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書籍詳細

未契約
書籍名 β遮断薬のすべて 第2版
出版社 先端医学社
発行日 2004-06-15
著者
  • 荻原俊男(編集)
  • 築山久一郎(編集)
  • 横山光宏(編集)
ISBN 4884071360
ページ数 387
版刷巻号 第2版第1刷
分野
シリーズ 各薬剤の臨床実践
閲覧制限 未契約

治療薬を日常臨床にいかに応用すべきか、あらゆる角度からその可能性を探り、EBMから治療戦略までも網羅した薬剤の使い方の実践書。 初版(2000)発売より4年。2002年のカルベジロール登場後、ますます臨床応用が広がる「Class Effectを超えた薬剤」β遮断薬。現時点における大規模臨床試験から導き出されたEBMを掲載。また日常臨床に有用な基礎・臨床データを満載。

目次

  • 表紙
  • 初版 序
  • 執筆者一覧
  • 目次
  • Part 1 /β遮断薬のプロファイル
    P.25閲覧
    • 1. β遮断薬の歴史-狭心症治療薬, 降圧薬から心不全治療薬への臨床応用-
      • はじめに
      • (1) 狭心症治療薬としてのβ遮断薬の開発とプロプラノロールの登場
      • (2) 副作用の軽減を目指したβ遮断薬の開発-ISAを有するピンドロールの登場とその後
      • (3) β1選択性β遮断薬の開発と狭心症, 高血圧より心不全への適応の拡大
      • (4) αβ遮断薬カルベジロールの開発とその心不全における高い評価
      • (5) わが国におけるβ遮断薬の開発状況
      • おわりに
    • 2. β遮断薬の分類
      • はじめに
      • (1) β受容体の種類, 分布, 生理作用
      • (2) β遮断薬の分類とその作用
        • 1) β1受容体選択性
        • 2) α1遮断作用
        • 3) ISA
        • 4) 血液脳関門通過性
      • おわりに
    • 3. β遮断薬の薬物動態
      • はじめに
      • (1) β受容体の分類と臓器分布および生理機能
      • (2) β受容体遮断薬の特徴
      • (3) β受容体遮断薬の薬物動態
      • おわりに
    • 4. β遮断薬の心血管保護作用
      • はじめに
      • (1) β遮断薬のおもな作用-心拍低下作用
      • (2) β遮断薬の心保護作用-慢性心不全
      • (3) β遮断薬の心保護作用-急性心筋梗塞
      • (4) β遮断薬の血管保護作用
      • おわりに
    • 5. β遮断薬の降圧作用
      • はじめに
      • (1) β遮断薬の降圧機序と適応, 禁忌
      • (2) β遮断薬の分類と特徴
        • 1) β1(心臓)受容体選択性の有無
        • 2) ISAの有無
        • 3) α遮断作用のあるもの
        • 4) 直接血管拡張作用の有無
      • おわりに
  • Part 2/ β遮断薬の臓器別作用
    P.57閲覧
    • 1. β遮断薬の心筋に対する作用
      • はじめに
      • (1) β受容体のdown-regulationおよび情報伝達系
      • (2) β受容体とCa2+ハンドリング
      • (3) β受容体と遺伝子改変マウスモデル
      • おわりに
    • 2. β遮断薬の血管血管内皮に対する作用
      • はじめに
      • (1) 内皮細胞に対する作用
        • 1) プロスタグランジン合成促進作用
        • 2) ET-1産生抑制作用
      • (2) 平滑筋細胞に対する作用
        • 1) β受容体に対する作用
        • 2) ISA
        • 3) α受容体遮断作用
        • 4) β遮断薬のCa2+拮抗作用
        • 5) β遮断薬の硝酸薬様作用
        • 6) β遮断薬のK+チャネル開口作用
      • (3) 血管病変の形成過程に及ぼす影響
        • 1) 抗酸化作用
        • 2) 脂質に対する作用
        • 3) 細胞増殖 / 血管リモデリングに及ぼす影響
        • 4) 動脈硬化に対する作用
      • おわりに
    • 3. β遮断薬の脳循環に対する作用
      • はじめに
      • (1) 脳血管の神経支配とβ遮断薬の脳循環に対する作用
