antihypertensive drug

出典: meddic

anti-hypertensiveantihypertensiveantihypertensive agentantihypertensivesdepressorhypotensive agenthypotensive drug

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2017/04/07 00:52:29」(JST)

wiki en

[Wiki en表示]

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2017/08/06 04:26:56」(JST)

wiki en

[Wiki en表示]

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2017/08/15 20:00:32」(JST)

wiki en

[Wiki en表示]

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

英文文献

  • Biofilm inhibition of spoilage bacteria by argentinean fruit juices with antihypertensive activity.
  • Vallejo CV, Aredes-Fernández PA, Farías ME, Rodríguez-Vaquero MJ1.Author information 1Facultad de Bioquímica, Química y Farmacia. Universidad Nacional de Tucumán, Ayacucho 471, (4000) Tucumán, Argentina, UNT-CONICET. mariajo@fbqf.unt.edu.ar.AbstractArgentinean juices have been studied for their antihypertensive activity, the inhibition of bacteria biofilm formation and the effect on the viability of wine yeast. The influence of phenolic compounds on these activities was evaluated. These studies are the first step for the development of a new type of wine that includes grape must supplement with fruit juices with antihypertensive effect. All juices posses a high antihypertensive activity, higher than 50%. Strawberry juices and eureka lemon showed the highest activity, whereas clarified juices posses the lowest activity. All studied juices produce a high inhibition of bacteria biofilm formation, and the strawberry, orange and mandarin varieties not affect the growth or viability of yeast. Our results permit to conclude that it could be possible the use of these juices in a new type of wine or as a source of new antihypertensive agents for pharmaceutical industry.
  • Current pharmaceutical biotechnology.Curr Pharm Biotechnol.2014 Oct;14(9):802-8.
  • Argentinean juices have been studied for their antihypertensive activity, the inhibition of bacteria biofilm formation and the effect on the viability of wine yeast. The influence of phenolic compounds on these activities was evaluated. These studies are the first step for the development of a new t
  • PMID 24372267
  • A new strategy for treating hypertension by blocking the activity of the brain renin-angiotensin system with aminopeptidase A inhibitors.
  • Gao J1, Marc Y, Iturrioz X1, Leroux V1, Balavoine F2, Llorens-Cortes C1.Author information 1*Laboratory of Central Neuropeptides in the Regulation of Body Fluid Homeostasis and Cardiovascular Functions, CIRB, Collège de France, INSERM U1050, Paris, F-75231, France.2†Quantum Genomics, Massy, F-91300, France.AbstractHypertension affects one-third of the adult population and is a growing problem due to the increasing incidence of obesity and diabetes. Brain RAS (renin-angiotensin system) hyperactivity has been implicated in the development and maintenance of hypertension in several types of experimental and genetic hypertension animal models. We have identified in the brain RAS that APA (aminopeptidase A) and APN (aminopeptidase N), two membrane-bound zinc metalloproteases, are involved in the metabolism of AngII (angiotensin II) and AngIII (angiotensin III) respectively. The present review summarizes the main findings suggesting that AngIII plays a predominant role in the brain RAS in the control of BP (blood pressure). We first explored the organization of the APA active site by site-directed mutagenesis and molecular modelling. The development and the use in vivo of specific and selective APA and APN inhibitors EC33 and PC18 respectively, has allowed the demonstration that brain AngIII generated by APA is one of the main effector peptides of the brain RAS, exerting a tonic stimulatory control over BP in conscious hypertensive rats. This identified brain APA as a potential therapeutic target for the treatment of hypertension, which has led to the development of potent orally active APA inhibitors, such as RB150. RB150 administered orally in hypertensive DOCA (deoxycorticosteroneacetate)-salt rats or SHRs (spontaneously hypertensive rats) crosses the intestinal, hepatic and blood-brain barriers, enters the brain, generates two active molecules of EC33 which inhibit brain APA activity, block the formation of brain AngIII and normalize BP for several hours. The decrease in BP involves two different mechanisms: a decrease in vasopressin release into the bloodstream, which in turn increases diuresis resulting in a blood volume reduction that participates in the decrease in BP and/or a decrease in sympathetic tone, decreasing vascular resistance. RB150 constitutes the prototype of a new class of centrally acting antihypertensive agents and is currently being evaluated in a Phase Ib clinical trial.
  • Clinical science (London, England : 1979).Clin Sci (Lond).2014 Aug 1;127(3):135-48. doi: 10.1042/CS20130396.
  • Hypertension affects one-third of the adult population and is a growing problem due to the increasing incidence of obesity and diabetes. Brain RAS (renin-angiotensin system) hyperactivity has been implicated in the development and maintenance of hypertension in several types of experimental and gen
  • PMID 24697296
  • Modulation of the action of insulin by angiotensin-(1-7).
  • Dominici FP1, Burghi V1, Muñoz MC1, Giani JF2.Author information 1*IQUIFIB, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.2†Department of Biomedical Sciences and Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, U.S.A.AbstractThe prevalence of Type 2 diabetes mellitus is predicted to increase dramatically over the coming years and the clinical implications and healthcare costs from this disease are overwhelming. In many cases, this pathological condition is linked to a cluster of metabolic disorders, such as obesity, systemic hypertension and dyslipidaemia, defined as the metabolic syndrome. Insulin resistance has been proposed as the key mediator of all of these features and contributes to the associated high cardiovascular morbidity and mortality. Although the molecular mechanisms behind insulin resistance are not completely understood, a negative cross-talk between AngII (angiotensin II) and the insulin signalling pathway has been the focus of great interest in the last decade. Indeed, substantial evidence has shown that anti-hypertensive drugs that block the RAS (renin-angiotensin system) may also act to prevent diabetes. Despite its long history, new components within the RAS continue to be discovered. Among them, Ang-(1-7) [angiotensin-(1-7)] has gained special attention as a counter-regulatory hormone opposing many of the AngII-related deleterious effects. Specifically, we and others have demonstrated that Ang-(1-7) improves the action of insulin and opposes the negative effect that AngII exerts at this level. In the present review, we provide evidence showing that insulin and Ang-(1-7) share a common intracellular signalling pathway. We also address the molecular mechanisms behind the beneficial effects of Ang-(1-7) on AngII-mediated insulin resistance. Finally, we discuss potential therapeutic approaches leading to modulation of the ACE2 (angiotensin-converting enzyme 2)/Ang-(1-7)/Mas receptor axis as a very attractive strategy in the therapy of the metabolic syndrome and diabetes-associated diseases.
  • Clinical science (London, England : 1979).Clin Sci (Lond).2014 May;126(9):613-30. doi: 10.1042/CS20130333.
  • The prevalence of Type 2 diabetes mellitus is predicted to increase dramatically over the coming years and the clinical implications and healthcare costs from this disease are overwhelming. In many cases, this pathological condition is linked to a cluster of metabolic disorders, such as obesity, sy
  • PMID 24450744

