Ca拮抗薬のすべて(第2版)

出版社: 先端医学社
著者:
発行日: 1999-12-25
分野: 臨床医学:内科  >  血管
ISBN: 9784915892882
電子書籍版: 1999-12-25 (第2版第1刷)
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商品紹介

治療薬を日常臨床にいかに応用すべきか、あらゆる角度からその可能性を探り、EBMから治療戦略までも網羅した薬剤の使い方の実践書。循環器領域に登場して40年。いま最も頻用されているCa拮抗薬について臨床薬理から治療の実践にいたるまで詳細に解説。EBMを実践するうえで知っておくべき基礎知識から疾患別の臨床応用解説を詳述。臨床家・研修医のための実践書。

目次

  • 表紙
  • 初版序
  • 執筆者一覧
  • 目次
  • Part 1 / 歴史と進歩
  • Ca拮抗薬の歴史と進歩
  • はじめに
  • [1] Ca拮抗薬の開発の歴史
  • [2] Ca拮抗薬の臨床応用の歴史
  • A. 狭心症・心筋梗塞に対する使用
  • B. 不整脈への使用
  • C. 高血圧への使用
  • [3] 高血圧治療におけるCa拮抗薬の位置づけの変遷
  • おわりに
  • Part 2 / 臨床薬理編
  • 第1節 Ca拮抗薬の分類と薬物動態
  • はじめに
  • [1] Caチャネルの種類, 構造, 機能
  • A. Caチャネルのサブクラス
  • B. 電位依存性Caチャネルの分子構造
  • C. Caチャネルの機能
  • [2] Ca拮抗薬の分類
  • A. Fleckensteinの分類
  • B. WHO分類
  • C. イヌ血液灌流心筋標本での血管選択性
  • D. 組織 ( 血管 ) 選択性の基礎
  • E. 化学構造式による分類
  • [3] Ca拮抗薬の臨床薬物動態
  • A. Ca拮抗薬の臨床的分類
  • B. Ca拮抗薬の副作用 ( 有害事象 )
  • C. Ca拮抗薬の薬物動態
  • D. Ca拮抗薬の臨床適応
  • E. Ca拮抗薬の世代別分類
  • おわりに
  • 第2節 Ca拮抗薬とT / P比
  • はじめに
  • [1] T / P比とは
  • [2] T / P比が高いことの利点
  • A. 24時間を通しての降圧が期待できる : 夜間から早朝にかけての血圧管理
  • B. 過大降圧の防止と血圧の変動性の抑制
  • [3] 理想的な降圧パターン
  • [4] T / P比の問題点
  • A. プラセボの必要性
  • B. 再現性の問題
  • C. 計算方式の多様性
  • [5] Ca拮抗薬とT / P比
  • A. Ca拮抗薬はなぜ長時間作用型でなければならないか ?
  • B. 各種Ca拮抗薬とT / P比
  • おわりに
  • 第3節 Ca拮抗薬の血管平滑筋に対する作用
  • はじめに
  • [1] 基礎的側面
  • [2] Ca拮抗薬の併用療法
  • [3] 臨床薬理学的な側面
  • [4] Ca拮抗薬の分類 - 第三世代Ca拮抗薬の概念の提唱 -
  • おわりに
  • 第4節 Ca拮抗薬の心筋に対する作用
  • はじめに
  • [1] Ca拮抗薬の心筋収縮抑制作用
  • [2] Caチャネルの構造とCa拮抗薬の結合部位
  • [3] "tonic" block と "use - dependent" block
  • [4] Ca拮抗薬の血管 / 心筋選択性
  • おわりに
  • 第5節 Ca拮抗薬の冠循環に対する作用
  • はじめに
  • [1] 冠血行動態と薬理作用
  • A. 血管平滑筋の弛緩
  • B. 冠血流量の変化
  • C. 血管内皮細胞のはたらきと冠動脈攣縮
  • D. 収縮物質の遊離抑制作用
  • E. 弛緩特性変化と冠循環
  • [2] 心筋虚血と心筋梗塞に関するCa拮抗薬の効果
  • [3] Ca拮抗薬の長期効果
  • A. 動脈硬化に対する作用
  • B. 後負荷軽減と心肥大の抑制
  • おわりに
  • 第6節 Ca拮抗薬の脳循環に対する作用
  • はじめに
  • [1] 摘出脳血管に対する作用
  • [2] 脳循環に対する作用