      • (2) β遮断薬の脳卒中予防効果, 脳機能に及ぼす影響
      • (3) β遮断薬カルベジロールの脳保護効果
      • (4) 脳機能賦活時の血流・代謝のカップリング : β受容体の関与
      • おわりに
    • 4. β遮断薬と腎臓
      • はじめに
      • (1) β遮断薬の腎臓に対する作用
        • 1) プロプラノロール(非心選択性, ISAなし, 胆汁排泄)
        • 2) ピンドロール(非心選択性, ISAあり)
        • 3) アセブトロール(心選択性, ISAあり)
        • 4) ナドロール(非心選択性, ISAなし)
        • 5) 心選択性を有するβ遮断薬
      • (2) β遮断薬の腎臓における血圧調節機構
      • (3) 腎血管拡張性β遮断薬
      • (4) β遮断薬の体液量と電解質に与える影響
      • (5) α1β遮断薬
        • 1) ラベタロール
        • 2) カルベジロール
        • 3) アロチノロール
      • (6)長期間の使用でのβ遮断薬の腎機能に及ぼす影響
      • おわりに
  • Part 3/ 酸化ストレスとβ遮断薬
    P.87閲覧
    • 1. 高血圧における酸化ストレスとβ遮断薬
      • はじめに
      • (1) 高血圧による酸化ストレスの増加
        • 1) 細胞レベルでの検討
        • 2) 実験動物レベルでの検討
        • 3) ヒトでの検討
      • おわりに
    • 2. 心筋症における酸化ストレスとβ遮断薬
      • はじめに
      • (1) 拡張型心筋症における酸化ストレスの増加
      • (2) 拡張型心筋症における酸化ストレス増加の要因
        • 1) 交感神経活動・カテコールアミンの活性化
        • 2) レニン・アンジオテンシン(RA)系の活性化
        • 3) 炎症・免疫・サイトカインの活性化
        • 4) 頻拍
        • 5) 機械的負荷
        • 6) 虚血
        • 7) NADPHオキシダーゼの活性化
        • 8) 抗酸化酵素作用の低下
      • (3) β遮断薬による治療と酸化ストレス
        • 1) 治療による酸化ストレス軽減
        • 2) 酸化ストレス軽減の機序
          • A. β1受容体を介した活性酸素産生の抑制
          • B. RA系の抑制
          • C. 炎症・免疫・サイトカインの抑制
          • D. 陰性変時作用
          • E. 抗虚血作用
          • F. NADPHオキシダーゼの抑制
          • G. 直接の抗酸化作用
      • おわりに
    • 3. 心不全における酸化ストレスとβ遮断薬
      • はじめに
      • (1) 不全心筋におけるROSの産生亢進
      • (2) ROSによるミトコンドリア傷害
        • 1) 不全心筋におけるmtDNAの量的欠乏
        • 2) mtDNAの量的欠乏をきたす因子
        • 3) mtDNAの酸化損傷とその防御・修復機構
      • (3) 酸化ストレスによる心筋障害
      • (4) 心不全における酸化ストレスと骨格筋障害
      • (5) 酸化ストレス制御とβ遮断薬による慢性心不全治療
      • おわりに
  • Part 4/ 高血圧
    P.109閲覧
    • 1. 第一選択薬としてのβ遮断薬の位置づけ
      • はじめに
      • (1) 最近の高血圧管理指針における評価
      • (2) 病態および合併症別のβ遮断薬の評価
        • 1) 虚血性心疾患合併例
        • 2) 心不全の予防 / 心不全合併例
        • 3) 糖尿病合併例
        • 4) 心臓手術 / 心臓以外の手術時の評価
        • 5) 老年者高血圧
      • (3) β遮断薬の併用療法における評価
        • 1) β遮断薬・利尿薬併用
        • 2) β遮断薬・Ca拮抗薬併用
        • 3) β遮断薬・ACE阻害薬併用
        • 4) β遮断薬・α遮断薬併用
      • (4) 薬理作用別にみたβ遮断薬の評価
        • A. 非選択性β遮断薬
        • B. β1選択性β遮断薬