和文文献

  • 治療のポイント : 生活習慣の修正と降圧薬治療 (特集 高血圧 : 全ての内科医が知っておくべき高血圧治療のポイント : 日本高血圧学会治療ガイドライン2014年をふまえて)
  • 石光 俊彦,石川 弥生,本多 勇晴
  • 日本内科学会雑誌 104(2), 218-231, 2015-02-10
  • NAID 40020361690
  • 教育講座 新しい高血圧治療ガイドラインJSH2014に見る日本人の高血圧治療 (第20巻記念号)
  • 檜垣 實男
  • 高知県医師会医学雑誌 = Journal of Kochi Medical Association 20(1), 9-13, 2015
  • NAID 40020427780
  • 交感神経の活動亢進が疑われた維持血液透析患者の繰り返す急性心不全の1例
  • 西川 真那,宮川 一也,玉田 直己 [他],前川 浩一,三木 隆
  • 日本透析医学会雑誌 48(5), 303-308, 2015
  • 50歳女性, 血液透析 (HD) 歴6年. 急性心不全で入院しdry weightの減量と降圧薬の調整を行い退院した. 退院4日後に突然の呼吸苦が出現し, 血圧263/99mmHg, 脈拍109bpm, SpO2 (室内気) 41%であった. 胸部単純写真は肺水腫像であったが, 心エコーでは明らかな体液過剰はなく拡張障害を認めた. 動静脈の収縮による体液の末梢から心肺へのシフト (vascular …
  • NAID 130005072760

