抗精神失常药的概念和分类

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,*,抗精神失常药的概念和分类,*,PPT,文档演模板,Office,PPT,抗精神失常药的概念和分类,2024/11/19,抗精神失常药的概念和分类,Why?,抗精神失常药的概念和分类,神经,兮兮,神经稀稀,神经搭错,抗精神失常药的概念和分类,Neuro,pathy,psycho,pathy,note,（神经病）,（精神病）,抗精神失常药的概念和分类,Introduction,1、Concept,Psychotic,disorders,various reason,severe mental disorders.,抗精神失常药的概念和分类,2、classification,1,、,schizophrenia,精神分裂症,2、mania-depressive disorder,躁狂抑郁症,3、anxiety,焦虑症,4、others,抗精神失常药的概念和分类,1）the most familiar,2）inpatient 6070%;,3）thought and behavior,-cloven,(分裂),4）limbic system(,边缘系统,),DA function,.,Schizophrenia,(I type,II type ),抗精神失常药的概念和分类,Mania-depressive disorder,mania,5-HT,NA,NA,1）,Mania-depressive,2）,depression,5-HT,抗精神失常药的概念和分类,3、anxiety,焦虑症,4、others,青春期、,周期性、,更年期,抗精神失常药的概念和分类,10月10日是世界精神卫生日,健康体魄,+,健康心理,美好人生,抗精神失常药的概念和分类,Classification of drugs,Antipsychotic drugs,chlorpromazine,Antimanic drugs,lithium carbonate,Antidepressants,imipramine,Anxiolytics,diazepam,氯丙嗪,碳酸锂,米帕明,地西泮,抗精神失常药的概念和分类,1,Antipsychotic Drugs,吩噻嗪类,：,chlorpromazine,硫杂蒽类,：,chlorprothixene,丁酰苯类,：,haloperidol,其他类,：,sulpiride，clozapine,抗精神失常药的概念和分类,chlorpromazine,CPZ,氯丙嗪,（wintermin,冬眠灵,）,pharmacokinetics,1、po.slow and irregular,F,variable,im.absorb,quickly,；,2、pass BBB easily,distribution is wide(,in brain higher),;,3、metabolize mainly in liver;,4、elimination：kidney.,抗精神失常药的概念和分类,chlorpromazine,actions uses,I.,CNS,1、Antipsychotic effects,(抗,精神病作用),characteristics,1)long use,cant produce tolerance,;,2)symptomatic treatment,(对症治疗);,3)the onset of effect is,slow,(6W-6M),.,抗精神失常药的概念和分类,mechanism,four important dopaminergic pathways:,1)mesolimbic pathway,中脑边缘系统,2)mesocortical pathway,中脑皮质通路,3)nigrostriatal pathway,黑质纹状体通路,4)tubero-infundibular pathway,结节漏斗通路,CPZ,()D2-R,antipsychotic effects,抗精神失常药的概念和分类,Clinical uses,psychotic disorder：,1）schizophrenia-,first choice;,2）other psychotic states:,manic states;,delirium(,谵妄,)states.,no effect on depression.,(I type,II type ),抗精神失常药的概念和分类,2、Antiemetic effects,(镇吐作用),Antiemetic effect is strong;,But,no effect,on motion sickness.,(,晕动性呕吐,),CPZ,low dosage,CTZ,（催吐化学感受区）,(+),vomiting center,large dosage,vomit,c,hemoreceptor,t,rigger,z,one,抗精神失常药的概念和分类,nausea and vomit,induced by uremia,(尿毒症),cancer,pregnant toxemia,(,妊娠毒血症),radiation,(,辐射,),and some drugs.,stubborn hiccup,顽固性呃逆,Clinical uses,抗精神失常药的概念和分类,3、influence of temperature regulation,characteristics:,1),temperature,normal person and,patients with fever;,2)action correlative with,environmental temperature,(环境温度),;,3）,produce fever,dispel fever,(散热),.,抗精神失常药的概念和分类,Clinical uses,1）hypothermal anesthesia,低温麻醉,2）artificial hibernation,人工冬眠,CPZ,+pethidine,(,哌替啶),+promethazine(,异丙嗪),hibernation mixture,抗精神失常药的概念和分类,配合物理降温,使体温降至,34,以下 机体进入“冬眠”状态。