        • C. ISAを有するβ遮断薬
        • D. αβ遮断薬
        • E. 親水性 / 親油性β遮断薬
      • (5) β遮断薬の副作用と禁忌
      • おわりに
    • 2. 軽症高血圧におけるβ遮断薬の位置づけ
      • はじめに
      • (1) 軽症高血圧の定義
      • (2) β遮断薬の適応患者と副作用
      • (3) 大規模臨床試験からみたβ遮断薬の適応
      • (4) ガイドラインからみたβ遮断薬の位置づけ
      • おわりに
    • 3. 中等度・重症高血圧におけるβ遮断薬の位置づけ
      • はじめに
      • (1) 合併症を伴わない中等度, 重症高血圧におけるβ遮断薬の位置づけ
      • (2) 冠動脈疾患合併高血圧例におけるβ遮断薬の位置づけ
      • (3) 心不全合併高血圧例におけるβ遮断薬の位置づけ
      • (4) 脳卒中合併高血圧例におけるβ遮断薬の位置づけ
      • (5) 糖尿病合併高血圧例におけるβ遮断薬の位置づけ
      • (6) 高齢者高血圧におけるβ遮断薬の位置づけ
      • おわりに
    • 4. 二次性高血圧とβ遮断薬
      • はじめに
      • (1) 腎実質性高血圧
      • (2) 腎血管性高血圧
      • (3) 褐色細胞腫
      • (4) 原発性アルドステロン症
      • (5) 妊娠に伴う高血圧
      • おわりに
    • 5. 若年者高血圧とβ遮断薬
      • はじめに
      • (1) 若年者の血圧の年齢による推移
      • (2) 若年者高血圧の頻度
      • (3) 白衣高血圧
      • (4) 若年者高血圧の機序
      • (5) 若年者高血圧の代謝因子
        • 1) 若年者高血圧の管理
          • A. 非薬物治療
          • B. 薬物治療
      • おわりに
    • 6. 老年者高血圧とβ遮断薬
      • はじめに
      • (1) 老年者高血圧の特徴とβ遮断薬
      • (2) β遮断薬の治療効果に対するエビデンス
      • おわりに
    • 7. 24時間生体リズムとβ遮断薬
      • はじめに
      • (1) β遮断薬の薬剤特性と血圧日内変動
        • 1) ISAを有するβ遮断薬が血圧日内変動に及ぼす影響
        • 2) ISAを有さないβ遮断薬が血圧日内変動に及ぼす影響
        • 3) α遮断作用を併せ持つβ遮断薬が血圧日内変動に及ぼす影響
      • (2) β遮断薬の時間治療への応用
      • おわりに
  • Part 5/ 合併症を伴った高血圧とβ遮断薬
    P.159閲覧
    • 1. 虚血性心疾患を伴った高血圧とβ遮断薬
      • はじめに
      • (1) 虚血性心疾患を伴った高血圧にβ遮断薬が良い場合
      • (2) 虚血性心疾患を伴った高血圧でβ遮断薬使用に注意を要する場合
      • (3) 急性冠症候群におけるβ遮断薬について
      • (4) 国内で実施されたβ遮断薬のEBM : JBCMI
      • おわりに
    • 2. 不整脈を伴った高血圧とβ遮断薬
      • はじめに
      • (1) 高血圧に合併した心房細動
        • 1) 高血圧患者における心房細動の頻度と臨床的意義
          • A. 高血圧と心房細動
          • B. 自律神経不均衡と心房細動
        • 2) 高血圧に合併した心房細動の治療
          • A. 心拍数コントロールとβ遮断薬
          • B. 除細動後の洞調律の維持とβ遮断薬
      • (2) 高血圧に合併した心室期外収縮
        • 1) 高血圧患者と心室期外収縮
        • 2) 高血圧性心疾患とβ遮断薬
          • A. 血行動態の変化
          • B. 心肥大と心臓の線維化
          • C. 心筋虚血に伴う心室期外収縮
          • D. 自律神経の不均衡と心室期外収縮
      • (3) 高血圧患者の突然死とβ遮断薬
      • おわりに
    • 3. 腎障害を伴った高血圧とβ遮断薬
      • はじめに
      • (1) 腎臓と高血圧
      • (2) 腎保護的降圧とその指標
      • (3) 腎障害合併高血圧とβ遮断薬
      • おわりに