関連リンク

Antihypertensive drugとは?goo Wikipedia (ウィキペディア) 。出典:Wikipedia(ウィキペディア)フリー百科事典。 Antihypertensive drugとは - goo Wikipedia (ウィキペディア) gooトップ サイトマップ スタートページに設定 RSS ヘルプ ...
In addition, approximately two-thirds of hypertensive patients will require more than one drug to achieve blood pressure goals, further emphasizing the importance of antihypertensive drug combinations and of studies of safety and ...

関連画像


押しても画像が表示されない場合はサーバが混雑しています。2週間ほどあけて、再度押下してください。


★リンクテーブル★
リンク元降圧薬」「depressor」「hypotensive drug」「antihypertensive agent」「hypotensive agent
関連記事drug」「antihypertensive」「antihypertensives

降圧薬」

  [★]

hypotensor, depressor, hypotensive drugs hypotensive agent hypotensive drug
降圧剤血圧降下薬高血圧症治療薬抗高血圧薬 antihypertensive antihypertensive drug, antihypertensive drugs
[show details]

降圧薬

  • (作用部位で分類)
  • 近位尿細管:アセタゾラミド:炭酸脱水酵素を阻害
  • 太いヘンレループ上行脚:フロセミド:Na+-K+-2Cl-共輸送体(NKCC)を阻害
  • 遠位尿細管前半部:チアジド系利尿薬:Na+とCl-の共輸送体を阻害
  • 遠位尿細管後半部と集合管:
スピラノラクトン:アルドステロン受容体に競合的に結合
トリアムチレン:Na+流入を抑制
  • (薬剤で分類)
  • チアジド系薬 thiazide diuretic
  • ヒドロクロロチアジド
  • トリクロルメチアジド
  • ループ利尿薬
  • フロセミド furosemide
  • K保持性利尿薬-抗アルドステロン薬
  • スピロノラクトン spironolactone
  • K保持性利尿薬-尿細管直接作用薬
  • トリアムテレン triamterene
  • 交感神経抑制薬
  • 受容体遮断薬
  • β遮断薬  プロプラノールなど
  • αβ遮断薬 
  • カルベジロール(α1遮断により末梢血管を拡張。β遮断により陽性変力作用を抑制)
  • アムスラロールなど
  • α遮断薬
  • プラゾシン
  • 中枢性交感神経抑制薬(α2受容体刺激薬)
  • クロニジンなど
  • 末梢性交感神経抑制薬 
  • カルシウム拮抗薬
強力な降圧効果を示す
細胞内へのCa流入を抑制することにより血管平滑筋を弛緩させ末梢血管抵抗を下げる
脳、心臓、腎臓への血流を保つ
膜電位依存性Caチャネルに作用して血管平滑筋を弛緩させる
副作用:ジルチアゼムの副作用:洞性徐脈、洞性ブロック
  • ニフェジピン: 血管への親和性が高い→抗高血圧薬として優れる
副作用:反射性交感神経緊張、顔面紅潮、浮腫(静脈拡張より動脈拡張の度合いが大きいため)、便秘
  • 血管拡張薬
  • ACE阻害薬
臓器障害の改善、進展予防 beyond blood pressure
RA系の抑制
アンジオテンシノゲン→(レニン)→アンジオテンシンI→(アンジオテンシン転換酵素)→アンジオテンシンII-(アンジオテンシン受容体遮断薬)-|アンジオテンシン受容体1
ACE阻害薬の腎機能保護
ACE阻害薬:輸入細動脈 拡張、輸出細動脈 拡張 → 糸球体内圧↓
Ca拮抗薬 :輸入細動脈 拡張、輸出細動脈 なし → 糸球体内圧↑
副作用
ACEはブラジキニンを分解するキニナーゼIIと同一の酵素である。ACE阻害薬はこの酵素を阻害するが、ブラジキニンは血管拡張、決勝滲出決勝進出、発痛作用に関わっている。このため咳を誘発することがある。
禁忌
妊婦。ブラジキニンは胎児の動脈管閉鎖に関わっている。このた、母胎にACE阻害剤を加え、ブラジキニンが増えると胎児の動脈管が閉鎖してしまう。(血管浮腫?)
  • 1型アンジオテンシンII受容体拮抗薬(AT1受容体拮抗薬)