  • [3] 脳循環自動調節能 ( autoregulation ) に対する作用
  • [4] 脳血管攣縮に対するCa拮抗薬
  • [5] 脳梗塞急性期におけるCa拮抗薬
  • おわりに
  • 第7節 Ca拮抗薬の腎循環に対する作用
  • はじめに
  • [1] 腎微小循環の特徴
  • [2] Ca拮抗薬の種類による腎血行動態に及ぼす影響の差異
  • [3] 生体内でのCa拮抗薬の腎血行動態に及ぼす効果 - 動物における検討 -
  • [4] 生体内でのCa拮抗薬の腎障害に及ぼす効果 - 動物における検討 -
  • [5] 生体内でのCa拮抗薬の腎血行動態に及ぼす効果 - ヒトにおける検討 -
  • おわりに
  • 第8節 Ca拮抗薬の動脈コンプライアンスに対する作用
  • はじめに
  • [1] 動脈コンプライアンスの測定と評価
  • A. コンプライアンス
  • B. 動脈内径あるいは伸展性の測定法
  • [2] 高血圧と動脈コンプライアンス
  • [3] Ca拮抗薬と動脈コンプライアンス
  • A. 動物におけるCa拮抗薬の効果
  • B. 臨床成績 - 動脈内径に対するCa拮抗薬の効果 -
  • C. 臨床成績 - 動脈コンプライアンスに対するCa拮抗薬の効果 -
  • おわりに
  • 第9節 Ca拮抗薬の肥大心筋退縮作用
  • はじめに
  • [1] 心肥大の特徴と疫学
  • [2] 心肥大の成因と病態
  • A. 心筋細胞の肥大
  • B. 心筋内血流量の低下
  • C. 間質の線維化
  • [3] Ca拮抗薬による心肥大治療効果
  • A. 心肥大の退縮
  • B. 冠血流量の回復
  • C. 線維化の減少
  • おわりに
  • 第10節 Ca拮抗薬の内分泌, 代謝系への作用
  • はじめに
  • [1] 内分泌, 代謝系への影響
  • A. レニン・アンジオテンシン・アルドステロン系および交感神経系
  • B. 副甲状腺ホルモン ( PTH )
  • C. 尿酸代謝
  • D. 脂質代謝
  • E. 糖代謝
  • [2] インスリン抵抗性とCa拮抗薬
  • A. Ca拮抗薬のインスリン感受性に与える影響
  • B. Ca拮抗薬の高インスリン血症時の腎Na代謝, 交感神経活性に対する影響
  • おわりに
  • 第11節 Ca拮抗薬の抗不整脈作用
  • はじめに
  • [1] Caチャネルの関与する不整脈
  • A. 洞房結節自動能の亢進・減弱
  • B. 異所性 ( 異常 ) 自動能の亢進
  • C. 撃発活動
  • D. 伝導遅延とブロック
  • E. リエントリー
  • [2] Caチャネル電流の抑制の機序
  • A. 膜電位依存性ブロック
  • B. 使用依存性ブロック
  • [3] Ca拮抗薬による心電図変化と不整脈治療
  • おわりに
  • 第12節 Ca拮抗薬の抗血小板作用
  • はじめに
  • [1] 血小板活性化機序とCa2 +
  • [2] Ca拮抗薬と抗血小板作用
  • [3] 臨床効果
  • おわりに
  • 第13節 Ca拮抗薬の抗動脈硬化作用
  • はじめに
  • [1] 動脈硬化発症のメカニズム
  • [2] Ca拮抗薬の抗動脈硬化作用機序
  • A. in vitroにおける検討
  • B. 実験動物を用いた検討
  • C. ヒトにおける検討
  • おわりに
  • Part 3 / 治療編
  • I. 高血圧
  • 第1節 Ca拮抗薬の降圧薬としての位置づけ
  • はじめに
  • [1] 高血圧治療における第一選択薬の条件
  • [2] 降圧療法における第一選択薬
  • [3] 単独療法におけるCa拮抗薬の位置づけ
  • [4] 併用療法におけるCa拮抗薬の位置づけ
  • [5] 高血圧緊急症や手術前後の血圧コントロールにおけるCa拮抗薬の適応
  • [6] 降圧療法におけるCa拮抗薬の使用上の注意点
  • おわりに
  • 第2節 Ca拮抗薬の大規模介入試験と長期予後
  • はじめに
  • [1] Ca拮抗薬を用いておこなわれた大規模介入試験の成績
  • A. Shanghai Trial of Nifedipine in the Elderly ( STONE ) 試験
