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).
blood flow and redistribution of blood to ischemic areas may occur with β-blockers. More free fatty acids may be available for substrate consumption by the myocardium. Microcirculatory oxygen delivery improves, and oxygen dissociates more easily from hemoglobin after β-adrenergic blockade. Platelet aggregation is inhibited. β-Blockers
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