    • 4. 脳血管障害を伴った高血圧とβ遮断薬
      • はじめに
      • (1) 脳血管障害の循環動態と血圧管理
        • 1) 急性期の循環動態と血圧管理
        • 2) 慢性期の循環動態と血圧管理
      • (2) β遮断薬の脳循環動態に対する作用
      • (3) 脳卒中合併高血圧とβ遮断薬
        • 1) 脳卒中の一次予防とβ遮断薬
        • 2) アテローム血栓性脳梗塞とβ遮断薬
        • 3) 脳卒中のリスクとしての早朝高血圧とβ遮断薬
      • おわりに
    • 5. 糖尿病を伴った高血圧とβ遮断薬
      • はじめに
      • (1) 糖尿病を伴った高血圧におけるβ遮断薬の位置づけ
      • (2) β遮断薬のインスリン抵抗性に及ぼす影響
        • 1) 糖代謝に及ぼす影響
        • 2) 脂質代謝に及ぼす影響
      • (3) β遮断薬と低血糖
      • (4) 糖尿病患者におけるβ遮断薬のエビデンス
      • (5) 虚血性心疾患を伴った糖尿病患者のエビデンス
      • おわりに
    • 6. 高脂血症動脈硬化を伴った高血圧とβ遮断薬
      • はじめに
      • (1) β遮断薬の血清脂質に対する影響
      • (2) β遮断薬の抗動脈硬化作用
        • 1) 動物実験
        • 2) 臨床的検討
      • (3) 動脈硬化を伴った高血圧の治療
        • 1) 頸動脈病変
        • 2) 大動脈瘤
        • 3) 閉塞性動脈硬化症(ASO)
      • おわりに
  • Part 6/ 虚血性疾息治療薬としてのβ遮断薬
    P.199閲覧
    • 1. 虚血・再灌流障害に対するβ遮断薬
      • はじめに
      • (1) 虚血・再灌流障害の発生機序
        • 1) 心筋内Ca2+過負荷
        • 2) 活性酸素・フリーラジカル
      • (2)心筋バイアビリティ : 何が心筋の生死を規定するのか
        • 1) 心筋スタニング
          • A. 心筋スタニングのメカニズム
        • 2) No-reflow現象
          • A. No-reflow現象のメカニズム
      • (3) 虚血・再灌流障害におけるβ遮断薬の効果とその臨床的意義
        • 1) β遮断薬の付加的作用
          • A. β1選択性
          • B. ISA
          • C. 膜安定化作用
          • D. α遮断作用
          • E. その他の血管拡張作用
          • F. 抗酸化作用
      • (4) 臨床への展開
      • おわりに
    • 2. 心筋梗塞治療薬としてのβ遮断薬の作用機序
      • はじめに
      • (1) 心筋梗塞の病態全体からみたβ遮断薬の作用点
      • (2) 心筋梗塞後心室リモデリングの発現とβ遮断薬の作用機序
        • 1) 梗塞部位の心筋組織の伸展(infarct expansion)
        • 2) 非梗塞部位心筋組織の肥大および拡張(ventricular dilatation)と機能不全
      • (3) 心筋梗塞二次予防におけるβ遮断薬の作用機序
      • おわりに
    • 3. 心筋梗塞急性期のβ遮断薬療法
      • はじめに
      • (1) 抗虚血作用
        • 1) 抗虚血作用に関する基礎的検討
        • 2) 臨床における抗虚血効果
      • (2) 抗不整脈作用
        • 1) カテコールアミンの催不整脈作用とβ遮断薬の影響
        • 2) 臨床における抗不整脈効果
      • (3) 左室リモデリングに対する効果
        • 1) 心破裂および梗塞部位伸展への影響
        • 2) 晩期左室リモデリングへの影響
        • 3) 免疫応答系を介した効果の可能性
      • (4) 再灌流療法とβ遮断薬
      • (5) β遮断薬投与の問題点
      • (6) β遮断薬の具体的投与法
      • おわりに
    • 4. 心筋梗塞慢性期治療薬としてのβ遮断薬
      • はじめに
      • (1) 大規模臨床試験の経緯
      • (2) 低左心機能患者へのβ遮断薬の適応について
      • (3) 心不全のない心筋梗塞後慢性期患者へのβ遮断薬の適応について
