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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Part 10,Drugs Treating Parkinson Disease and Alzheimer Disease,Levodopa,and related drugs,Cholinoceptor,antagonists,Drugs treating dementia,Drugs for treatment of Parkinson disease (PD),Levodopa,and related drugs,Cholinoceptor,antagonists,Parkinson disease and therapeutic drugs,Rigidity:,one of the common symptoms of PD,Tremor:,one of the common symptoms of PD,Pyramidal and extrapyramidal pathways,Striatum,黑质,-,纹状体通路,中脑,-,皮层通路,结节,-,漏斗通路,Substantia,nigro,-striatum,dopaminergic,pathway,is involved in PD pathogenesis,Parkinson disease,Dopaminergic neuron degeneration in,substantia,nigro,and striatum,Normal,PD,Control,Produce,dopamine,Dopamine,Acetylcholine,Abnormal balance of DA/,ACh,neuronal functions in extrapyramidal system of Parkinson disease,Levodopa,Muscarinic,antagonists,Normal,Parkinson disease,(-),(-),injured,relatively potentiated,PD:,GABA,HD:,GABA,(+),(-),(-),(+),(-),(-),(-),Levodopa,and related drugs,Levodopa, L-dopa,左,旋多巴,Drugs for treatment of Parkinson disease,Levodopa,Dopamine,Levodopa,1. ADME,Penetrating into the brain, transformed to DA or NE (less),Distributed in peripheral tissue (most),2. Effects and uses,Parkinson disease:,decreases the rigidity, tremors, and other symptoms,3. Adverse effects,(1) CNS:,abnormal involuntary; hallucinations;,etc,.,(2) GI:,nausea, vomiting,etc,.,(3) CVS:,hypotension, arrhythmia,etc,.,Drugs for treatment of Parkinson disease,Inhibitors of aromatic L-amino acid,decarboxylase,Carbidopa,卡比多巴,can not cross BBB, but can inhibit peripheral dopamine synthesis.,increases availability of,levodopa,to the CNS and decreases peripheral effects,Drugs for treatment of Parkinson disease,Levodopa,alone,Levodopa,+,Carbidopa,Other drugs,1. DA,receptor agonist,s,Bromocriptine,溴隐亭,Pergolide,培高利特,Pramiperole,普拉克索,Ropinirole,罗平尼咯,Drugs for treatment of Parkinson disease,2. MAO,inhibitor,s,decreasing DA metabolism in the CNS,Selegiline,司来吉兰,Rasagiline,雷沙吉兰,3. COMT inhibitors,decreasing DA metabolism in the CNS,Nitecapone,硝替卡朋,4.,Amantadine,金刚烷胺,increasing DA release,Drugs for treatment of Parkinson disease,Muscarinic,antagonists,Trihexyphenidyl,（,苯海索,，,artane,安坦,）,Decreasing CNS cholinergic functions,Adjuvant of,Parkison,disease treatment,Drugs for treatment of Parkinson disease,Drugs for treatment of dementia,(Alzheimer and related diseases),Anticholinesterase,drugs,Cholinoceptor,agonists,Neurotrophic,factor-like drugs,Anticholinesterase,drugs,Tarcrine,他克林,Huperzine,石杉碱甲（哈伯因）,Galantamine,加兰他敏,Cholinoceptor,agonists,Xanomeline,占诺美林,Milameline,米拉美林,Neurotrophic,factor-like drugs,AIT 082,Propentofylline,丙戊茶碱,Drugs for treatment of dementia,Pathological characteristics of AD,Atrophy of the brain,Senile plaques,Neurofibrillary,tangles,Senile plaques,and,neurofibrillary,tangles,Regions related to neuronal injury,Importance of,ACh,system,淀粉样多肽（,A,）,形成,淀粉样多肽,细胞外蓄积,tau,蛋白,细胞内蓄积,神经元功能损伤，神经变性,痴呆发生,炎症反应，氧自由基产生,钙平衡失调，细胞功能紊乱,遗传异常，环境影响,
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