,BMR,，对各种病理刺激的反应性，组织对缺氧的耐受力 。,mostly used for,严重感染、中毒性休克、高热惊厥、甲状腺危象等,辅助治疗,。,人工冬眠,抗精神失常药的概念和分类,4、,the effects of CNS depressants,e.g.,general anaesthetics,sedative-hypnotics,analgesics,(,镇痛药,),alcohol,抗精神失常药的概念和分类,II.,autonomic nerve system,1、cardiovascular,(-)-R,(-),血管运动中枢,dilate the blood vessel directly,BP,orthostatic hypotension,体位性低血压,adrenaline reversal,cannot use in the hypertension:,tolerance,2、,(-)M R dry mouth,constipation,(,便秘,),blurred vision,(,视力模糊,),抗精神失常药的概念和分类,III.endocrine system,CPZ,(-)D,2,-R,(tubero-infundibular pathway),prolactin inhibitory factor(,催乳素释放抑制因子,);,the secretion of growth hormone;,the secretion of GnRH(,促性腺激素);,the secretion of ACTH,;,（内分泌系统）,抗精神失常药的概念和分类,adverse reactions,1、,common adverse reaction,1)CNS,2)M-R,3),-R,:,BP,orthostatic hypotension,4)local irritative,(,刺激性,),.,抗精神失常药的概念和分类,2.extrapyramidal system reactions,锥体外系反应,1)parkinsonism,帕金森综合征,2)acute dystonia,急性肌张力障碍,3)akathisia,静坐不能,4)tardive dyskinesia,迟发性运动障碍,中枢抗胆碱药,CPZ,(,),nigrostriatal pathway D,2,-R,抗精神失常药的概念和分类,3.allergic reactions,4.acute toxication,po.large dose:12 g/time，,clinical symptoms：,narcoma，Bp,shock，,（麻醉性昏睡）,cardiac damage,arrhythmia,contraindications p.160,抗精神失常药的概念和分类,brief summary,CPZ,blocking,中脑-皮质通路,D,2,-R,中脑-边缘叶通路,D,2,-R,抗精神病作用,黑质-纹状体通路,DA-R,锥体外,系反应,结节-漏斗通路,DA-R,影响内分泌,抗精神失常药的概念和分类,other antipsychotic drugs,p.161-163,硫杂蒽类,tardan,泰尔登,丁酰苯类,haloperidol,氟哌啶醇,其他口服长效类,penfluridol,五氟利多,sulpiride,舒必利,clozapine,氯氮平,risperidone,利培酮,抗精神失常药的概念和分类,2,Antimanic drugs,lithium carbonate,碳酸锂,characteristics,1.,absorbed well；wide distribution；,2.Na,+,enhance the excretion of Li,+,;,incept Na,+,renal,discharge Li,+,3.,onset of effect is slow,individual variation,（个体差异）,;,抗精神失常药的概念和分类,4.mechanism is complex;,p.164,5.,mania and the manic state of schizophrenia,clinical first choice;,6.,adverse reaction,safe margin is narrow;,common adverse reaction,acute toxication:CNS(,)coma,death,.,withdrawal,treatment:,iv.0.9%NaCl,TDM,important!,抗精神失常药的概念和分类,3,Anti,depressant,drugs,Imipramine,米帕明,（丙咪嗪）,characteristics,1.po.,absorbed well；wide distribution；,2.,Antidepressant,selectivity high;,action slow;,normal-CNS(,),depressed,-,uplift,(,情绪高涨,),抗精神失常药的概念和分类,.,mechanism：,inhibit the reuptake of NA、5-HT in the brain.,4,.Clinical uses:,different types of depression,enuresis,(,遗尿症),anxiety and phobia,(,恐怖症