      • おわりに
    • 5. 狭心症治療薬としてのβ遮断薬
      • はじめに
      • (1) 狭心症について
        • 1) 病因
        • 2) 臨床像と分類
        • 3) 発症機序
        • 4) 無症候性心筋虚血
      • (2)狭心症に伴う合併症
        • 1) 心室機能障害
        • 2) 不整脈
      • (3) β遮断薬の役割
        • 1) 治療方針
        • 2) β遮断薬の位置づけ
        • 3) 薬理作用と適応
          • A. 安定労作狭心症
          • B. 不安定狭心症
          • C. β遮断薬の種類による差異
      • おわりに
    • 6. 無症候性心筋虚血とβ遮断薬
      • はじめに
      • (1) 無症候性心筋虚血の分類とその治療方針
      • (2) 無症候性心筋虚血の病態と治療薬の選択
      • (3) 無症候性心筋虚血における狭心症治療薬の併用効果
      • (4) 無症候性心筋虚血におけるβ遮断薬の自律神経機能に及ぼす効果
      • (5) 無症候性心筋虚血に対する長期予防効果
      • おわりに
  • Part 7/ 不整脈治療薬としてのβ遮断薬
    P.247閲覧
    • 1. 不整脈治療薬としてのβ遮断薬の機序
      • はじめに
      • (1) β受容体刺激による心筋の電気生理学的反応
      • (2) β遮断薬の電気生理学的作用
      • (3) 臨床不整脈でのβ遮断薬の適応
        • 1) 上室性不整脈
        • 2) 心室性不整脈
      • おわりに
    • 2. 不整脈におけるβ遮断薬の位置づけ
      • はじめに
      • (1) 基礎心疾患を伴わない例
        • 1) 期外収縮
        • 2) 上室頻拍
        • 3) 心房細動 / 粗動
        • 4) 心室頻拍 / 細動
      • (2)基礎心疾患を伴う場合
        • 1) 心筋梗塞例
        • 2) 心不全例
        • 3) 突然死蘇生例
        • 4) QT延長症候群
      • おわりに
  • Part 8/ 心不全治療薬としてのβ遮断薬
    P.261閲覧
    • 1. 心不全治療薬としてのβ遮断薬の位置づけと有効性の機序
      • はじめに : β遮断薬の有効性のエビデンス
      • (1) β遮断薬による心機能の改善
      • (2) 心臓交感神経活性の亢進と心機能 : 不全心筋の分子生物学的変化
      • (3) 心機能の改善と臨床効果との関係
      • (4) β遮断薬の効果はクラスエフェクトか : COMET
      • (5) 酸化ストレス, エネルギー代謝
        • 1) 酸化ストレス
        • 2) エネルギー代謝
      • (6) Responder, non-responder
      • (7) β遮断薬と他の心不全治療薬との併用
      • (8) β遮断薬不忍容例への対応
      • おわりに
    • 2. 左室肥大とβ遮断薬
      • はじめに
      • (1) 左室肥大の診断
      • (2) 左室肥大の病的意義
      • (3) 左室肥大のメカニズム
      • (4) 降圧療法と心筋肥大の退縮
      • おわりに
    • 3. 心不全におけるCa2+動態とβ遮断薬
      • はじめに
      • (1) β受容体と細胞内シグナル伝達
      • (2) β遮断薬と心筋筋小胞体機能
        • 1) Ca2+取り込み能の改善
        • 2) Ca2+放出能の改善
          • A. 心不全時のCa2+放出チャネル機能異常
          • B. β遮断薬のリアノジン受容体に及ぼす効果
        • おわりに
    • 4. 心不全におけるβ遮断薬の使用法
      • はじめに
      • (1) どのβ遮断薬が有効か?
      • (2) 重症心不全例に対するβ遮断薬治療
      • (3) 無症候性心機能低下例に有効か?
      • (4) 実際にどうやってはじめるか?
      • (5) β遮断薬治療中に心不全増悪をきたした場合どうするか?
      • (6) BNP測定は有用か?
      • (7) β遮断薬は第二選択薬か?
