• Title/Summary/Keyword: 심혈관계약물

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Drug Interactions between Cardiovascular Agents and Psychotropic Drugs (심혈관질환약물과 향정신성약물의 약물상호작용)

  • Park, Joo-Eon;Jung, Kyung-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.57-65
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    • 2011
  • There are numerous drug interactions related to many psychotropic and cardiovascular medications. Firstly, the principles in predicting drug interactions are discussed. Cytochrome P (CYP) 450 plays a significant role in the metabolism of these drugs that are substrates, inhibitors, or inducers of CYP450 enzymes. The two most significant enzymes are CYP2D6 and CYP3A4. The ability of psychotropic drugs to act as inhibitors for the enzymes may lead to altered efficacy or toxicity of co-administered cardiovascular agents as a substrate for the enzymes. The following is also a review of the known interactions between many commonly prescribed cardiovascular agents and psychotropic drugs. Most beta blockers are metabolized by CYP2D6, which may lead to drug toxicity when they use in combination with potent CYP2D6 inhibitors including bupropion, chlorpromazine, haloperidol, selective serotonin reuptake inhibitors, and quinidine. Concomitant administration of lithium with angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and diuretics may increase serum lithium concentrations and toxicity. Calcium channel blockers and cholesterol lowering agents are subject to interactions with potent inhibitors of CYP3A4, such as amiodarone, diltiazem, fluvoxamine, nefazodone, and verapamil. Prescribing antiarrhythmic drugs in conjunction with medications are known to prolong QT interval and/or inhibitors on a relevant CYP450 enzyme is generally not recommended, or needs watchful monitoring. Digoxin and warfarin also have warrant careful monitoring if co-administered with psychotropic drugs.

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후시상하부의 choline성 기전에 의한 심혈관 조절작용

  • 이상복;김성윤;성기욱;조영진;김정진;이석용
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.194-194
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    • 1994
  • 후시상하부의 choline성 수용체는 혈압상승 조절작용에 관여하는 것으로 보고되었다. 그러나 후시상하부는 심혈관계의 중추조절 분만 아니라 호흡, 체온 및 운동등의 중추조절에 중요한 역할을 하는 것으로 보고된 바 있으므로, 후시상하부의 일차적인 심혈관 조절작용을 규명하기 위해서는 호흡, 체온, 운동상태등을 일정하게 유지하게 유지한 조건에서 실험을 시행하여야 된다고 사료된다. 따라서 마취하고 호흡 및 체온을 일정하게 유지한 흰쥐에서 후시상하부의 choline성 수용체에 의한 혈압조절 작용을 규명하고자 본 연구를 실시하였다. 또한 후시상하부의 choline성 기정에 의한 심혈관 조절작용과 교감신경 활성의 척도인 혈장 catecholamine 농도의 상관성을 알아 보고자 하였다.

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Current Guidelines for Non-Steroidal Anti-Inflammatory Drugs (비스테로이드 소염제의 최신 사용 지침)

  • Park, Min-Gyue;Yoo, Jae-Doo;Lee, Kyu-Ho
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.9-28
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    • 2020
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs worldwide for chronic pain, such as arthritis, and there are many different types depending on their composition and mechanism. After long-term use, various side effects can occur, such as gastrointestinal and cardiovascular complications. With a similar analgesic effect to that of traditional non-selective NSAIDs, cyclooxygenase-2-selective NSAIDs have been highly anticipated, because they could complement gastrointestinal tolerance. On the other hand, because of concerns about cardiovascular safety in 2004 and 2005, and the license withdrawals of rofecoxib and valdecoxib, the interest in the side effects of NSAIDs is increasing. Therefore, it is important to use the necessary drugs at a minimum, considering the side effects and interactions of each drug. This study examined the side effects and characteristics of each NSAID that may occur and reviewed the recent research and guidelines related to the use of non-selective NSAIDs and cyclooxygenase-2-selective NSAIDs.