  • B. Systolic Hypertension in Europe ( Syst - Eur ) 試験
  • C. Systolic Hypertension in China ( Syst - China ) 試験
  • D. Syst - Eur Vascular Dementia Project
  • E. Hypertension Optimal Treatment ( HOT ) 試験
  • [2] わが国でおこなわれたCa拮抗薬とほかの降圧薬との大規模比較試験
  • A. Evaluation Group of Long - term Antihypertensive Treatment ( GLANT ) 試験
  • B. National Intervention Cooperative Study for the Treatment of Elderly Hypertension ( NICS - EH ) 試験
  • おわりに
  • 第3節 Ca拮抗薬と血圧日内変動
  • はじめに
  • [1] 血圧日内変動
  • A. 短期変動
  • B. 血圧日内変動
  • [2] Ca拮抗薬と血圧日内変動
  • A. 血圧短期変動とCa拮抗薬
  • B. 血圧日内変動とCa拮抗薬
  • 第4節 本態性高血圧とCa拮抗薬
  • はじめに
  • [1] 本態性高血圧治療におけるCa拮抗薬の生理学的作用
  • [2] 本態性高血圧症におけるCa拮抗薬の選択と適応
  • [3] JNC VIにおけるCa拮抗薬の適応と禁忌
  • [4] 高齢者高血圧におけるCa拮抗薬の有効性
  • [5] Ca拮抗薬の使用と虚血性心疾患の関連
  • [6] どのようなCa拮抗薬を選択するか ?
  • おわりに
  • 第5節 二次性高血圧とCa拮抗薬
  • はじめに
  • [1] 二次性高血圧の種類と頻度
  • [2] 二次性高血圧の治療の目的と治療薬の選択基準
  • [3] 二次性高血圧の発症・維持機構
  • A. 腎実質性高血圧
  • B. 腎血管性高血圧
  • C. その他の二次性高血圧
  • [4] Ca拮抗薬の降圧薬としての特性
  • [5] Ca拮抗薬の二次性高血圧における降圧効果
  • [6] Ca拮抗薬の腎機能に及ぼす影響
  • [7] 腎実質性高血圧治療におけるCa拮抗薬の問題点
  • おわりに
  • 第6節 高血圧緊急症とCa拮抗薬
  • はじめに
  • [1] 血圧のレベルと組織の変化
  • [2] 治療の原則
  • [3] 治療薬と注意点
  • [4] ニフェジピンと高血圧緊急症
  • [5] 各種高血圧緊急症の治療
  • A. 高血圧性脳症
  • B. 脳血管疾患
  • C. 解離性大動脈
  • D. 高血圧性急性左心不全
  • E. 妊娠に伴う重症高血圧
  • F. 不安定狭心症, 急性心筋梗塞
  • G. 術前・術後の高血圧
  • H. 降圧薬中断による反跳性高血圧
  • I. 急性頭部外傷
  • J. 悪性高血圧
  • K. 褐色細胞腫の高血圧クリーゼ
  • おわりに
  • 第7節 老年者高血圧とCa拮抗薬
  • はじめに
  • [1] 老年者高血圧の降圧療法の有効性
  • A. Ca拮抗薬を用いた大規模介入試験成績
  • [2] 老年者高血圧治療のガイドライン
  • A. 老年者高血圧の米国国立高血圧教育プログラム作業部会報告
  • B. わが国の「老年者の高血圧治療ガイドライン 1995」
  • [3] 老年者高血圧治療におけるCa拮抗薬の最近の話題
  • おわりに
  • 第8節 小児高血圧とCa拮抗薬
  • はじめに
  • [1] 高血圧判定基準
  • [2] 病態の把握
  • [3] 小児科におけるCa拮抗薬
  • [4] 本態性高血圧の薬物療法
  • [5] 腎性高血圧とCa拮抗薬
  • A. 腎実質性高血圧
  • B. その他の腎性高血圧
  • [6] 高血圧性緊急症
  • おわりに
  • 第9節 妊婦の高血圧とCa拮抗薬
  • はじめに
  • [1] 慢性高血圧の薬物治療
  • [2] 薬物治療のリスク
  • [3] 慢性高血圧の管理
  • [4] 妊娠中毒症の成因, 病態
  • [5] 妊娠中毒症の治療
  • [6] 妊娠中毒症の予防
