掌握平喘药的分类优秀培训书.pptVIP

平喘药 ANTIASTHMATIC DRUGS 张京玲 司武霞 邵宜 王威 Antiasthmatic drugs 目的 掌握平喘药的分类，作用和应用。 Antiasthmatic drugs 内容 平喘药：拟肾上腺素药（异丙肾上腺素、叔丁胺醇）、M胆碱受体阻断药（异丙托溴胺）、茶碱类（氨茶碱）、色甘酸钠、肾上腺皮质激素类的平喘作用原理、临床应用及用药注意。 INTRODUCTION Asthma is a kind of disease characterized as nonspecific bronchial inflammation and hyperactivity, contraction of airway smooth muscle, mucosal thickening, viscid plugs of mucus. ANTIASTHMATIC DRUGS classification β-adrenoceptor stimulants theophylline antimuscarinic agents Corticosteroid inhibitors of mediator release ?-R AGONISTPharmacological effects ?2-R agonist Relaxation of smooth muscle of airway Inhibition release of inflammatory mediators ?-ADRENOCEPTOR AGONIST Mechanism of action ?-adrenoceptor agonist ?2-R Gs cAMP PKC activated Intracellular Ca Opening of potassium channel MLCK activated ?-ADRENOCEPTOR AGONIST Clinical use Adrenaline-not commonly used Ephedrine-used for mild asthma and taken prophylactically Isoprenaline-powerful effect , but sometimes severe adverse effects. Selective β2-R agonist Moderate duration: salbutamol, terbutaline, clenbuterol Used to treat acute bronchial spasm and prevent exercise asthma Long duration: Formoterol, Salmeterol controllers, esp for asthma occurs at night, interact with inhaled corticosteroid to improve asthma control. Used for mild, occasional asthma on an ‘as-needed’ basis. Adverse effects Cardiac effects: large dose, tachycardia Muscular tremor Disturbance of metabolism Theophylline Pharmacological effects Relaxation of smooth muscle of airway Improvement of diaphragm activity Theophylline Mechanism of action Inhibition of enzyme phosphodiesterase Inhibition of cell surface receptors for adenosine Mechanism of action Increase release of intrinsic catecholamine Inhibition of transport of Ca Anti-inflammatory action and regulation immunological function Clinical use Stopping onset of acute asthma, if not effective , add inhaled corticosteroids Treatment of chronic asthma maintenance treatment