Cardiovascular and Perceived Exertion Response to Treadmill Running and Cycle Ergometer Exercise in Responder and Nonresponder Acute Coronary Syndrome Patients (심장재활에 참여한 급성 관상동맥증후군 환자에서 약물 반응과 운동 형태의 변화에 따른 심혈관과 운동자각도의 반응)

  • Kim, Young-Joo;Kim, Chul-Hyun
    • Journal of Life Science
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    • v.18 no.9
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    • pp.1263-1270
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    • 2008
  • The purpose of this study is to investigate the effect of exercise mode and anti-hypertensive drug responding status on the cardiovascular response and perceived exertion in acute coronary syndrome (ACS) patients. Seventy-five patients who participated in six-week exercise rehabilitation therapy performed a treadmill running and a cycle ergometer exercise at intensities of 60%HRR and 85%HRR respectively. Systolic and diastolic blood pressure, mean arterial blood pressure (MAP), rate pressure production (RPP), and ratings of perceived exertion (RPE) were measured. The results of cardiovascular response by the different exercise modes with moderate and intensive intensity of anti-hypertensive drug responder and nonresponder ACS patients were following: First cycle ergometer exercise induced significantly higher SBP, DBP, MAP, RPP and MAP than treadmill running exercise at the intensities of 60%HRR and 85%HRR in both anti-hypertensive responder and nonresponder ACS patients (p<0.05). Secondly anti-hypertensive nonresponder ACS patients had significantly higher DBP and MAP that anti-hypertensive responder ACS patients at all the exercise modes (p<0.05). Finally there was no difference of RPP between anti-hypertensive responder and nomresponder ACS patients, although anti-hypertensive nonresponder ACS patients showed higher blood pressure and RPP than anti-hypertensive responder ACS patients. In conclusion, cycle ergometer induced increased cardiovascular response at same intensities of treadmill running exercise and anti-hypertensive nonresponder ACS patients had even more increased cardiovascular response than anti-hypertensive responder ACS patients with no difference in perceived exertion during exercise. These results suggested that cycle ergometer exercise should be greatly careful with the risk of higher blood pressure, especially for those who are patients with hypertensive blood pressure.

Left Ventricular Hypertrophy and Prelude to Hypertensive Cardiovascular Diseases: from the Pediatric Cardiologist's Point of View (좌심실 비대와 고혈압성 심혈관 합병증: 소아 심장 의사의 관점)

  • Cho, Min-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.14-21
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    • 2011
  • Although left Left ventricular hypertrophy (LVH) is not only an adaptive response of the heart to increased cardiac workload in hypertension, it surelybut also is the most potent risk factor of overt cardiovascular complications such as coronary heart disease, heart failure, arrhythmia and stroke in the hypertensive population. Also it has become generally accepted that subclinical cardiovascular disease begins in childhood and LVH is the most readily assessed marker for that. As LVH can be seen in children and adolescents with even mild blood pressure elevation with the reported prevalence of 10 to 47%, aggressive antihypertensive treatment is critical in preventing the development of hypertensive heart disease in that those cases.

후 시상하부의 심혈관계 조절기전(I): 흰쥐 후 시상하부에서 세포외액의 모노아민과 그 대사체들에 대한 생체내 미세투석법에 의한 연구

  • 이상복;성기옥;조영진;이석용;김인순;김성윤
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1992.05a
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    • pp.34-34
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    • 1992
  • 심혈관계의 중추 조절작용과 고혈압 치료제의 작용기전을 규명하기 위한 연구의 한 단계로서 생체내 미세투석법(in vivo microdialysis)을 이용하여 후 시상하부의 국소부위에서 catecholamine들과 serotonin 및 그 대사체들의 세포와 농도의 변화를 정상혈압 횐쥐 (WKY)에서 관찰하고, 자연발생성 고혈압 횐쥐(SHR)에서 이들의 기준치를 비교하였다. 뇌정위 고정장치에 의해서 미세투석관을 후 시상하부에 위치시킨 후 링거액으로 관류하였다. 모노아민들과 그 대사체들은 고속액체 크로마토그라피와 전기화학 검출기률 이용하여 정량하였다. WKY에서 imipramine(50$\mu$M)의 관류에 의하여 norepinephrine의 농도가 유의하게 증가되었고, 또한 Pargyline (75mg/kg, i.p.)에 의하여 norepinephrine의 농도는 유의하게 증가된 반면에 DOPAC, HVA 및 5-HIAA는 감소하였다. WKY와 SHR에서 비교하였을때 norepinephrine, epinephrine, dopamine, serotonin의 농도는 차이가 없었으나 DOPAC, HVA, 5-HIAA의 농도는 SHR에서 유의하게 증가된 결과를 얻었다. 상의 결과들은 모노아민중에서 norepinephrine이 정상혈압 흰쥐의 후 시상하부에서 유리되는 주된 신경전달물질임을 시사한다. 또한 자연 발생성 고혈압 흰쥐의 후 시상하부에서 dopamine과 serotonin의 교체속도가 증가되었을 가능성이 큰 것으로 사료된다.