  • おわりに
  • 第10節 透析患者とCa拮抗薬
  • はじめに
  • [1] 血液透析を受けている場合
  • [2] 腹膜透析 [ continuous ambulatory peritoneal dialysis : CAPD ( 連続携行式腹膜透析 ) ]
  • [3] 糖尿病性腎症
  • [4] 高齢者の非糖尿病性腎症
  • A. 糖尿病性腎症で血液透析を受けている場合
  • B. 非糖尿病性腎症の高齢者
  • [5] 上記以外の人々
  • A. 腹膜透析
  • B. 血液透析
  • おわりに
  • 第11節 合併症を伴った高血圧とCa拮抗薬
  • a. 脳血管障害を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 高血圧患者における脳循環
  • [2] Ca拮抗薬の脳循環代謝への影響
  • [3] Ca拮抗薬による脳梗塞患者の降圧療法
  • おわりに
  • b. 虚血性心臓病を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 高血圧と虚血性心臓病の関連
  • [2] Ca拮抗薬の抗動脈硬化作用
  • [3] Ca拮抗薬の大規模介入試験成績
  • [4] Ca拮抗薬使用の注意点
  • おわりに
  • c. 腎障害を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 腎障害の進行と糸球体過剰濾過学説
  • [2] 高血圧動物の腎障害に及ぼすCa拮抗薬の影響
  • [3] 高血圧患者の腎障害に及ぼすCa拮抗薬の影響
  • [4] 腎障害を伴う高血圧に対するCa拮抗薬の効果
  • おわりに
  • d. 糖尿病を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] Ca拮抗薬のインスリン分泌・インスリン感受性に及ぼす影響
  • [2] 糖尿病性腎症とCa拮抗薬
  • [3] 糖尿病を合併した高血圧の降圧治療開始時期と降圧目標
  • おわりに
  • e. 高脂血症を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 降圧薬と脂質代謝
  • A. サイアザイド系利尿薬
  • B. α1遮断薬, β遮断薬
  • C. ACE阻害薬
  • [2] Ca拮抗薬と血清脂質代謝
  • [3] Ca拮抗薬と血管壁脂質代謝
  • [4] 高脂血症を合併した高血圧における降圧療法と抗高脂血症療法
  • おわりに
  • f. 高尿酸血症を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 高血圧の非薬物的治療と血清尿酸レベル
  • [2] 降圧薬治療と血清尿酸レベル
  • [3] 痛風を伴う高血圧に使用する降圧薬
  • [4] 本態性高血圧に伴う高尿酸血症の管理
  • [5] 老年者高血圧における尿酸の意義
  • おわりに
  • g. 慢性呼吸器疾患を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] Ca拮抗薬と慢性呼吸器疾患
  • [2] 慢性呼吸器疾患の治療薬とCa拮抗薬
  • A. 解熱鎮痛薬とCa拮抗薬
  • B. 気管支拡張薬とCa拮抗薬
  • C. 抗生剤とCa拮抗薬
  • D. 抗結核薬とCa拮抗薬
  • E. 免疫抑制薬とCa拮抗薬
  • おわりに
  • h. 肝障害を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 肝臓における薬物代謝
  • [2] Ca拮抗薬の代謝経路
  • [3] 肝障害時のCa拮抗薬の体内薬物動態の変化
  • [4] 肝障害時のCa拮抗薬の降圧効果
  • [5] 肝機能に及ぼすCa拮抗薬の影響
  • [6] Ca拮抗薬の肝代謝型薬剤としての相互作用
  • おわりに
  • i. 膠原病, 免疫疾患を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] SLEの高血圧
  • [2] SLE腎症の高血圧治療薬としてACE阻害薬かCa拮抗薬か ?