      • (8) どのような心不全例に有効か?
      • おわりに
    • 5. 高齢者の慢性心不全とβ遮断薬
      • はじめに
      • (1) 慢性心不全患者の臨床像
      • (2) 高齢者心不全の特徴
      • (3) 高齢者におけるβ遮断薬のエビデンス
      • (4) 高齢者心不全におけるβ遮断薬の使い方
      • おわりに
    • 6. 不整脈を伴う慢性心不全に対するβ遮断薬療法
      • はじめに
      • (1) β遮断薬による心臓性急死リスクの軽減
      • (2) 心房細動をもつCHF患者とβ遮断薬療法
      • (3) 徐脈をもつCHFとβ遮断薬療法
      • おわりに
    • 7. 拡張不全による慢性心不全とβ遮断薬
      • はじめに
      • (1) 拡張機能不全のみに起因する心不全(拡張不全)
      • (2) 拡張機能とは?
      • (3) 拡張不全発症のメカニズム
      • (4) 拡張機能不全の診断
      • (5) 拡張不全の治療におけるβ遮断薬の位置づけ
      • おわりに
    • 8. わが国におけるβ遮断薬療法の将来
      • はじめに
      • (1) β遮断薬の生命予後改善効果
      • (2) β遮断薬の用量 : 忍容性と改善効果
      • (3) β遮断薬のresponder
      • (4) 個別的医療への展開
      • (5) J-CHF
      • おわりに
  • Part 9/ 心血管手術とβ遮断薬
    P.323閲覧
    • 1. 心血管手術とβ遮断薬
      • はじめに
      • (1) 不整脈
      • (2) 急性術後高血圧
      • (3) 低心機能
      • (4) 血管手術
      • (5) その他
      • おわりに
  • Part 10/ β遮断薬使用上の注意点
    P.333閲覧
    • 1. β遮断薬の副作用とその対策
      • はじめに
      • (1) β受容体の遮断による副作用
        • 1) 心不全
        • 2) 徐脈
        • 3) 末梢血管への作用
        • 4) 離脱症候群
        • 5) 呼吸器系
        • 6) 糖・脂質代謝
        • 7) 腎機能
        • 8) 電解質
        • 9) 中枢神経・性機能
        • 10) 周産期での副作用
      • (2) β受容体の遮断と直接関係しない副作用
        • 1) 発疹
        • 2) 線維性腹膜炎
        • 3) 白血球減少, 血小板減少
      • おわりに
    • 2. β遮断薬の禁忌
      • はじめに
      • (1) β受容体遮断作用による禁忌
        • 1) 高度の徐脈, 房室・洞房ブロック, 洞不全症候群, 心原性ショック
        • 2) 心不全
        • 3) 異型狭心症
        • 4) 重度の末梢循環障害, 閉塞性動脈硬化症
        • 5) 気管支喘息, 気管支痙攣, 慢性閉塞性肺疾患
        • 6) 糖尿病
        • 7) 中枢神経に関する禁忌
        • 8) 老年者高血圧
        • 9) 褐色細胞腫
      • (2) β受容体遮断作用が直接関係しない禁忌
        • 1) 過敏症
        • 2) 妊婦
        • 3) 糖尿病性・代謝性アシドーシス
      • (3) 併用薬による禁忌
        • 1) チオリダジン
        • 2) シルデナフィル
      • おわりに
    • 3. β遮断薬の薬物相互作用
      • はじめに
      • (1) β遮断薬とチオリダジン
        • 1) 臨床報告
        • 2) メカニズム
      • (2) β遮断薬とクエン酸シルデナフィル
      • (3) β遮断薬と血糖降下薬
        • 1) 臨床報告
        • 2) メカニズム
      • (4) β遮断薬とCa拮抗薬
        • 1) 臨床報告
        • 2) メカニズム
      • (5) β遮断薬とクロニジン
        • 1) 臨床報告
        • 2) メカニズム
      • (6) β遮断薬とクラスI抗不整脈薬
        • 1) 臨床報告
