obat kardiovaskular
DESCRIPTION
kkTRANSCRIPT
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DRUG AFFECTING CARDIOVASCULAR FUNCTIONPeter Kabo
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Physiology & pathophysiology of the cardiovascular systemDrug Affecting Cardiovascular Function
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JantungPembuluh darah
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ANATOMI SSO
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FAAL SSOTransmisi NeurohormonalAcetyl cholineAdrenaline/nor adrenaline
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Respon Efektor terhadap perangsangan SSO
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Transmisi Adrenergik
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Anti Hypertensive Agents
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Diuretics
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Pharmacological EffectsAdverse effectTherapeutic usesDiuretic Resistance
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-methyldopa (Dopamet 250 mg/tab)-methyl dopamine-methyl Noradrenaline
Sympatholytic agents (Anti Adrenergic)Pharmacological Effects:
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Pharmacological EffectsIndicationAdverse Effects
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KardioselektifISABio Availibilitas Oral (%)Metabolisme lintas I (Hati)t1/2 (jam)ACEBUTOLOL++30 - 50+3METOPROLOL+-40 - 50+3 - 6ATENOLOL+-40 - 60-6 - 8BISOPROLOL+++-9010%11PROPANOLOL--25 - 35+2 - 6PINDOLOL-++95 - 100-3 - 4OKSPRENOLOL-+25 - 50+2SOTALOL--90 - 100-10 - 15TIMOLOL--50 - 75+4 - 5LABETOLOL (Alfa blocker)-+25+5 - 8CARVEDILOL
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FarmakodinamikindikasiEfek sampingSistem kardiovaskular(-) inotropik(-) kronotropik resistensi perifer(non-selektif) sekresi renin cardiak output resistensi perifer(pengguna kronis)
Turunkan TDTakikardiTakiaritmiaHipertensiangina pektorisInfark miokardHOCMFeokromasitomaTirotoksikosisGlaukomaGagal jantungBradikardiSaluran nafasBronkokonstriksiBronkospasmeEfek metabolik Asam lemak Trigliserida HDLglikogenolisisHipertrigliseridHipoglikemi!! Putus obat
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Penghambat saraf adrenergikClonidineMethyl DopaNegative Feed back mechanism
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Calcium Channel Blockers (CCB)
Relative Cardiovascular EffectsVasodilatasiSupression ofContractilityAutomaticityConductionNifedipinDiltiazemVerapamil534124155045
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ANGIOTENSIN CONVERTING ENZYME (ACE) - INHIBITORSAdverse effectAngiotensin receptor antagonistsAT1 - antagonists
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PENGHAMBAT ACE & ANGIOTENSIN RECEPTOR ANTAGONISTEfek samping:Mekanisme Kerja ACE-I
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PreparatKegunaan: Angiotensin antagonis:
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ACE - Inhibitors
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First line:1. Diuretics2. blockerPharmacological Treatment of HypertensionCompelling indication & drug of choice (except contraindication)
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VASODILATORS
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ANGINA PECTORIS
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Mekanisme kerja
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Rebound fenomenaKontraindikasi: Syok &HipersensitifFarmakokinetik :Farmakodinamik :Indikasi
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William Withering (1789)Digitalis lanata (foxglove putih)Digitalis purpura (foxglove ungu)Cardiac Glicoside
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Farmakokinetik
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Sign & Symptoms of Cardiac Glycoside ToxicityDrug interaction with Digoxin
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PharmacodynamicManagement of Digoxin toxicity
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Efek pada organ lainEfek pada Jantung
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Anti Arrhytmic drugs
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Mechanism of anti arrhythmias drug actionAnt arrhythmic drugs can cause arrhythmiasSome arrhythmias should not be treated
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Classification of anti arrhythmia drugs
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Farmakokinetik
OPDosisKadar puncakMetabEksIndikasiEfek sampingKINIDIN++3 X 200 mg60 90HG/HAF, SVTPROKAINAMID++3X (250000 500) mg45 70HGVES, SVTLupus like syndrome, leukopeniDIISOPIRAMID+-3X 100 mg60 120HGVES, SVTMulut kering, konstipasi, penglihatan kaburLIDOKAIN-+1 MG/ KG bb =1mg/ jamHVT (pasca miokard infark)hipotensiPROPAFENON++3 x(150 -300) mg60 180VES
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AmiodaronSotalol
FarmakokinetikindikasiEfek sampingOPT1/2DosisVT, AFPro aritmik,Hipotensi, gangguan fungsi: hati, tiroid, paru & mata++25 60 jamLoading 600 s/d 800 mg/ hariMaintenance 300mg/ hari
FarmakokinetikindikasiEfek sampingOPT1/2DosisSVT, VTGagal jantung+-11 jam800 s/d 320 mg/hari
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BradicardyHeart BlockAtropine (I.V.)Temporary PacemakerPermanent Pacemaker
Sinus BradicardyEphedrineAminophylineAtropine (I.V.)
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Permanent Pacemaker
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