  • [3] レイノー現象
  • [4] レイノー現象の治療薬としてのCa拮抗薬
  • [5] 原発性肺高血圧症
  • おわりに
  • j. 下肢循環不全を伴った高血圧とCa拮抗薬
  • はじめに
  • [1] 下肢循環不全
  • A. 閉塞性動脈硬化症
  • B. バージャー病
  • C. レイノー症候群
  • D. 静脈血栓症および血栓性静脈炎
  • [2] Ca拮抗薬の下肢血行動態に及ぼす作用
  • A. 細動脈・細小動脈拡張作用
  • B. 抗動脈硬化作用
  • C. 抗血小板凝集作用
  • [3] 下肢循環不全を伴った高血圧に対するCa拮抗薬の有効性
  • [4] 下肢循環不全を伴う高血圧患者に対する降圧薬治療におけるCa拮抗薬の位置づけ
  • おわりに
  • II. 虚血性心臓病
  • 第1節 虚血性心臓病治療薬としてのCa拮抗薬の位置づけ
  • はじめに
  • [1] 狭心症
  • [2] 不安定狭心症
  • [3] 心筋梗塞
  • A. ジルチアゼム
  • B. ベラパミル
  • C. ニフェジピン
  • D. ニソルジピン
  • E. アムロジピン
  • F. その他
  • おわりに
  • 第2節 Ca拮抗薬の活性酸素防御機構
  • はじめに
  • [1] Ca拮抗薬の抗酸化作用
  • [2] 抗酸化作用と心筋保護
  • [3] 抗酸化作用と抗動脈硬化作用
  • おわりに
  • 第3節 Ca拮抗薬と仮死心筋
  • はじめに
  • [1] 仮死心筋の概念
  • [2] 仮死心筋の病態生理
  • A. Ca2 + 過負荷
  • B. フリーラジカル
  • [3] 仮死心筋に対するCa拮抗薬の影響
  • A. ジヒドロピリジン系Ca拮抗薬
  • B. 非ジヒドロピリジン系Ca拮抗薬
  • おわりに
  • 第4節 Ca拮抗薬と冬眠心筋
  • はじめに
  • [1] ハイバネーションの機序
  • [2] スタニングとハイバネーション
  • [3] ハイバネーションとCa拮抗薬
  • おわりに
  • 第5節 狭心症, 心筋梗塞とCa拮抗薬
  • はじめに
  • [1] 狭心症, 心筋梗塞の病態と病型
  • [2] 狭心症の治療
  • A. 狭心症治療の基本方針
  • B. Ca拮抗薬の作用機序
  • C. 安定労作狭心症
  • D. 安静狭心症
  • E. 不安定狭心症
  • [3] 心筋梗塞の治療
  • A. 急性期
  • B. 慢性期
  • [4] 無症候性心筋虚血
  • [5] 治療上のCa拮抗薬の問題点
  • A. 虚血性心疾患治療で問題となる副作用
  • B. withdrawal phenomenon
  • C. 合併症を有する虚血性心疾患に対するCa拮抗薬
  • おわりに
  • III. 心不全
  • 第1節 心不全治療薬としてのCa拮抗薬の位置づけ
  • はじめに
  • [1] Ca拮抗薬による心不全治療
  • [2] 新しいCa拮抗薬
  • [3] アムロジピンの慢性心不全治療効果
  • [4] アムロジピンの生存率改善機序
  • [5] Ca拮抗薬の免疫抑制作用
  • 第2節 Ca拮抗薬の心不全治療に対する大規模介入試験と長期予後
  • はじめに
  • [1] 第一世代Ca拮抗薬を用いた慢性心不全臨床試験の成績
  • [2] 第二世代Ca拮抗薬の評価
  • [3] 第三世代Ca拮抗薬の評価
  • IV. 肥大型心筋症
  • 第1節 肥大型心筋症治療薬としてのCa拮抗薬の位置づけ
  • はじめに
  • [1] 肥大型心筋症の血行力学的特徴
  • [2] 肥大型心筋症とCa拮抗薬
  • A. Ca拮抗薬の拡張機能に及ぼす影響
  • B. Ca拮抗薬の肥大型心筋症患者の運動耐容能に及ぼす影響
  • C. Ca拮抗薬の予後に及ぼす影響
  • [3] 肥大型心筋症とCa拮抗薬類似作用を有する抗不整脈薬
  • おわりに
  • V. 不整脈
  • 第1節 不整脈治療薬としてのCa拮抗薬の位置づけ
  • はじめに
  • [1] Ca拮抗薬の心筋への特異性
  • [2] 心筋細胞におけるCaチャネルの機能
  • [3] 不整脈の発生機序とCaチャネル
  • A. リエントリー
  • B. 異常自動能
  • C. triggered activity ( 撃発活動 )
  • [4] Ca拮抗薬の抗不整脈作用のメカニズム
  • A. 房室結節の抑制効果
  • B. 特発性心室頻拍に対する効果
  • C. ジギタリス, カテコールアミンなどによる不整脈
  • D. 心筋虚血による不整脈
  • E. 虚血再灌流による不整脈
  • F. 心房細動に対する効果
  • [5] Sicilian GambitにおけるCa拮抗薬の位置づけ
  • [6] 抗不整脈薬としてのCa拮抗薬の位置づけは変化したか ?
