血管活性药物/正性肌力药物的受体分布特点与选择

摘要

Vasoactive medications in clinical use exert their cardiovascular effects by interacting with adrenergic receptors and non-adrenergic receptors,including vasopressors,inotropes and vasodilators.A classi-fication of vasoactive drugs based on their direct effects on the heart(presence or absence of positive inotropic effects) and on vascular tone(vasoconstriction or vasodilation) include inodilators(dobutamine and milri-none),inoconstrictors(norepinephrine,epinephrine,and dopamine),pure vasoconstrictors(phenylephrine and vasopressin) and pure vasodilators(sodium nitroprusside).Selection of vasoactive medications based on de-sired pharmacologic effects that are matched to the patient′s underlying pathophysiology situation may opti-mize hemodynamics while reducing the potential of adverse effects.%血管活性药主要包括血管加压药、正性肌力药和血管扩张药,通过作用于肾上腺素能受体和非肾上腺素能受体来实现对心血管系统的调节.可通过对心肌的直接作用(有无正性肌力作用)和对血管张力的直接作用(收缩或扩张血管)分为强心扩张血管药(多巴酚丁胺、米力农)、强心收缩血管药(去甲肾上腺素、肾上腺素、多巴胺)、单纯收缩血管药(去氧肾上腺素、血管加压素)和单纯扩张血管药(硝普钠).血管活性药的选择要根据临床病理生理状态及血流动力学情况,选择合适的血管活性药物及剂量,减少潜在不良反应.