药理学英文课件：Anti mental disorder Drugs

Anti mental Anti mental disorderdisorder Drugs DrugsCLASSIFICATIONCLASSIFICATIONv1.Antipsychotic drugs1.Antipsychotic drugsv2.Antimanic Drugs2.Antimanic Drugsv3. Antidepressants3. Antidepressantsv4. Antianxiety drugs 4. Antianxiety drugs 1 Antipsychotic drugsAntipsychotic drugs Hypothesis for Schizophrenia: Hyperactivity of DA receptor in brain dopaminergic pathways in CNSvNigral-striatum pathway: the center of extrapyramidal system of motor function hyperactivity: hyperkinetic syndrome weakness: PDvMesolimbic-mesocortical pathway:to regulate emotion with cognition, thinking, perception, inference. .vTuberoinfundibular system: To regulate the hormone secretion of pituitary gland.Classification of Antipsychotics()Pharmacological effects 1.central nervous system(1)Antipsychotic effects: To ameliorate the symptoms such as delusions, hallucinations and maniaThe influence to average peoples psychomotility and behavior: sedation, apathy(感情淡漠), slow reaction Mechanism: to block D2 receptor of mesolimbic and mesocortical pathway. v(2)Antiemetic effect: CPZ has powerful effect on vomit brought from various cause (except from kinetia)Mechanism: vIn little dose, it inhibit D2 receptors on CTZ vIn high dose, it may depress the medullary vomiting center directly. (3)Temperature regulation: In low temperature, it can decrease body temperature to behind the normal. In high temperature, the body temperature will increase Not only decrease body temperature of fever patient, but also decrease normal body temperature. (4) enhance central depressive drug action -adrenergic receptor blocking effect:vascular dilatation, blood pressure decrease. M receptor blocking effect: High dose can cause dry mouth, constipation, blurred vision.3. Decreases prolactin inhibitory factory; increase the secretion of prolactinMechanism: block the D2 receptor of tuberoinfundibular pathwayCLINICAL USES:1. Psychotic disorder: Used to treat various types of schizophrenia Mania and other schizophrenia with excitation and delusion2. Antiemetic effects and treating stubborn hiccup. Nausea and vomiting induced by uremia, cancer, pregnant toxemia, radiation. 3. Hypothermic anesthesia and artificial winter sleep To decrease oxygen consumption of heart and brain and prevent shock in operation. SIDE EFFECTSv1.general side effectsv central depressive action M receptor blocking effect: High dose can cause dry mouth, constipation, blurred vision. -adrenergic receptor blocking effect: Orthostatic hypotension, stuffy nose.v2. Extrappyramidal system reactions A.Parkinsonism B.Acute dysmyotonia C. Akathisia(静坐不能静坐不能) Mechanism : CPZ block D receptor of nigrostriatal pathway. Central anticholinegic drugs can be used to treat it, but levo-dopa can not be used to treat it. D.Tardive dyskinesiavmay be seen with chronic therapy . Anticholinergic drug deteriorate the symptom.v Mechanism: Up regulation of D receptor3 3.Cardiovascular effects.Cardiovascular effects: : Orthostatic hypotension, which can result in syncope and reflex tachycardia.4. Allergic reaction4. Allergic reaction5.Others 5.Others galactorrhea(溢乳) hepatic 2 antimanic drugsLithium carbonateCorrect the overactivity of catecholaminergic systemsmechanism1.Inhibit release of transmitters at the synapse2.Enhance the reuptake of NA. 3.Inhibite inositol phosphatase (肌醇磷酸酶) ,decrease IP3-PIP2Adverse reactionTI is lower ,light safeMEC=0.6-1.2mmol/LMTC=1.4mmol/LANTIDEPRESSANTSvEtiological factor of depression:deficiency of NA and 5-HT,and DA vClassification of antidepressants, tricyclics antidepressivevpharmacodynamicsv1. antidepressive (slowly) vtricyclic block the amine (norepinephrine or serotonin) reuptake pumps,which terminate amine neurotransmission.v2. autonomic nervous system block M receptor.v3. Cardiovascular system inhibited reflex of cardio-vascular, hypotension ,arrhythmia.adverse reactionv1. similar to atropinev2. cardiovascular heart rate increase ,posture hypotrension ,arrhythmiav3. nervous systemv4. others emetictetrecyclic antidepressivevCharacteristic: fast; tolerance; light adverse reaction.MAOIvMAO-A is the amine oxidise primarily responsible for norepinephrine serotonin, and tyramine metabolism. MAO-B is more selective for dopamine. as a result ,the irreversible MAO inhibitor are subject to a very high risk of hypertensive reaction to tyramine ingested in food .selective 5-HT uptake inhibitorvthey lack many of the toxicityes of the tricyclic antidepressants. Thus patient acceptance has been high despite adverse effects such as nausea ,decreased libido and even decreased sexual function.v