Klaus W
Arzneimittelforschung. 1977;27(3a):731-6.
The rational use of cardiac glycosides and anti-anginal drugs is deduced on the basis of the pathophysiological interdependence between cardiac and coronary insufficiency. With respect to therapeutic influence on myocardial function and oxygen balance the following rules ought to be regarded: 1. The use of cardiac glycosides should be restricted to patients with cardiac insufficiency in which these drugs are able to reduce the myocardial oxygen consumption due to the hemodynamic consquences of the positive-inotropic action. 2. Organic nitrates and/or beta-receptor blocking agents are compatible with simultaneous cardiac glycoside therapy, but both must be applied according to the individual requirement. 3. Coronary dilators are of questionable value in the therapy of coronary insufficiency, an additional advantage of a combination with cardiac glycosides still has to be proven. 4. There is no rational basis for the use of fixed combinations of these drugs, they do not allow effective and/or safe therapy.
基于心脏功能不全与冠状动脉功能不全之间的病理生理相互依存关系,推断出强心苷和抗心绞痛药物的合理使用方法。就对心肌功能和氧平衡的治疗影响而言,应遵循以下原则:1. 强心苷的使用应限于心脏功能不全患者,此类药物可因正性肌力作用的血流动力学后果而降低心肌耗氧量。2. 有机硝酸盐和/或β受体阻滞剂可与强心苷同时使用,但两者均须根据个体需求应用。3. 冠状动脉扩张剂在冠状动脉功能不全治疗中的价值存疑,与强心苷联合使用的额外优势仍有待证实。4. 这些药物的固定组合使用缺乏合理依据,无法实现有效和/或安全的治疗。