高血壓藥物臨床藥理學

Clinical Pharmacology of Antihypertensive Drugs

陳樹仁(S. J. Chen) ； 陳幸一(H. I. Chen)

《Journal of Medical Sciences》 3卷2期 (1979/07) Pp. 911-918

摘要

因為不同的藥理作用，治療高血壓的藥物大致可分為八大類：（1）改變中樞交感神經活動性的藥物；（2）神經節阻斷劑；（3）交感節後神經原阻斷劑；（4）甲型阻斷劑；（5）乙型阻斷劑；（6）細動脈舒張劑；（7）細動脈與靜脈舒張劑；（8）利尿劑。這些藥物的降血壓作用可因分別作用交感神經系統對之不同部位，影響腎素—血管張力素—醛類酯醇系統，直接舒張細動脈或靜脈，也有影響血量者。對於高血壓的治療，每一種藥物都有其優點及缺點，沒有一種病人需要用一種特定的藥物，一種藥物也許對某些病人無效而且副作用大；但對另一組病人則十分有效，而且副作用小。有時要經過小心的試用才可找出一種或一組合適的藥物及其劑量。因為藥物眾多而無特定的使用原則，在這種情況下，臨床醫師必需熟悉每一種藥物的臨床藥理及副作用，而加以靈活應用。

並列摘要

Antihypertensive drugs act in several ways. They can be classified into 8 categories: 1). Drugs altering central sympathetic activity 2). Ganglionic blocking agents 3). Postsynaptic adrenergic neuron blockers 4). Alpha-adrenergic receptor blocking agents 5). Beta-adrenergic receptor blocking agents 6). Arteriolar vasodilators 7) Arteriolar and venous dilators 8). Diuretics. These drugs act respectively on the sympathetic nervous system at various sites, on the renin-angiotensin-aldosterone system, on the arterioles and/or veins, and on the plasma volume etc. In this brief review article, we have discussed the pharmacological actions and the clinical application of the major antihypertensive agents. Every drug has its advantages and disadvantages. There is not a drug specific for an antihypertensive effect. A given agent may exert antihypertensive effect without significant side effects in some patients, whereas less antihypertensive effect with severe side effects in the other patients. With careful trials, satisfactory regimens can be devised for most patients. Because of the drug variety and arbitrary choice, clinicians must be aware of the pharmacological actions and the clinical application of antihypertensive drugs to achieve a successful control of hypertension.