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Amiloride-sensitive $Na^+$ Channels Are Not Involved in the Cardiovascular Responses to Increased $Na^+$ Concentration in Cerebrospinal Fluid (뇌척수액내 $Na^+$ 농도 증가에 의한 심혈관 반응과 Amiloride 민감성 $Na^+$ Channel과의 관계)

  • Kook, Hyun;Kim, Jae-Ha;Baek, Yung-Hong
    • The Korean Journal of Pharmacology
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    • v.30 no.3
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    • pp.313-319
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    • 1994
  • This study was undertaken to investigate the relationship between the $Na^+$ channels of the cardiovascular regulation center and the responses to increased $Na^+$ concentration in the cerebrospinal fluid (CSF), by observing the effects of icv administration of the agents affecting $Na^+$ transport. Icv infusion of $200\;{\mu}l$ of 1 M NaCl produced hypertension and bradycardia in the urethane-anesthetized rabbit, and the bradycardia was inhibited and reversed to tachycardia by vagotomy. Amiloride, a $Na^+$ transport inhibitor, produced hypertension and bradycardia, which were not altered by vagotomy, and it did not affect the NaCl-induced responses. Benzamil, a derivative of amiloride with higher specificity, neither produced any cardiovascular effects by itself, nor affected the NaCl-induced responses. In vagotomized rabbits, icv amiloride reversed the NaCl-induced tachycardia to a bradycardia, but the bradycardiac effect was not altered by pretreating with NaCl. This study showed that although amiloride and benzamil slightly differ in their cardiovascular action, neither of them did affect the NaCl-induced responses. We suggest that the $Na^+$ channels which are sensitive to amiloride or benzamil in the cardiovascular regulation center are not involved in the NaCl-induced response.

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Effects of Silsosangami-extract on Endotoxin-induced Experimental Thrombosis in Rats (실소산가미 및 그 구성약물이 세포내독소로 인한 혈전증 흰쥐에 미치는 영향)

  • Jong-Chan, Ahn;Won-Hwan, Park
    • The Journal of Korean Medicine
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    • v.23 no.4
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    • pp.105-112
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    • 2002
  • 목적: 한의학에서 어혈증으로 야기되는 여러 가지 증상의 개선에 사용되는 실소산가미의 범발성혈관내응고증 및 혈전증에 미치는 영향을 연구하는 것이다. 방법 : 동물은 Wistar-King atrain Rats(150-200g)를 사용하였고, 혈전증은 세포내독소로 유발하였다. 측정은 실소산가미와 각 구성약물들에 대한 혈소판, 섬유소원, 프로트롬빈시간, 섬유소섬유소원분해산물에 미치는 영향을 연구하였다. 결과: 항혈전의 특성에 관한 것은 실소산가미와 구성약물중 포황, 오령지, 적작약, 도인 그리고 울금에서 억제특성이 나타났으며, 또한 실소산가미와 구성약물은 정상쥐에서 범발성혈관내응고증에서 혈소판과 섬유소원의 감소가 억제되었고, 섬유소분해산물의 증가가 억제 되었다. 실험관 실험에서 실소산가미와 구성약물은 트롬빈에 의해 섬유소원에서 섬유소로 전환이 억제되었으며, 플라스미노겐 또는 플라스민의 활성을 억제하였다. 결론: 실소산가미가 세포내독소로 유발된 혈전증에 대한 억제작용을 보이므로, 혈전증으로 야기되는 심혈관계질환등의 치료 및 예방에 응용가능성이 있을 것으로 사료된다.

