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零电位阈电位静息电位动作电位细胞膜+_+_+_+_+_+_+_+_+_+_+_+_+_+_+_+__+Na+,K+-ATPaseATPNa+K+Ca++Cl-Na+K+K+¿çĤµçλmv-100-80-60-40-200+20¸´¼«»¯È¥¼«»¯43210-------NHCHCH2NCH3OHHOH12356781'2'3'4'5'6'7'8'49NHCHCH2NCH3OOHHH¿üÄᶡQuinidine(+)8S:9S¿üÄþQuinine(-)8S:9R948'7'6'5'4'3'2'1'8765321NHCHCH2NCH3OHHOHNHCHCH2NCH3OHHOHHO12356781'2'3'4'5'6'7'8'49NHCHCH2NCH3OHHOHOH12356781'2'3'4'5'6'7'8'49NHCHCH2NHOHHOH12356781'2'3'4'5'6'7'8'49NHHOCH2CH2NCH3OHHOH12356781'2'3'4'5'6'7'8'49ÆÕ³¿¨ÒòProcaineH2NCNHCH2CH2N(C2H5)2OH2NCOCH2CH2N(C2H5)2OÆÕ³¿¨Òò°·ProcainamideCH3CONHCNHCH2CH2N(C2H5)2OÒÒõ£¿¨ÄáAcecainide°¢ÒåÂíÁÖAjmalineCCH2CH2NH2NCONCH(CH3)2CH(CH3)2±ûßÁ°·DisopyramideNNOHC2H5OHCH3ßÁÃÀŵPirmenolÎ÷±½ßòÁÖCibenzolineNNHOHCH2CH2CH2NH3CH3CR药名NHCOCH2N(C2H5)2利多卡因LidocaineNHCOCH(CH3)NH2妥卡胺TocainideOCH2CH(CH3)NH2美西律MexiletineNHCONH(CH2)3NHCH(CH3)2瑞卡南RecainamNHCOCH2N+(CH3)(C2H5)2.Cl-甲基利多卡因MethyllidocaineCH3RCH3神经细胞膜稳定作用ĪÀ×Î÷àºMoricizineNSCOCH2CH2NNHCOOC2H5OIB、IC类抗心律失常作用，扩张冠脉，解痉·ú¿¨ÄáFlecainide¶÷¿¨ÄáEncainideNHCOCH2CH2OCH3NCH3NHCH2NHCOOCH2CF3OCH2CF3Ó¢µØ¿¨ÄáIndecainideÀÍ¿¨ÄáLorcainideClNNCOCH2CH(CH3)2H2NOC(CH2)3NHCH(CH3)2³£¿©ßøPyrozolinÆÕÂÞÅÁͪPropafenoneCOCH2CH2OCH2CHCH2NH(CH2)2CH3OHNNNHOHCH2CH2NNÒÒõ£¿¨ÄáAcecainide°·µâͪAmiodaroneCONHCH2CH2N(C2H5)2CH3CONHOCOOCH2CH2N(CH2)3CH3C2H5C2H5ÃÀßß¡Melperone¼×Ñõ±½Í¡MeobentineFCOCH2CH2CH2NCH3CH2NHCCH3ONNHCH3CH3äåÜа·BretyliumtosylateCH2N+CH2CH3CH3CH3BrCH3SO3-选择性作用于心肌钾离子通道，致心律失常副作用较小抗高血压药物的作用部位和机理紧张脑神经节肾脏心输出量增加血流量增加血管收缩肾素血管紧张素I血管紧张素II醛固酮增大血容积高血压外周阻力增加发病机制发病机制皮层下神经中枢功能变化神经递质浓度与活性异常交感神经系统活性亢进血浆儿茶酚胺浓度升高小动脉阻力增加高血压高血压各种病因各种病因肾性水钠潴留为避免组织过度灌注机体代偿小动脉阻力增加高血压高血压血管紧张素原血管紧张素Ⅰ肾素血管紧张素ⅡACEAT1小动脉收缩醛固酮分泌激活交感神经高血压高血压心、血管重构细胞膜通透性增强钙泵活性降低钠泵活性降低细胞内Na+、Ca2+升高血管收缩心、血管重构高血压高血压胰岛素抵抗高胰岛素血症交感神经活性亢进肾脏钠水潴留高血压高血压Asp-Arg-Val-Tyr-Ile-His-Pro-Phe-His-Leu-Leu-Val-Tyr-Ser血管紧张素原AngiotensinogenAsp-Arg-Val-Tyr-Ile-His-Pro-Phe-His-Leu血管紧张素IAngiotensinIAsp-Arg-Val-Tyr-Ile-His-Pro-Phe血管紧张素IIAngiotensinII血管收缩血压升高醛固酮Aldosterone血容量增加肾素Renin血管紧张素转化酶ACEAngiotensin-convertingenzymeArg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg缓激肽BradykininArg-Pro-Pro-Gly-Phe-Ser-Pro血压下降ACE血管舒张NHCHRCONHCHCCH2OOZn++S1S1'OCOCH2CHCCH2OOsubstrate(R)-2-benzylsuccinicacidZn++S1S1'NCHOCCHNHR2OOCCOCHR3NHHS2'peptideinhibitorCCH2COOR2CHCOCHNOOSCH2COOR2CHCOCHNcarboxyalkylprolinemercaptoalkylproline°¢ÀÆÕÀûAlaceprilCH2CHCH3CONCONHCHCOOHCH3CSOCH2C6H5¿¨ÍÐÆÕÀûCaptoprilCH2CHCH3CONCOOHHSÌæÆÕÂÞëÄTeprotideGlu-Trp-Pro-Arg-Pro-Glu-Ile-Pro-ProCH2CCONHSHCOOHH3CCH2CCONSHCOOHH3CNOÀµÅµÆÕÀûLisinoprilH2N(CH2)3CH2CHCONCOOHNHCH2CH2CHCOOHÒÀÄÇÆÕÀûEnalaprilCHCONCOOHCH3NHCH2CH2CHCOOC2H5À×Ã×ÆÕÀûRamiprilÂÝÆÕÀûSpiraprilNCOOHCOHNPhCOOC2H5CH3OCNHOOCNHPhCH3C2H5OOCSS(R)NH(R)CH3NO(S)(S)(S)C2H5OOHOOCHH1233a4566aÎ÷ÀÆÕÀûCilazaprilàÄÇÆÕÀûQuinaprilNN...