抗心绞痛药物在药学专业学生中的讲解

根据近几年来的教学经验,结合多种教学方法从不同角度谈谈药理学中抗心绞痛一课的教学体会。     

单基和双基发射药力学性能的MD模拟研究

本文用分子动力学(MD)方法,模拟研究了由含氮量分别为11%、12%、13%、14%的硝化纤维素(NC)构成的单基药模型及其与硝化甘油(NG)构成的双基发射药模型的力学性能,得到其各力学参数:弹性系数、拉伸模量、体积模量、剪切模量和泊松比.结果表明,增加含氮量可使单基药NC塑性增强、刚性减弱.相比于单基药NC,双基药NC/NG的刚性较弱、塑性较强,具有较好的力学性能.     

硝酸甘油治疗慢性肺心病心衰两例分析

目的通过典型慢性肺心病心衰治疗时加用硝酸甘油,探索硝酸甘油作为血管扩张剂治疗慢性肺心病心衰的疗效。方法在抗感染、氧疗、纠正酸碱平衡及电解质紊乱、纠正心率失常、利尿的基础治疗上加用硝酸甘油微泵推注。结果 2例慢性肺心病心衰患者在常规综合治疗基础上加用硝酸甘油,咳嗽、呼吸困难、胸闷、心慌症状得以缓解,紫绀、水肿消退,肺部啰音减轻或消失,心功能也得以改善。结论硝酸甘油能有效控制心衰,改善症状。     

Effect of nebulized nitroglycerin on children with ventricular septal defect and pulmonary hypertension

In order to find a safe, simple, effective and selective pulmonary vasodilator, we tested the effectiveness and safety of inhalation of nebulized nitroglycerin (Neb-NTG) by children with ventricular septal defect and pulmonary hypertension (VSD-PH). Twenty μg/kg Neb-NTG was inhaled by seven children with VSD-PH using face mask during cardiac catheterization. The pulmonary artery pressure (PAP), systemic arterial pressure (SAP) and methemoglobin (MetHb) concentration were measured before and after inhalation of Neb-NTG. After inhalation of Neb-NTG, the PAP and pulmonary-to-systemic pressure ratio (Pp/Ps) decreased significantly; There was no significant decrease in SAP. The systolic and diastolic PAP decreased respectively 13±4% and 9±7% in 5 min, 21±3% and 13±17% in 10 min, 24±3% and 16±19% in 15 min. The Pp/Ps decreased 12±4% in 5 min, 21±9% in 10 min and 24±6% in 15 min. There was no significant increase in the MetHb level after inhalation of 20 μg/kg of Neb-NTG. The MetHb level was below 1.5%. Neb-NTG is a safe, simple, effective and selective pulmonary vasodilator.     

Delayed preconditioning-mimetic actions of exercise or nitroglycerin do not affect haemodynamics and exercise performance in trained or sedentary individuals

Abstract

Nitroglycerin induces the so-called second window of protection (SWOP), which alleviates myocardial damage and stunning after ischaemia/reperfusion. To determine whether myocardial performance during exercise is improved in the second window of protection, we studied the haemodynamic responses of 12 trained and 11 sedentary individuals during a sequence of maximal tests on a cycle ergometer. A baseline test (basal test) was followed by a second effort performed during the second window of protection (exercise-SWOP test). Haemodynamics was also evaluated after pharmacologically induced SWOP 48 h after transdermal administration of 10 mg of nitroglycerin (pharmacologically induced SWOP test). The exercise-SWOP and pharmacologically induced SWOP tests were separated by a 1-week washout period. Endothelial-dependent vasodilatation after nitroglycerin pre-treatment was also assessed in five sedentary individuals to determine whether nitrate donors could affect vascular function. We found that nitroglycerin pre-treatment did not induce any improvement in haemodynamics in either trained or sedentary individuals, since maximum values of workload, heart rate, stroke volume, cardiac output, myocardial contractility, and double product were similar between the exercise-SWOP and pharmacologically induced SWOP tests in both groups. Furthermore, nitroglycerin pre-treatment did not alter flow-mediated dilation during pharmacologically induced SWOP. Although nitroglycerin pre-treatment alleviates post-ischaemic myocardial stunning, our results suggest that it does not affect the myocardial performance of healthy individuals during exercise performed in the second window of protection, independently of the training status of the individuals. Moreover, nitroglycerin pre-treatment does not ameliorate endothelial function.     

EFFECT OF NEBULIZED NITROGLYCERIN ON CHILDREN WITH VENTRICULAR SEPTAL DEFECT AND PULMONARY HYPERTENSION

ＩＮＴＲＯＤＵＣＴＩＯＮＰｕｌｍｏｎａｒｙｈｙｐｅｒｔｅｎｓｉｏｎ(ＰＨ)ｉｓｖｅｒｙｃｏｍｍｏｎａｎｄａｐｒｉｍａｒｙｃａｕｓｅｏｆｍｏｒｔａｌｉｔｙｉｎｃｈｉｌｄｒｅｎｗｉｔｈｓｏｍｅｃｏｎｇｅｎｉｔａｌａｎｄａｃｑｕｉｒｅｄｈｅａｒｔａｎｄｌｕｎｇｄｉｓｅａｓｅｓ(Ｈｏｆｆｍａｎｅｔａｌ.,1981;Ｂｕｓｈｅｔａｌ.,1988).Ｈｏｗｅｖｅｒ,ｕｐｔｏｎｏｗ,ｎｏｓａｆｅ,ｓｉｍｐｌｅ,ｅｆｆｅｃｔｉｖｅａｎｄｓｅｌｅｃｔｉｖｅｐｕｌｍｏｎａｒｙｖａｓｏｄｉｌａｔｏｒｈａｓｂｅｅｎｉｄｅｎｔｉｆｉｅｄ.Ｓｉ…