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The Effects of Gastrodiae Rhizoma Powder on Plasma Lipid Profiles in the Elderly with Cardiovascular Disease (천마분말 복용이 심혈관계 질환 노인들의 혈중 지질 양상 변화에 미치는 영향)

  • Yang, Kyung-Mi
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.7
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    • pp.858-868
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    • 2008
  • This study was carried out to investigate the effects of Gastrodiae Rhizoma powder on plasma lipid profiles in elderly volunteers with hyperlipidemia, hypertension, diabetes or heart disease. 32 elderly people, 11 males and 21 females aged $60{\sim}77$ years, were given Gastrodiae Rhizoma powder 15 g twice daily for 6 months. We investigated the antheropometric data, general characteristics and dietary habit by using questionnaires. Fasting blood samples were collected from the subjects before and after this 6 months intervention study. Blood pressure, glucose, hemoglobin and lipid levels of plasma, atherogenic index (AI) and cardiac risk factors (CRF, LHR, HTR) were determined before and after consumption of Gastrodiae Rhizoma powder. The mean body mass index (BMI) of the male and female subjects were 22.4 and 23.6, respectively. The percent of ideal body weight (PIBW) of males and females were 105.6% and 122.3%, respectively. The subjects had decreased intake frequency of fish and meat in their dietary habit. After consumption of Gastrodiae Rhizoma powder, there were no significant differences in blood pressure; however, the blood glucose significantly decreased with Gastrodiae Rhizoma intake in the males. In the subjects, the levels of plasma total cholesterol, triglyceride, and LDL-cholesterol were decreased by the consumption of Gastrodiae Rhizoma powder; while the levels of plasma LDL-cholesterol was significantly decreased in female. Blood pressure and biochemical assessment (blood glucose, hemoglobin, triglyceride, total cholesterol, LDL and HDL-cholesterol) of the subjects were within the normal range. It was found that AI, CRF and LHR were significantly decreased by Gastrodiae Rhizoma intake. The present results indicate that dietary supplementation of Gastrodiae Rhizoma improved lipid metabolism and cardiac risk factor in cardiovascular disease.

Suppression of Lipid Peroxidation and CYP Isozymes activities by Circium japonicum Herbal-acupuncture Solution ; Basic Study for Screening of Medicinal Herb on Reactive Oxygen Radical and CYP-Mediated Atherosclerosis (대계 약침액(藥鍼液)의 지질과산화 및 CYP 억제에 미치는 영향(影響) ; 활성산소자유기 및 CYP 매개의 동맥경화 치료를 위한 천연약물 개발의 기초 평가)

  • Lee Jeong-Joo;Kim Hyuck;Yi Hyo-Seung;Park Won-Hwan;Moon Jin-Young
    • Korean Journal of Acupuncture
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    • v.23 no.4
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    • pp.177-186
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    • 2006
  • 목적 : 약침액(藥鐵液)의 지질과산화 예방 및 cytocome P450과의 상호 작용에 있어서 대계의 역할은 과거 연구가 거의 없었다. 따라서 본 실험에서는 대계 약침액이 지질과산화를 예방하고, 심혈관계질환 유발에 밀접한 연관이 있는 cytochrome P450의 직접적인 저해 효과를 검토 하고자 한다. 방법 : 대계 약침액이 지질과산화를 억제하는 정도를 평가하기 위하여 세포막을 구성하는 불포화지방산의 일종인 linoleic acid를 대상으로 지질과산화 진행 시간과 대계 약침액의 농도에 의존적인 저해 효과를 실험하였다. 또한 실험쥐의 간조직을 이용하여, 강제적인 과산화를 유도한 후 이를 방어하는 효능을 검토하였다. 그리고 cytochrome P450을 구성하는 그룹의 1A1, 1A2 및 2E1의 활성을 각각 EROD, MROD, p-nitrophenol, aniline 방법으로 측정하였다. 결과 및 결론 : 대계 약침액은 세포막 구성의 불포화 지방산인 linoleic acid의 산화를 시간 및 처리 농도에 의존적으로 억제하였고, 실험쥐의 조직 과산화를 유의성 있게 저해하였다. 또한 aryl hydrocarbon receptor (AHR)을 활성화 시켜 polycyclic aromatic hydrocarbons (PAHs)에 의한 심혈관계 질환 유발 인자로 알려진 cytochrome P450 1A1 및 1A2의 발현을 일부 저해하였으며, 특히 체내에 흡수된 알콜 대사에 관여하는 P450 2E1을 강하게 억제 시켰다.

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