降圧薬の積極的な適応と禁忌

降圧薬 積極的な適応 禁忌
高齢者 糖尿病 狭心症 心不全 脳血管障害 左室肥大 腎障害 心筋梗塞 頻脈 脂質代謝異常 前立腺肥大
Ca拮抗薬               心ブロック(ジルチアゼム)
ACE阻害薬         妊娠、高カリウム血症両側腎動脈狭窄
A-II受容体拮抗薬        
利尿薬                   痛風高尿酸血症
β遮断薬             ○(後)     喘息、心ブロック、末梢循環不良
α遮断薬                 起立性低血圧

  • 合併症を有する高齢者高血圧に対する第一選択薬と併用薬
合併症 Ca拮抗薬 ACE阻害薬 利尿薬 β遮断薬 α遮断薬
脳血管障害慢性期    
虚血性心疾患    
心不全  
腎障害    
糖尿病
高脂血症
痛風(高尿酸血症) ×    
慢性閉塞性肺疾患     ×  
閉塞性動脈硬化症 ×  
骨粗鬆症        
前立腺肥大        

○:第一選択 空欄:適応可 △:注意が必要 ×:禁忌

妊婦への降圧薬 (妊娠中毒症)

理由はACE参照

使用できる降圧薬

α2作動薬
  • 胎児がしっかりしているのなら
  • Ca拮抗薬
β遮断薬
α遮断薬

参考

  • 1. 高血圧治療ガイドライン
[display]http://www.jhf.or.jp/a&s_info/guideline/kouketuatu.html



depressor」

  [★]

anti-hypertensiveantihypertensiveantihypertensive agentantihypertensive drugantihypertensiveshypotensive agenthypotensive drug

WordNet   license wordnet

「a device used by physician to press a part down or aside」

WordNet   license wordnet

「any skeletal muscle that draws a body part down」
depressor muscle

WordNet   license wordnet

「any nerve whose activity tends to reduce the activity or tone of the body part it serves」
depressor nerve


hypotensive drug」

  [★]

anti-hypertensiveantihypertensiveantihypertensive agentantihypertensive drugantihypertensivesdepressorhypotensive agent


antihypertensive agent」

  [★]

anti-hypertensiveantihypertensiveantihypertensive drugantihypertensivesdepressorhypotensive agenthypotensive drug
specific agents


hypotensive agent」

  [★]

anti-hypertensiveantihypertensiveantihypertensive agentantihypertensive drugantihypertensivesdepressorhypotensive drug

drug」

  [★]

drugs

WordNet   license wordnet

「use recreational drugs」
do drugs

WordNet   license wordnet

「administer a drug to; "They drugged the kidnapped tourist"」
dose

WordNet   license wordnet

「a substance that is used as a medicine or narcotic」

PrepTutorEJDIC   license prepejdic

「『薬』,薬品,薬剤 / 『麻薬』,麻酔剤 / 〈人〉‘に'薬(特に麻酔剤)を与える / 〈飲食物〉‘に'(麻酔薬・毒薬などの)薬を混ぜる」


antihypertensive」

  [★]

  • adj.
  • 降圧性の、降圧の、抗高血圧作用の、
  • n.
anti-hypertensiveantihypertensive agentantihypertensive drugantihypertensivesdepressorhypotensivehypotensive agenthypotensive drug

WordNet   license wordnet

「a drug that reduces high blood pressure」
antihypertensive drug

PrepTutorEJDIC   license prepejdic

「(高血圧症に有効な)降圧剤」


antihypertensives」

  [★]

  • np.
anti-hypertensiveantihypertensiveantihypertensive agentantihypertensive drugdepressorhypotensive agenthypotensive drug




★コメント★

[メモ入力エリア]
※コメント5000文字まで
ニックネーム:
コメント:




表示
個人用ツール


  meddic.jp

リンク
連絡