肾上腺素受体激动剂解决方案.ppt

?-adrenoceptor agonists 去甲肾上腺素 noradrenaline ? 、?-adrenoceptor agonists 肾上腺素 adrenaline ?-adrenoceptor agonists 异丙肾上腺素 isoprenaline §2 ?-adrenoceptor agonists 【 Source and chemistry 】 1) unstable（不稳定） in solution, 2) inactivate（灭活）by light and alkali （碱性） solution , 2、Distribution: iv, distribute to the adrenergic nerve innerved organs ( heart and adrenal medulla) 3、 inactivation (失活 ) : 1）Uptake 1(main): endogenous and exogenous Metabolism: MAO and COMT 2）Excretion: vanilly mandelic acid(VMA)90%, ?-R (++) stimulation stronger ?1-R （+） weaker ?2-R （-） nearly not at all 1）Arteriole and venule constriction 2）Skin mucosa stronger Renal Brain,hepatic,mesentery weaker 3）Augment coronary flow， coronary vessel dilation, small dose larger dose heart excitation vessel constriction SBP increase increase DBP invariable increase Pulse pressure enlarge decrease 1、 antishock 抗休克 （shock early period） 2、 hypotension induced by drug intoxication 药物中毒性低血压 3、esophageal or stomach hemorrhage 1、 extravasation（外漏） 1) local necrosis 局部组织坏死 2) warm pack, infiltration phentolamine or procaine 2、renal failure (too long and too large dose) 用药期间尿量应 ＞ 25ml / h 1）Directly stimulate ??-R 2）Replace NA out of the vesicle（囊泡） 3）MAO destroyed little 4）Tachyphylaxis（快速耐受性） 5）Use as the substitute of NA 1、（+） ?1-R, 2、decrease the renal flow marker than NA 3、 Phenylnephrine --- Mydriasis（扩瞳） 【 procedure in the body 】 Po, destroyed by alkali intestinal solution,intestinal mucus and liver. Dilate the coronary vessel,increase blood supply 1、（+）arteriole and precapillary sphincter