【高血压精品英文课件】hypertension in the inpatient setting mechanisms

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

2、entsetting.Identifytreatmentgoalsandtreatmentoptionsfortheseverelyhypertensivepatient.Discussthepharmacologicprofileandpotentialbenefitsoffenoldopaminthetreatmentofhypertension.SituationsRequiringInpatientAntihypertensiveTreatmentPreexistingHypertensionPrimary/Essentia

3、lSecondaryNoPreexistingHypertensionAcuteCrisisPerioperativeAtleast45%ofhospitalizedpatientshavepreexistinghypertensionAbout25%ofsurgicalpatientshavepreexistinghypertensionHypertensivepatientsfrequentlyhavecoexistingcardiacandvasculardiseaseGoldmanL,etal.NEnglJMed1977;2

4、97:845-850EpidemiologyandRelevanceEMMICUSICUORPACUObstetricsSuiteParenteralTreatmentofHypertensionMaybeRequiredin...UncontrolledorMalignantHypertensionDrug-InducedHypertensioncocaine,amphetaminesdrugwithdrawaldrug-druginteractionsEndocrineDisordersParenteralTreatmento

5、fHypertensionMaybeRequiredforMedicalEmergenciesParenteralTreatmentofHypertensionMayBeRequiredDuring/AfterPerioperativePeriodCardiacSurgeryMajorVascularSurgerycarotidendarterectomyaorticsurgeryNeurosurgeryHeadandNeckSurgeryRenalTransplantationMajorTrauma-BurnsorHeadInj

6、uryFactorsintheDevelopmentofAcuteHypertensionPACUPainAnxietyDistendedBladderHypervolemiaVasoconstrictionER/CCMyocardialIschemiaHypercarbia/HypoxemiaReducedorganperfusion-Renal-CerebralORVascularclamping(afterload)HyperdynamicMyocardiumMalignantHyperthermiaDiastolicDys

7、functionAdverseConsequencesofUncontrolledHypertensionPostsurgicalHemorrhageSuturelinedisruptionAorticdissectionEndOrganInjuryMyocardialischemiaStrokeRenalfailurePulmonaryEdemaAdrenergicToneBaroreceptorReflexesVolume/PressureRenin/AngiotensinPreloadCardiacOutputBloodPr

8、essureCatecholaminesAdrenalGlandCNSVeinsArteriesCapacitanceResistanceSympatheticNervousSystemRegulationofBloodPressur