Professional Documents
Culture Documents
Peter Kabo
- Conservative
Parasimpati Acetyl cholin
s - Reservation
- Fight Adrenaline/nor
Sympathies - Flight reaction adrenaline
Respon Efektor terhadap perangsangan SSO
Denervasi kurase
Reseptor Langley (1878)
Nikotin respon
Muskarinik
Asetilkolin
(M)
Nikotinik
(N)
Noradreanalin α
Adrenalin
Isoprenalin β
Anti Hypertensive Agents
Cardiac Blood
output pressure
Diuretics
Sympatholytic drugs
Vasodilators
Diuretics
Diuresis CO
Adverse effect
Hypo kalemia
Hyper uricemia
Hyoerglycemia
Sexual impotance
Sympatholytic agents (Anti Adrenergic)
Pharmacological Effects:
↓ Sympathetic tone
• ↓ Cardiac output
• ↓ Peripheral resistance
• ↓ Myocardial contractility
• ↓ Heart rate
• ↓ Renin secretion
α-Blockers
Prazosin (Minipress, 1 & 2 mg/tab)
Pharmacological Effects
Vasodilatation
•↓ Arterial resistence
•↓ Venous capaetance
↓ Triglyceride
↓ LDL Cholesterol
↓ HDL Cholesterol
Propanolol Timolol
Atenolol Pindolol
Metoprolol
Bio
Metabolisme t1/2
Kardioselektif ISA Availibilitas
lintas I (Hati) (jam)
Oral (%)
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
LABETOLOL
- + 25 + 5-8
(Alfa blocker)
CARVEDILOL
Farmakodinamik indikasi Efek samping
Reserpin
Penghambat saraf adrenergik
Mekanisme kerja
• Mengosongkan katekolamin di ujung saraf adrenergik
Farmakodinamik
• Cardiac output ↓
• Resistensi perifer ↓
Indikasi
• Hipertensi
Efek samping
• Depresi psikotik
Calcium Channel Blockers (CCB)
• Nifedipin
• Amlodipin
• Nikardipin
• Nimodipin
Benzoditiazepin • Ditiazem
Difenalkilamin • Verapamil
Supression of
Vasodilatas
i Contractilit Automaticit Conductio
y y n
Nifedipin
5 1 1 0
Diltiazem
3 2 5 4
Verapami
4 4 5 5
l
ANGIOTENSIN CONVERTING ENZYME (ACE) – INHIBITORS
+
NA Antigrowth
Pharmacodynamic
reabsorbsion
Endothelium
Symathetic activity
Bradykinine Angiotensin I
Apoptosin
Prostaglandin NO ACE-I
ion
Inactive peptide Angiotensin
t rict II
ns
oco
s
Va
Va AT1
sGrowth
od
(cardiac remodeling
Vascular
ila hyperthrophy) AT2
ta
tio
n G
Vasodilatory
PLC
DAG IP3
Proteinkinase C
Contraction
Adverse effect Angiotensin receptor antagonists
AT1 - antagonists
Cough Losartan
Angioedema Valsartan
Applets anemia
Dygensia
Sel juxtaglomerolus
Angitensoinogen
Renin
Bradikinin
AI
Non - ACE
ACE-I
AI ACE
Peptide maktif
Vasokinstriksi ↑ Aldosteron
Mekanisme Kerja ACE-I Efek samping:
↓ Prostaglandin
Angiotensin antagonis:
Losartan
Valsartan
Kegunaan: Preparat
ACE - Inhibitors
VASODILATORS
NITRAT ORGANIK
ANGINA PECTORIS
Arnil nitrat
Nitro gliserin
(Gliseril trinitrat = GTN)
Isosorbid Di-Nitrat
• (ISDN)
Isosorbid 5 – Mononitrat
Penta Eritritol Tetranitrat
Eritritil Tetranitrat
Mekanisme kerja
in
res
T p
so
-H bi
n
Va
G P m
h o
ad ac AD Tr
Nitrat B2 M S P T V
Endotel
EDRF NO?)
GS
GMP
GMP
Toleransi P
- SH
CGMP
CGMP
Relaksasi
Relaksasi
Farmakokinetik :
Reabsorbsi Hati
• SL • Metablolik
• Oral Sirkulasi Ginjal
• Topikal
• IV
Farmakodinamik :
Relaksasi otot polos Pembuluh darah ↑ Supply
Rebound fenomena
Kontraindikasi: Syok &Hipersensitif
Indikasi
Angina Pektoris
Miokard Infark
Gagal Jantung Kongestif
Cardiac Glicoside
William Withering (1789) Digitalis lanata (foxglove putih)
Digitalis purpura (foxglove ungu)
Farmakokinetik
Absorbsi (40 – 75%) • Kardenolit : Inti steroid → lipofilik
tergantung jenis • Inti lakton → hidrofilik
• Metabolit → usus → (reabsorbsi) → sirkulasi & lerohepatis
Metabolisme : Hati
• (t 1/ 2 ↑)
Distribusi : Seluruh tubuh
terutama di jantung
Eliminasi : tanpa perubahan
melalui ginjal
Farmakokinetik
Farmakodinamik