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カテゴリ:抗不整脈薬

18,471 バイト追加、2014年11月25日 (火) 13:52
[[category:薬]][[category:薬理学]][[category:循環器作用薬]]
 
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</style>
</head>
<body>
<p class="p1"><br></p>
<table cellspacing="0" cellpadding="0" class="t1">
<tbody>
<tr>
<td valign="middle" class="td1">
<p class="p2"><span class="s1"><b>クラス</b></span></p>
</td>
<td valign="middle" class="td2">
<p class="p2"><span class="s1"><b>作用機序</b></span></p>
</td>
<td valign="middle" class="td3">
<p class="p2"><span class="s1"><b>特徴</b></span></p>
</td>
<td valign="middle" class="td4">
<p class="p2"><span class="s1"><b>代表的な薬</b></span></p>
</td>
</tr>
<tr>
<td rowspan="3" valign="middle" class="td5">
<p class="p3"><span class="s1"><b>クラス1</b></span></p>
</td>
<td rowspan="3" valign="top" class="td6">
<p class="p4"><span class="s1">Ｎａ＋ﾁｬﾈﾙ抑制</span></p>
<p class="p4"><span class="s1">活動電位の最大立ち上がり速度を低下させ伝導速度を遅くする。</span></p>
<p class="p4"><span class="s1">ﾘｴﾝﾄﾘｰ回路での活動電位の伝達速度はさらに低下し、結果ﾘｴﾝﾄﾘｰは消失。</span></p>
<p class="p4"><span class="s1">さらに異所性自動能も抑制</span></p>
<p class="p5"><span class="s1"></span><br></p>
<p class="p4"><span class="s1">ﾘｴﾝﾄﾘ―：心室細動の原因</span></p>
<p class="p4"><span class="s1">一度通り過ぎた興奮が逆戻りしたﾝ時間に再び同じ場所を興奮させる。</span></p>
</td>
<td valign="top" class="td7">
<p class="p4"><span class="s1">1ａ　活動電位持続時間↑　有効不応期　↑</span></p>
</td>
<td valign="top" class="td8">
<p class="p4"><span class="s1">ｷﾆｼﾞﾝ⇒房細動に使える。Ca２＋ﾁｬﾈﾙ遮断作用もあり心収縮力↓。αﾌﾞﾛｯｶｰなので降圧作用あり。ｷﾆｰﾈの光学異性体</span></p>
<p class="p4"><span class="s1">ﾌﾟﾛｶｲﾝｱﾐﾄﾞ：ｷﾆｼﾞﾝと似た作用を持つ。心収縮抑制はｷﾆｼﾞﾝより弱い。体内消失が早く、一日に6回以上の投与が必要</span></p>
</td>
</tr>
<tr>
<td valign="top" class="td7">
<p class="p4"><span class="s1">1ｂ　活動電位持続時間　有効不応期↓</span></p>
</td>
<td valign="top" class="td8">
<p class="p4"><span class="s1">リドカイン：虚血部の伝導を強く抑制しＡＰＤ，ＥＲＰともに↓。頻脈のときに作用が強まる。心室性頻脈やｼﾞｷﾀﾘｽ中毒時の不整脈に使用されるが体内消失が速く30～60分ごとに投与するか、点滴注入が要求される。緊急時のみ</span></p>
<p class="p4"><span class="s1">フェニトイン</span></p>
</td>
</tr>
<tr>
<td valign="top" class="td9">
<p class="p4"><span class="s1">1ｃ</span></p>
<p class="p4"><span class="s1">　活動電位持続時間</span></p>
<p class="p4"><span class="s1">　有効不応期不変</span></p>
</td>
<td valign="top" class="td10">
<p class="p4"><span class="s1">フレカイニド</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td11">
<p class="p3"><span class="s1"><b>クラス2</b></span></p>
</td>
<td valign="top" class="td12">
<p class="p4"><span class="s1">βブロッカー</span></p>
</td>
<td valign="top" class="td7">
<p class="p6"><br></p>
</td>
<td valign="top" class="td8">
<p class="p4"><span class="s1">ﾌﾟﾛﾌﾟﾗﾉﾛｰﾙ：ｷﾆｼﾞﾝ様作用（膜安定化作用）</span></p>
<p class="p4"><span class="s1">　カテコラミンによる自動能亢進を抑制。</span></p>
<p class="p4"><span class="s1">作用時間が短く4時間以内の反復投与が必要。</span></p>
<p class="p4"><span class="s1">心不全や心ブロックが併発しているときに使用するのは危険</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td13">
<p class="p3"><span class="s1"><b>クラス3</b></span></p>
</td>
<td valign="top" class="td14">
<p class="p4"><span class="s1">Ｋ＋ﾁｬﾈﾙ抑制</span></p>
</td>
<td valign="top" class="td15">
<p class="p4"><span class="s1">活動電位持続時間、有効不応期延長</span></p>
</td>
<td valign="top" class="td16">
<p class="p4"><span class="s1">ｱﾐｵﾀﾞﾛﾝ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td11">
<p class="p3"><span class="s1"><b>クラス4</b></span></p>
</td>
<td valign="top" class="td12">
<p class="p4"><span class="s1">Ｃａ２＋ﾁｬﾈﾙ抑制</span></p>
</td>
<td valign="top" class="td7">
<p class="p4"><span class="s1">緩徐方反応を抑制</span></p>
</td>
<td valign="top" class="td8">
<p class="p4"><span class="s1">ﾍﾞﾗﾊﾟﾐﾙ　ﾁﾙｼﾞｱｾﾞﾑ</span></p>
<p class="p4"><span class="s1">洞房結節や房室結節ではNa＋ﾁｬﾈﾙは不活化していて活動電位の立ち上がりにはCa２＋ﾁｬﾈﾙが関与している。</span></p>
<p class="p4"><span class="s1">このため活動電位の立ち上がりが遅い（緩徐型反応）　</span></p>
<p class="p4"><span class="s1">ﾍﾞﾗﾊﾟﾐﾙﾔｼﾞﾙﾁｱｾﾞﾑはＣａ２＋ﾁｬﾈﾙの開口を抑制するので洞房結節や房室結節での電導抑制効果が強い。</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td17">
<p class="p3"><span class="s1"><b>その他</b></span></p>
</td>
<td valign="top" class="td18">
<p class="p4"><span class="s1">ﾍﾟｰｽﾒｰｶｰ活動↑　</span></p>
<p class="p4"><span class="s1">心拍数↑　</span></p>
<p class="p4"><span class="s1">房室伝導を改善して房室ﾌﾞﾛｯｸを解消</span></p>
</td>
<td valign="top" class="td9">
<p class="p6"><br></p>
</td>
<td valign="top" class="td10">
<p class="p4"><span class="s1">ｱﾄﾛﾋﾟﾝ：ﾑｽｶﾘﾝＲ拮抗　</span></p>
<p class="p4"><span class="s1">　ｲｿﾌﾟﾛﾃﾚﾉｰﾙ：β興奮　洞性徐脈、重症房室ブロックなど使用</span></p>
</td>
</tr>
</tbody>
</table>
<p class="p6"><br></p>
</body>
</html>
 
