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:

-

Ca

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AOYIOOIKH TAINOMHH

MYOKAPIAKH IXAIMIA

O2

O2

M 1 2

KATHOPIE THAXH

A

Prinzmetal

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:

= 2 2

AV 2

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2

2

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ACa++

,

,

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,

,

,

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A Ca

++

Ca2+

Ca2+

VSM

VOC 3

L, N, T

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1) A

Ca

++

, (

1

L )

2) E

Ca

++

3) E

Ca

++

Ca

++

??

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Ca

++

??

4) E Ca

++

5)

Ca

++

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+

-

Ca++

Ca++-

Ca++

-

- Ca++

Ca++-

-

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~

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Ca++ ?

I. A O2A.

.

II. E O2

(verapamil).

(Verapamil).

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Ca++

X , :)

)

Nifedipine, Nicardipine & Nimodipine ,

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: Nifedipine, Nicardipine & Nimodipine

, ,

:,

+-

,

+

+ ,

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E Ca++

1)

2) O

3) K

4) A:

K

K

5) Y

7)

8) Y

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Salim Yusuf calcium blockers

AmlodipineAmlodipine

,

: diuretics beta-blockers, ACEinhibitors

, CHF,

;

;

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Calcium blockers

Salim Yusuf

;

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Dihydropyridine calcium blockers

(nifedipine, nicardipine, and isradipine)

,

Yusuf S. Circulation 1995;92:1079-1082.

Kloner RA. Circulation 1995;92:1074-1078.

28 randomized trials involving 19,000 patients with

MI and unstable angina

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Verapamil and Diltiazem?

Searle: , 15,000-

CONVINCE trial (Controlled ONset VerapamilINvestigation of Cardiovascular Endpoints)

Verapamil COER-24

,

-

,

(2001).

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, , ,

(,

)

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-

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GTN ISDN 5-ISMN

T1/2 (min) 3 10 280

(L/min) 50 4 0,1

Vd (L/kg) 3 4 0,6

-

~ 0 20 100

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:

NO

P N

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Finding Nitric Oxide Dr. Ferid Murad

Bubbled NO gas through tissuecontaining guanylyl cyclase-> cGMPlevels increased in that tissue.Was well known that nitroglycerinactivated the same enzyme-> mustrelease NO.

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APMAKOOIKE ENEPEIE NITPIKN

A

+

~ CO

~ HR

,

: >>BP

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- O2

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(

)

Trimetazidine: a new metabolic approach in angina

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Trimetazidine: a new metabolic approach in angina

.

(long-

chain 3-ketoacyl-CoA-thiolase) FFA

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IIYPIYPIAMOAMOHH

A

,

IOAZINH

IYPIAMOH

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H

, ,

[]

2- ( )

cAMP

,

M

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A PGI

E

IYPIAMOH

Nicorandil for Angina Pectoris (Icorel*)

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Nicorandil for Angina Pectoris (Icorel*)

+

R-3 cGMP free calcium in VSM

P

+ VOC Ca2+ Ca2+

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(

)-

(

)

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Nitronaproxen & nitrofenac

-80933

ROS

-

Alzheimer: Selegiline

-

-

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,

. (11 )

. Ca

,

. - (3 )

(10 )

(Rlopresor)

Nicorandil

Trimetazidine

, , , ,

.

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