抗胆碱药课件.pptVIP

抗胆碱药 I. Definition classification cholinoceptor blocking drugs （胆碱受体阻断药）的概念 分类 1.按受体 M-cholinoceptor blocking drugs M1,M2,M3 N-cholinoceptor blocking drugs N1,N2 2.按用途 平滑肌解痉药，神经节阻断药，骨骼肌松弛药和中枢性抗胆碱药 Ⅱ. M-cholinoceptor blocking drugs Atropoine and related alkaloid（生物碱） 阿托品类生物碱及其来源 植物名称 主要生物碱 颠茄（Atropa belladonna) 莨菪碱 曼陀罗（Datura stramonium) 莨菪碱 洋金花（Datura sp.) 东莨菪碱 莨菪（Hyoscyamus niger) 莨菪碱 唐古特莨菪（Scopolia tangutica) 山莨菪碱 Atropine（阿托品）, An alkaloid that affects the nervous system 1.Mechanism of Action ①Competitive antagonism（对抗） of ACh to muscarinic receptors ②Not distinguish among M1, M2, M3 ③Most sensitive tissues: salivary, bronchial and sweat glands ④Less sensitive: gastric parietal cells（壁细胞）(gastric acid secretion) ⑤Intermediate: smooth muscle effectors and the heart 2. Pharmacological Effects ①Inhibition the secretion of gland a.salivary gland(dry mouth) b.sweat gland(dry skin) c.bronchial secretary gland d.large dosage---inhibits the secretary function of the stomach ②Visual a.mydriasis（散瞳） b.cycloplegia（睫状肌麻痹）--can`t focus for near vision c.increases intraocular（眼内的） pressure M-R 阻断药 M-R 激动药 ③Relaxation of visceral（内脏的）smooth muscle a. stomach intestine (reduced tone and motility) b. bronchial muscle, detrusor（逼尿肌） of bladder, urinary tract c. biliary tract – gallbladder（胆囊） and bile ducts（胆管） -- mild antispasmodic action d. uterus（子宫） -- very weak effect ④Heart a.small dosage: decreases heart rate ( M1-R blocker) b.large dosage: increases the heart rate (M2-R blocker) c.influence is most noticeable in the people whom vagal（迷走神经） tone is considerable. ⑤Dilate（扩张）blood vessels and improve（改善）microcirculation a.therapeutic dosage ---no significant effect b.large dosage--dilates cutaneous（皮肤的） blood vessels(face and neck) improve microcirculation,recover the blood supply to