具有擴張周圍血管作用的藥物,又稱周圍血管擴張藥(peripheral vasodilators)。至今,臨床使用的此類藥物種類繁多,大致可分為兩大類。
第一類是直接松弛血管平滑肌的藥物,即直接血管擴張藥,如肼苯噠嗪、硝普鈉和硝酸酯類。另一類則是通過不同的作用機制最終導致血管擴張的藥物,包括α-腎上腺素受體阻斷藥、鈣拮抗劑以及血管緊張素轉化酶抑制劑。
這些藥物不僅傳統上用于治療高血壓等多種心血管疾病,還常被應用于急性和慢性心功能不全。其主要原理在于:這類藥物能夠擴張小靜脈,減少回心血量,從而降低心室充盈壓,減輕心臟前負荷;同時,它們還能擴張小動脈,減弱外周血管阻力,降低心室射血阻抗,進而減輕心臟后負荷。
由于這些有益的作用,心肌梗塞、高血壓性心臟病或心臟直視手術后的急性左心衰竭和肺水腫患者,在使用血管擴張劑治療時往往能獲得顯著療效。尤其對慢性充血性心力衰竭而言,特別在洋地黃中毒或用洋地黃與利尿劑治療無效的頑固性病例中,也能發揮相當的緩解作用。
臨床實踐證明,當應用適宜劑量時,這類藥物能使動脈血壓保持不變或輕度降低,并且不會引起顯著的心率變化。然而,過大的劑量則可能導致嚴重低血壓,因此在使用過程中應從小劑量開始并密切監護心率和血壓;有條件的情況下,還可以監測肺毛細血管楔嵌壓。
值得注意的是,長期應用此類藥物時不應立即停藥,以免引發反跳現象。
| 中文名稱 | 英文名稱 | CAS號 | 化學式 |
|---|---|---|---|
| 阿魏酸鈉 | 24276-84-4 | C10H10NaO4 | |
| 長春西汀雜質N | (+/-)-Vincamin | 1617-90-9 | C21H26N2O3 |
| 長春西汀雜質1 | (+/-)-3-epi-apovincaminic acid ethyl ester | 42971-09-5 | C22H26N2O2 |
| 長春西汀雜質 A | ethyl eburnamenine-14-carboxylate | 42971-12-0 | C22H26N2O2 |
| 長春西汀 | Vinpocetine | 42971-09-5 | C22H26N2O2 |
| 長春胺 | vincamin | 1617-90-9 | C21H26N2O3 |
| 酚芐明 | phenoxybenzamine | 59-96-1 | C18H22ClNO |
| 酚妥拉明 | phentolamine | 50-60-2 | C17H19N3O |
| 萘呋胺酯 草酸鹽 | Gevatran | 3200-06-4 | C2H2O4*C24H33NO3 |
| 萘呋胺酯 | nafronyl | 31329-57-4 | C24H33NO3 |
| 腦清 | nylidrin | 447-41-6 | C19H25NO2 |
| 羥苯磺酸鈣 | 20123-80-2 | C6H6CaO5S | |
| 鹽酸酚芐明 | phenoxybenzamine hydrochloride | 63-92-3 | C18H22ClNO*ClH |
| 鹽酸酚妥拉明 | phentolamine hydrochloride | 73-05-2 | C17H19N3O*ClH |
| 鹽酸罌粟堿 | papaverine hydrochloride | 61-25-6 | C20H22NO4*Cl |
| 鹽酸托哌酮 | Tolperisone hydrochloride | 3644-61-9 | C16H23NO*ClH |
| 鹽酸妥拉唑林 | tolazoline hydrochloride | 59-97-2 | C10H12N2*ClH |
| 甲磺酸酚妥拉明 | phentolamine mesylate | 65-28-1 | CH4O3S*C17H19N3O |
| 甲磺酸倍他司汀 | betahistine methanesulphonate | 54856-23-4 | CH4O3S*C8H12N2 |
| 甲磺酸二氫麥角胺 | dihydroergotamine mesylate | 6190-39-2 | CH4O3S*C33H37N5O5 |
| 環扁桃酯 | cyclandelate | 456-59-7 | C17H24O3 |
| 煙酸占替諾 | xanthinol nicotinate | 437-74-1 | C6H5NO2*C13H21N5O4 |
| 海得琴 | dihydroergotamine mesylate | 11032-41-0 | CH4O3S*C33H37N5O5 |
| 氟桂利嗪 | flunarizine | 52468-60-7 | C26H26F2N2 |
| 桂利嗪 | cinnarizine | 298-57-7 | C26H28N2 |
| 托哌酮 | tolperisone | 728-88-1 | C16H23NO |
| 己酮可可堿 | pentoxyphylline | 6493-05-6 | C13H18N4O3 |
