Transcription of Cardiovascular Pharmacology - McGill University
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Cardiovascular Pharmacology - McGill University
118 Chapter 8 Cardiovascular PharmacologyRoger L. Royster, MD John F. Butterworth IV, MD Leanne Groban, MD Thomas F. Slaughter, MD David A. Zvara, MDAnti-ischemic Drug therApyAnti-ischemic drug therapy during anesthesia is indicated whenever evidence of myocardial ischemia exists. The treatment of ischemia during anesthesia is compli-cated by the ongoing stress of surgery, blood loss, concurrent organ ischemia, and the patient s inability to interact with the anesthesiologist. Nonetheless, the fundamental principles of treatment remain the same as in the unanesthetized state. All events of myocardial ischemia involve an alteration in the oxygen supply/demand balance (Table 8-1). The 2007 American College of Cardiology/American Heart Association (ACC/AHA) Guidelines on the Management and Treatment of Patients with Unstable Angina and Non ST-Segment Elevation Myocardial Infarction provide an excellent framework for the treatment of patients with ongoing myocardial (NTG) is clinically indicated as initial therapy in nearly all types of myocardial ischemia.
CARDIOVASCULAR PHYSIOLOGY, PHARMACOLOGY, AND MOLECULAR BIOLOGY 120 of blood in the splanchnic capacitance system. Mesenteric blood volume increases as ventricular size, ventricular pressures, and intrapericardial pressure decrease. NTG increases the distensibility and conductance of large arteries without chang-
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