遗传因素对临床用药的影响 高敏性（hypersnsitivity 耐受性（tolerance ....pptVIP

 ? * Autonomic drugs （II）  Chapter 6 Cholinoceptor agonists and drugs affecting cholinesterase activity 胆碱受体激动药和作用于胆碱酯酶药 pay attention to action types and representative drugs, instead of all drugs cholinoceptor agonists nonselective M, N receptor agonists M receptor agonists N receptor agonists cholinesterase inhibitors reversible cholinesterase inhibitors irreversible cholinesterase inhibitors cholinesterase reactivators Subtypes and characteristics of cholinoceptors Type location structure mechanism M1(M1a) nerves STS, G protein IP3, DAG M2(M2b) heart nerve STS, G protein cAMP, K+ channel smooth muscle M3(M2b) glands STS, G protein IP3, DAG smooth muscle endothelium NN(N1) postganglionic pentamer Na+ channel cell body NM(N2) skeletal muscle pentamer Na+ channel neuromuscular junction STS: seven transmembrane segments STS: seven trans-membrane segments M1 receptor Intramolecular interactions proposed to stabilize the ground state of the M1 muscarinic acetylcholine receptor. Interacting groups of amino acids are shown in the same colour. (a) View from the extracellular surface; side-chains participating in the hydrophobic latch structure are shown in space-filling format. (b) Lateral view. 1, nonselective M, N AchR agonists acetylcholine 乙酰胆碱 M, NN and NM like effects need to be understood action complex, wide, many untoward reactions, short-lived only as research tool Structures of Ach and carbamylcholine Carbamylcholine （氨甲酰胆碱） carbamylcholine（氨甲酰胆碱，卡巴可） like Ach, but action lasts longer only used in glaucoma（青光眼） 2, M AchR agonists pilocarpine 毛果芸香碱 南美植物Pilocarpusjaborandin或pilocarpusmicrophylus的叶子提取的植物碱。 Pilocarpine （毛果芸香碱） pilocarpine: actions: thr