  • おわりに
  • 第2節 Ca拮抗薬が適応の不整脈と禁忌の不整脈
  • はじめに
  • [1] 心臓組織内のCa拮抗薬に対する感受性
  • [2] 頻脈性不整脈の発生機序
  • [3] 不整脈に対するCa拮抗薬の有効性
  • A. 発作性上室性頻拍
  • B. 心房細動, 粗動
  • [4] 心室頻拍
  • A. 特発性心室頻拍
  • B. 先天性QT延長症候群
  • C. wide QRS tachycardiaの鑑別
  • [5] 禁忌と副作用
  • A. 偽性心室頻拍
  • B. 心房細動
  • C. 徐脈性不整脈
  • D. 心機能低下, 低血圧
  • [6] 不整脈に対するCa拮抗薬の使いかた
  • おわりに
  • VI. その他の疾患
  • その他の疾患の治療薬としてのCa拮抗薬
  • はじめに
  • [1] 呼吸器系での応用
  • A. 気管支収縮への効果
  • B. 運動誘発性気管支収縮
  • [2] 神経系への応用
  • A. 血管運動性頭痛
  • B. 精神分裂病
  • C. 筋萎縮性側索硬化症
  • D. 本態性振戦
  • E. てんかん
  • F. 反射性交感神経性ジストロフィー
  • G. メニエール病
  • [3] 消化器領域への応用
  • A. 食道機能障害
  • B. 過敏性大腸症候群
  • C. 肝硬変
  • D. その他の消化器系への応用
  • [4] 眼科領域での応用
  • A. 緑内障
  • B. その他の眼科領域における応用
  • [5] 産科領域での応用
  • A. 切迫早産に対するCa拮抗薬の効果
  • B. その他の産科領域での応用
  • おわりに
  • VII. Ca拮抗薬治療上の注意点
  • 第1節 Ca拮抗薬の禁忌の患者
  • はじめに
  • [1] わが国におけるCa拮抗薬の禁忌疾患
  • [2] 禁忌疾患におけるCa拮抗薬の評価
  • A. 急性心筋梗塞例
  • B. 高血圧緊急症
  • C. 妊婦または妊娠している可能性のある婦人
  • D. 頭蓋内出血
  • E. 心不全
  • F. 房室ブロック
  • G. その他
  • おわりに
  • 第2節 Ca拮抗薬の相互作用
  • はじめに
  • [1] 降圧薬との相互作用
  • A. Ca拮抗薬とACE阻害薬併用
  • B. Ca拮抗薬とβ遮断薬併用
  • C. Ca拮抗薬と利尿薬併用
  • D. Ca拮抗薬とAII受容体拮抗薬併用
  • E. Ca拮抗薬とα遮断薬併用
  • F. Ca拮抗薬と中枢神経作動性降圧薬併用
  • G. Ca拮抗薬間の相互作用
  • [2] ほかの循環器用薬との相互作用
  • A. Ca拮抗薬と強心配糖体併用
  • B. Ca拮抗薬とキニジン併用
  • C. Ca拮抗薬とアミオダロン併用
  • [3] 循環器用薬以外の薬剤との相互作用
  • A. Ca拮抗薬と非ステロイド性抗炎症薬併用
  • B. Ca拮抗薬と高脂血症治療薬併用
  • C. Ca拮抗薬と糖尿病治療薬併用
  • D. Ca拮抗薬とH2受容体拮抗薬併用
  • E. Ca拮抗薬とCa塩併用
  • F. Ca拮抗薬とリファンピシン併用
  • G. Ca拮抗薬と免疫抑制薬併用
  • H. Ca拮抗薬と炭酸リチウム併用
  • I. Ca拮抗薬と柑橘類果汁 / 食物併用
  • J. その他の薬剤との相互作用
  • おわりに
  • 第3節 Ca拮抗薬の副作用とその対策
  • [1] 副作用の概要
  • [2] 副作用各論
  • A. インタビューフォームに記載されている重大な副作用
  • B. 副作用各論
  • [3] ジヒドロピリジン系薬剤間の副作用の差異
  • A. 質的差異
  • B. 量的差異
  • VIII. Ca拮抗薬とQOL
  • Ca拮抗薬とQOL
  • はじめに
  • [1] 高血圧患者のQOLとその評価
  • [2] Ca拮抗薬の高血圧患者のQOLへの影響
