高血压英文ppt精品课件hypertension in the inpatient

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1、HYPERTENSIONINTHEINPATIENTSETTINGMechanismsandPharmacologicManagementDedicatedtothememoryofLEONI.GOLDBERG,MD,PHDApioneerintheresearchofdopaminereceptorpharmacologyandphysiologyLearningObjectivesOutlinetheprevalence,pathology,andpathophysiologyofhypertensioninth

2、einpatientsetting.Identifytreatmentgoalsandtreatmentoptionsfortheseverelyhypertensivepatient.Discussthepharmacologicprofileandpotentialbenefitsoffenoldopaminthetreatmentofhypertension.SituationsRequiringInpatientAntihypertensiveTreatmentPreexistingHypertensionPr

3、imary/EssentialSecondaryNoPreexistingHypertensionAcuteCrisisPerioperativeAtleast45%ofhospitalizedpatientshavepreexistinghypertensionAbout25%ofsurgicalpatientshavepreexistinghypertensionHypertensivepatientsfrequentlyhavecoexistingcardiacandvasculardiseaseGoldmanL

4、,etal.NEnglJMed1977;297:845-850EpidemiologyandRelevanceEMMICUSICUORPACUObstetricsSuiteParenteralTreatmentofHypertensionMaybeRequiredin...UncontrolledorMalignantHypertensionDrug-InducedHypertensioncocaine,amphetaminesdrugwithdrawaldrug-druginteractionsEndocrineD

5、isordersParenteralTreatmentofHypertensionMaybeRequiredforMedicalEmergenciesParenteralTreatmentofHypertensionMayBeRequiredDuring/AfterPerioperativePeriodCardiacSurgeryMajorVascularSurgerycarotidendarterectomyaorticsurgeryNeurosurgeryHeadandNeckSurgeryRenalTransp

6、lantationMajorTrauma-BurnsorHeadInjuryFactorsintheDevelopmentofAcuteHypertensionPACUPainAnxietyDistendedBladderHypervolemiaVasoconstrictionER/CCMyocardialIschemiaHypercarbia/HypoxemiaReducedorganperfusion-Renal-CerebralORVascularclamping(afterload)HyperdynamicM

7、yocardiumMalignantHyperthermiaDiastolicDysfunctionAdverseConsequencesofUncontrolledHypertensionPostsurgicalHemorrhageSuturelinedisruptionAorticdissectionEndOrganInjuryMyocardialischemiaStrokeRenalfailurePulmonaryEdemaAdrenergicToneBaroreceptorReflexesVolume/Pre

8、ssureRenin/AngiotensinPreloadCardiacOutputBloodPressureCatecholaminesAdrenalGlandCNSVeinsArteriesCapacitanceResistanceSympatheticNervousSystemRegulationofBloodPressur