        • 2) メカニズム
      • (7) β遮断薬と麻酔薬
      • (8) β遮断薬とジギタリス製剤
        • 1) 臨床報告
        • 2) メカニズム
      • (9) β遮断薬と非ステロイド系抗炎症薬
        • 1) 臨床報告
        • 2) メカニズム
      • (10) β遮断薬とシメチジン
        • 1) 臨床報告
        • 2) メカニズム
      • (11) β遮断薬とリファンピシン
        • 1) 臨床報告
        • 2) メカニズム
      • おわりに
  • Part 11/ 基礎編
    P.351閲覧
    • 1. β受容体の構造と情報伝達機構
      • はじめに
      • (1) β受容体の分類および構造
      • (2) 刺激伝達系
      • (3) G蛋白
      • (4) アデニル酸シクラーゼ
      • (5) Down-regulation
      • (6) カベオラとカベオリン
      • (7) β受容体ノックアウトマウス
      • おわりに : その他の話題
  • 座談会
    P.362閲覧
    • β遮断薬による循環器疾患治療の新展開-クラスエフェクトを超えたβ遮断薬の特徴と臨床効果への期待-
      • (1) 高血圧治療におけるβ遮断薬の位置づけ
        • 1) β遮断薬の降圧薬としてのプロファイル
        • 2) β遮断薬の降圧作用
        • 3) JNC7, 2003ESH-ESCガイドラインからみたβ遮断薬の位置づけ
      • (2) 冠動脈疾患に対するβ遮断薬の有効性
        • 1) 慢性時におけるβ遮断薬のメカニズム
        • 2) 急性時におけるβ遮断薬のメカニズム
        • 3) 冠動脈疾患治療に対するカルベジロールの使用状況とそのメリット
      • (3) 心不全治療薬としてのβ遮断薬
        • 1) 心不全治療におけるβ遮断薬の臨床試験結果
        • 2) 心不全治療におけるβ遮断薬のメカニズム
        • 3) β遮断薬の選択性の問題
        • 4) β遮断薬の慢性心不全に対する生命予後改善効果-クラスエフェクトを超えたカルベジロール : COMETの結果からの考察
        • 5) COMETにおけるカルベジロールの投与量について
      • (4) まとめ-実地臨床におけるβ遮断薬の使い方と今後求められるエビデンス-
        • 1) 降圧薬として用いる際の注意点
        • 2) 虚血性心疾患治療薬として用いる際の注意点
        • 3) 心不全治療薬として用いる際の注意点
  • 索引
    P.376閲覧
  • 奥付

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Part 1 /β遮断薬のプロファイル

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Part 3/ 酸化ストレスとβ遮断薬

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Part 4/ 高血圧

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Part 5/ 合併症を伴った高血圧とβ遮断薬

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Part 6/ 虚血性疾息治療薬としてのβ遮断薬

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Part 7/ 不整脈治療薬としてのβ遮断薬

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Part 8/ 心不全治療薬としてのβ遮断薬

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Part 9/ 心血管手術とβ遮断薬

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Part 10/ β遮断薬使用上の注意点

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Part 11/ 基礎編

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