  • A. ジヒドロピリジン系Ca拮抗薬
  • B. 非ジヒドロピリジン系Ca拮抗薬
  • おわりに
  • Part 4 / 基礎編
  • 第1節 Ca2 + チャネルの分子生物学
  • はじめに
  • [1] Ca2 + チャネルの進化
  • A. Ca2 + の濃度差の成立
  • B. Ca2 + 排除システムの進化
  • C. Ca2 + チャネルの進化
  • [2] Ca2 + チャネルの分子構造
  • A. α1サブユニット
  • B. α2 / δサブユニット
  • C. βサブユニット
  • D. γサブユニット
  • [3] Ca2 + チャネルの機能
  • A. Ca2 + イオン選択性
  • B. イオンの通過
  • C. 開閉制御 ( ゲート ) 機構
  • [4] 電位依存性Ca2 + チャネルの分類
  • A. 機能的分類
  • B. 構造的分類
  • [5] Ca2 + チャネルの制御
  • A. 膜電位による制御
  • B. 受容体・Gタンパク質によるCa2 + チャネルの制御
  • C. 環状ヌクレオチドによる直接制御
  • おわりに
  • 第2節 細胞内Ca2 + 濃度制御機構
  • はじめに
  • [1] 心筋細胞における細胞内Ca2 + 動態
  • A. 刺激伝導とCa2 + チャネル
  • B. 興奮収縮連関
  • C. 遅延後脱分極 ( delayed afterdepolarization : DAD )
  • [2] 平滑筋細胞における脱分極を介するCa2 + 濃度制御
  • A. 膜電位依存性Ca2 + チャネル ( VDC )
  • B. P2x受容体
  • C. 機械受容チャネル ( SAC )
  • D. ギャップジャンクション
  • [3] 平滑筋細胞における脱分極を介さないCa2 + 動員
  • A. IP3受容体
  • B. Ca2 + ウェーブ / Ca2 + オシレーション
  • C. ストア共役型Caチャネル ( SOC )
  • D. 内皮細胞によるCa2 + 濃度制御
  • [4] Ca2 + ストアと膜電位
  • A. Ca2 + によるCa2 + 放出 ( CICR )
  • B. STOCS
  • [5] Ca2 + 輸送系
  • A. 筋小胞体のCa2 + ポンプ ( SERCA )
  • B. 細胞膜のCa2 + ポンプ ( PMCA )
  • C. Na + / Ca2 + 交換機構
  • おわりに
  • 第3節 アポトーシスとCa拮抗薬 - とくに心疾患との関連について
  • はじめに
  • [1] アポトーシスの概説
  • A. 細胞死の形態 アポトーシスとネクローシス
  • B. アポトーシスの分子機構
  • C. 心疾患にみられるアポトーシス
  • [2] 細胞外誘導刺激による心筋アポトーシス
  • A. 血管作動性ペプチド
  • B. 炎症性サイトカイン
  • C. 低酸素状態 ( hypoxia )
  • D. ストレッチと活性酸素 ( スーパーオキシドと過酸化水素 )
  • [3] アポトーシスとCa拮抗薬との関連
  • おわりに
  • 付録 わが国で発売されているCa拮抗薬一覧
  • 索引
  • 奥付

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

Part 1 / 歴史と進歩

P.28 掲載の参考文献
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Part 2 / 臨床薬理編

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Part 3 / 治療編

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Part 4 / 基礎編

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