循環器ジャーナル65巻1号

2017年01月発行

特集 Clinical Scenarioによる急性心不全治療 Ⅲ．Clinical Scenario 1：起坐呼吸を呈する急性心不全

急性心不全治療における硝酸薬とニコランジルの使い方

著者： 南雄一郎¹

所属機関： ¹東京女子医科大学循環器内科

ページ範囲：P.36 - P.42

Point
・本邦の急性心不全治療ガイドラインにおいて，硝酸薬およびニコランジルを含む血管拡張薬は，CS1の症例に対する第一選択薬とされている．
・ニトログリセリンは降圧効果に優れ，著明な高血圧を伴う急性肺水腫の症例に対して，切れ味鋭い効果が期待できる．
・硝酸イソソルビドは剤型が豊富で，過度の降圧や反射性の頻脈などを来しにくく，非常に使いやすい薬剤である．
・ニコランジルは耐性が生じにくく，心拍出量を増加させるため，治療に時間を要する虚血性低心機能症例で，その効果が期待される．

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