| 尼麥角林 | nicergoline | 27848-84-6 | C24H26BrN3O3 |
| 卡維地洛 | carvedilol | 72956-09-3 | C24H26N2O4 |
| 丙帕硝酯 | propatylnitrate | 2921-92-8 | C6H11N3O9 |
| 2-苯甲基咪唑啉 | tolazoline | 59-98-3 | C10H12N2 |
| 2-(2-甲基氨基乙基)吡啶 | betahistine | 5638-76-6 | C8H12N2 |
| (aS,2R)-四氫-a-(1-萘甲基)-2-呋喃丙酸 2-(二乙基氨基)乙酯 | (2RS,2'SR)-2-(diethylamino)ethyl 2-<(naphth-1-yl)methyl>-3-(tetrahydrofuran-2-yl)propanoate | 31329-57-4 | C24H33NO3 |
| (E)-1-二苯甲基-4-肉桂基哌嗪 | cinnarizine | 16699-20-0 | C26H28N2 |
| —— | sodium 4-hydroxy-3-methoxycinnamate | 24276-84-4 | C10H9O4*Na |
| —— | flunarizine hydrochloride | 30484-77-6 | C26H26F2N2*ClH |
| —— | Betahistine mesilate | 54856-23-4 | C10H20N2O6S2 |
| —— | N-(7-benzyl-2-hydroxy-4-methyl-5,8-dioxo-3-oxa-6,9-diazatricyclo[7.3.0.02,6]dodecan-4-yl)-7-methyl-4,6,6a,7,8,9,10,10a-octahydroindolo[4,3-fg]quinolin-7-ium-9-carboxamide;methanesulfonate | 6190-39-2 | CH4O3S*C33H37N5O5 |
| —— | Cinnarazine | 298-57-7 | C26H28N2 |
| —— | 2-(diethylamino)ethyl (2S)-2-(naphthalen-1-ylmethyl)-3-[(2R)-oxolan-2-yl]propanoate;oxalic acid | 3200-06-4 | C2H2O4*C24H33NO3 |
| —— | 2-(diethylamino)ethyl (2R)-2-(naphthalen-1-ylmethyl)-3-[(2R)-oxolan-2-yl]propanoate;oxalic acid | 3200-06-4 | C2H2O4*C24H33NO3 |
| —— | 2-(diethylamino)ethyl (2R)-2-(naphthalen-1-ylmethyl)-3-[(2S)-oxolan-2-yl]propanoate;oxalic acid | 3200-06-4 | C2H2O4*C24H33NO3 |
| —— | 2-(diethylamino)ethyl (2S)-2-(naphthalen-1-ylmethyl)-3-[(2S)-oxolan-2-yl]propanoate;oxalic acid | 3200-06-4 | C2H2O4*C24H33NO3 |
| —— | Betahistine dihydrochloride | 5579-84-0 | C8H12N2*2ClH |
| —— | 1-[bis(4-fluorophenyl)methyl]-4-cinnamylpiperazine dihydrochloride | 27064-95-5 | C26H26F2N2*2ClH |
| —— | vinpocetine | 42971-09-5 | C22H24N2O2 |
| —— | Nicergolin | 27848-84-6 | C24H26BrN3O3 |
| —— | (+/-)-alloerythro-1-(4-Hydroxy-phenyl)-2-<(4-phenyl-butyl-(2)-amino>-propanol-(1) | 447-41-6 | C19H25NO2 |
| —— | (1<i>RS</i>,2<i>SR</i>)-1-(4-hydroxy-phenyl)-2-((<i>SR</i>)-1-methyl-3-phenyl-propylamino)-propan-1-ol | 447-41-6 | C19H25NO2 |
| —— | (1<i>RS</i>,2<i>SR</i>)-1-(4-hydroxy-phenyl)-2-((<i>RS</i>)-1-methyl-3-phenyl-propylamino)-propan-1-ol | 447-41-6 | C19H25NO2 |