二十八作用于呼吸系统的药物.pptVIP

objective 掌握 平喘药的概念、分类，沙丁胺醇、氨茶碱、色甘酸钠的药理作用、临床应用、不良反应。 熟悉 呼吸系统药物分类，异丙托溴铵、糖皮质激素的作用特点，平喘药的临床应用。可待因、右美沙芬、喷托维林等药理作用特点。 了解 镇咳药和祛痰药的概念；苯佐那酯、溴己新的药理作用及临床应用。 §1 introduction Respiratory disease is a familiar, repetitious disease. The common symptoms are : cough, sputum ( 痰); asthma (哮喘). §1 introduction §2 usual drugs-----Antiasthmatics I. Antiasthmatics Asthma pathologic features: Soakage（浸润） of inflammatory cells, contraction of airway smooth muscle, mucosal thickening from edema and cellular infiltration, the plug of mucus in the airway lumen. §2 usual drugs-----Antiasthmatics ↑ responsiveness of the trachea and bronchi to various stimuli. Asthmatic stimuli include: inhaled allergens(吸入性过敏原); drugs; non-specific stimuli such as cold air, exercise, stress, and pollution…. §2 usual drugs-----Antiasthmatics Bronchial inflammatory mediators : LTs, PGs, TXA2, PAF… cell factors ILs, TNF-?, GM-CSF …... §2 usual drugs-----Antiasthmatics Classifications of antiasthmatics ㈠. Bronchodilators 1. ?-R agonists; 2. Theophylline; 3. M-R antagonists; ㈡. Antiinflamatory drugs ㈢. Mast-cell stabilizers §2 usual drugs-----Antiasthmatics 一. Bronchodilators 1. ?-R agonists adrenerling; Ephedrine ; isoprenaline; selective β2 -R agonists Salbutamol ; Terbutaline Clenbuterol Formoterol ; Salmeterol §2 usual drugs-----Antiasthmatics Basic actions (+) AC→↑intracellular cAMP : brochodilation ; ↓release of inflammatory mediators; ↓microvascular leakage ; ↑mucociliary（粘膜纤毛） transport. §2 usual drugs-----Antiasthmatics β2 –selective agonists first line drugs for asthma at present ★ bronchodilation ≈ isoprenaline, ★but cardiovascular effects ↓; ★po. absorbed well, long duration; ★ adverse reactions not common. §2 usual drugs---