药理重点总结课件.ppt

表. 常见的肝药酶诱导剂和抑制剂及相互作用 P-450 底物 诱导药 抑制药 CYP1A2 咖啡因 奥美拉唑 非那西丁 CYP2A6 香豆素 地塞米松 香豆素 CYP2C9 S-华法令 巴比妥类 异烟肼 CYP2C19 地西泮 苯妥英钠 S-美芬妥英 CYP2D6 异喹胍 奎尼丁 CYP2E1 PAS 异烟肼 西咪替丁 CYP3A 红霉素 利福平 酮康唑 Parasympathomimetics拟副交感神经药 chapter 8 Cholinoceptor-Blocking Drugs Ⅱ ?-Receptor Blocking Drugs nonselective βblockers: Antagonist without ISA: propranolol(普萘洛尔), timolol(噻吗洛尔) Antagonist with ISA: pindolol(吲哚洛尔) selective b1 blockers: Antagonist without ISA: atenolol(阿替洛尔), metoprolol(美托洛尔) Antagonist with ISA: acebutolol(醋丁洛尔) a, b blocker: labetalol(拉贝洛尔), carvedilol(卡维地洛) 一、Pharmacological Effects 1.β-blocking effects A. Heart: negative chronotropic: decrease heart rate, negative inotropic: decrease cardiac contractility, cardiac output, myocardial oxygen consumption. negative dromotropic: Slow atrioventricular conduction; increase PR interval. B. Blood vessel and BP: decrease blood pressure in patients with hypertension, no effects on normal men. without prominent postural体位性 hypotension Chapter 12 Sedative-Hypnotics镇静催眠药 Ⅰ. Benzodiazepines （BDZ） 1.BDZs act by binding to a specific regulatory site on the GABAA-receptor in neuronal membranes in the central nervous system, thus enhancing the inhibitory effect of Gamma-aminobutyric acid (GABA, γ-氨基丁酸 ) 2.BDZs do not activate GABAA receptors directly; rather, act allosterically别构调节by modulating调节the effects of GABA. Diazepam Ⅲ. Phenobarbital (苯巴比妥，鲁米那) Clinical uses: 1.Used to prevent and treat grand mal, psychomotor epilepsy, simple partial seizure and status epilepticus 2.not effective for absence seizures. 3.First choice of drug to treat grand mal in children under five: little effect on cerebellum小脑 and vestibule前庭 Ⅵ. Benzodiazepines 1.Diazepam and Lorazepam (劳拉西泮) Used IV for status epilepticus, not used chronically长期, rapid development of tolerance. 2.Clonazepam(氯硝西泮) and Clorazepate(氯氮卓) Broad