CARDIOVASCULAR
FUNCTION
Peter Kabo
Drug Affecting Cardiovascular Function
Acetyl choline
Adrenaline/nor adrenaline
Transmisi Neurohormonal
Respon Efektor terhadap
perangsangan SSO
Organ Resptor Respon Perangsang Respon Perangsang
Adrenergik Kolinergik
Jantung
Nodus SA β1 Nadi ↑ Nadi ↓
AV
β1 Kontraktilitas ↑ Kontraktilitas ↓
Atrium/ Ventrikel otot
β1 Konduksi ↑ Kondulsi ↓ ↓
Sist – konduksi β1
Fenilalanin
Hidroksiterase
↓
Tirosin Hidroksilase
↓
Dopa Dekarboksilase
↓ β Hidroksilase
Dopamin
↓ Metiltrasferase
Noradrenalin
↓
Adrenalin
↓ ↓ Comt
↓ Normetanefrin
Metanefrin
3 – metoksi 4 –hidroksi femilglikol asam
3, 4 – dihidroksi mandelat
Denervasi kurase
Nikotin respon
Anti Hypertensive Agents
Diuretics
Pharmacological Effects Therapeutic uses
Pharmacological Effects:
Indication
Pharmacological Effects
Adverse Effects
Kardioselektif ISA Bio Metabolism t1/2 (jam)
Availibilitas e lintas I
Oral (%) (Hati)
ACEBUTOLOL + + 30 - 50 + 3
METOPROLOL + - 40 - 50 + 3-6
ATENOLOL + - 40 - 60 - 6-8
PROPANOLOL - - 25 - 35 + 2-6
OKSPRENOLOL - + 25 - 50 + 2
SOTALOL - - 90 - 100 - 10 - 15
TIMOLOL - - 50 - 75 + 4-5
CARVEDILOL
Farmakodinamik indikasi Efek samping
Clonidine
Methyl Dopa
Pharmacodynamic
Adverse effect
Endothelium
Bradykinine Angiotensin I
Prostaglandin ACE-I
NO
Inactive Angiotensin II
peptide
Va
so
di n
la tio
ta i c
tio st r
n on
AT
s oc
1 Va
G Angiotensin receptor antagonists
PLC
AT AT1 - antagonists
2
DAG IP3
Proteinkinase C
Contraction
PENGHAMBAT ACE & ANGIOTENSIN RECEPTOR ANTAGONIST
Sel
Angitensoinogen
juxtaglomerolus
Renin
Bradikinin
AI
Non - ACE-I
ACE
AI ACE
Peptide maktif
Vasokinstriksi ↑ Aldosteron
Kegunaan
:
Preparat
ACE - Inhibitors
Pharmacological Treatment of Hypertension
Compelling indication & drug of choice (except contraindication)
First line:
1. Diuretics
2. β blocker
VASODILATO
RS
ANGINA PECTORIS
Isosorbid 5 – Mononitrat
Endotel
EDRF
NO?)
GS
P
GMP
Toleransi - SH
CGMP
Relaksasi
Farmakokinetik :
Farmakodinamik :
Cinchonism
• Demam
• Tinitus
• Penglihatn kabur
• Diplopia
• Sakit kepala
• Delirium
• Prikosis
• Gangguan GIT
Amiodaron
Farmakokinetik indikasi Efek samping
Sotalol
Farmakokinetik indikasi Efek samping
Heart Block
1. Atropine (I.V.)
2. Temporary Pacemaker
3. Permanent Pacemaker
Permanent Pacemaker