== 犬の抗不整脈薬 ==
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</style>
</head>
<body>
<p class="p1"><br></p>
<table cellspacing="0" cellpadding="0" class="t1">
<tbody>
<tr>
<td valign="middle" class="td1">
<p class="p2"><span class="s1"><b>不整脈の種類</b></span></p>
</td>
<td valign="middle" class="td2">
<p class="p2"><span class="s1"><b>第一選択</b></span></p>
</td>
<td valign="middle" class="td3">
<p class="p2"><span class="s1"><b>第二選択</b></span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td4">
<p class="p3"><span class="s1"><b>洞性徐脈</b></span></p>
</td>
<td valign="top" class="td5">
<p class="p4"><span class="s1">ｱﾄﾛﾋﾟﾝ</span></p>
</td>
<td valign="top" class="td6">
<p class="p4"><span class="s1">ｲｿﾌﾟﾛﾃﾚﾉｰﾙ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td7">
<p class="p3"><span class="s1"><b>房性頻脈</b></span></p>
</td>
<td rowspan="3" valign="top" class="td8">
<p class="p4"><span class="s1">ｼﾞｺﾞｷｼﾝ</span></p>
</td>
<td rowspan="2" valign="top" class="td9">
<p class="p4"><span class="s1">ﾌﾟﾛﾌﾟﾗﾉﾛｰﾙ、ﾌﾟﾛｶｲﾝｱﾐﾄﾞ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td4">
<p class="p3"><span class="s1"><b>房粗動</b></span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td7">
<p class="p3"><span class="s1"><b>房細動</b></span></p>
</td>
<td valign="top" class="td10">
<p class="p4"><span class="s1">ﾌﾟﾛﾌﾟﾗﾉﾛｰﾙ、電気的除細動、ｷﾆｼﾞﾝ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td4">
<p class="p3"><span class="s1"><b>室性期外収縮</b></span></p>
</td>
<td valign="top" class="td5">
<p class="p4"><span class="s1">ﾘﾄﾞｶｲﾝ</span></p>
</td>
<td valign="top" class="td6">
<p class="p4"><span class="s1">ﾌﾟﾛｶｲﾝｱﾐﾄﾞ、ｷﾆｼﾞﾝ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td7">
<p class="p3"><span class="s1"><b>室性頻脈</b></span></p>
</td>
<td rowspan="2" valign="top" class="td11">
<p class="p4"><span class="s1">電気的除細動</span></p>
</td>
<td valign="top" class="td10">
<p class="p4"><span class="s1">ﾌﾟﾛｶｲﾝｱﾐﾄ、ﾘﾄﾞｶｲﾝ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td4">
<p class="p3"><span class="s1"><b>室細動</b></span></p>
</td>
<td valign="top" class="td6">
<p class="p4"><span class="s1">ｷﾆｼﾞﾝ、ﾘﾄﾞｶｲﾝ</span></p>
</td>
</tr>
<tr>
<td valign="middle" class="td7">
<p class="p3"><span class="s1"><b>重症房室ﾌﾞﾛｯｸ</b></span></p>
</td>
<td valign="top" class="td12">
<p class="p4"><span class="s1">人工ﾍﾟｰｽﾒｰｶｰ</span></p>
</td>
<td valign="top" class="td10">
<p class="p4"><span class="s1">ｱﾄﾛﾋﾟﾝ、ｲｿﾌﾟﾛﾃﾚﾉｰﾙ</span></p>
</td>
</tr>
</tbody>
</table>
<p class="p5"><br></p>
</body>
</html>
Geshtalt
ビューロクラット、管理者
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