛
- adrenoceptor anatagonist: beta-blocker
- CCB
- CHF
- diuretics
- adrenoceptor anatagonist: beta-blocker
- agents blocking production or action of angiotensin
- 慢性腎臟病
- BPH
- adrenoceptor anatagonist: alpha-blocker
- pulmonary artery hypertention肺動脈高血壓:最後會變成right heart dysfunction 摘自2013高雄榮總藥師再教育阮綜合醫院心臟內科林少琳醫師,studytogether整理,若有錯誤請不吝指正,謝~
- CCB:diltiazem、nifedipine
- use only when demostrated vasoreactivity in RHC(about 10% or less of patients)
- only 50% of patients maintain response to CCB
- titrate up to maximum tolerated dose
- 配伍禁忌:systemic hypotention、FC IV patients、severe right heart failure
- endothelin receptor antagonist(ETRA)(targets endothelin-1 receptor on endothelium and vascular smooth muscle):
- bosentan(Tracleer)(recommended laboratory monitoring:liver function testing prior to initiation of treatment and monthly、hemoglobin(prior to initiation of treatment and "after 1 month, then every 3 month."))(teratogenic致畸胎、lower sperm)
- ambrisentan(Letairis)(ET-A selective, relatively less increase in transaminase(GPT) than bosentan)(recommended laboratory monitoring:liver function testing prior to initiation of treatment and monthly)
- CCB:diltiazem、nifedipine
