第二十章 解热镇痛抗炎药（Chapter 20 antipyretic antiphlogistic drugs）.docVIP

第二十章 解热镇痛抗炎药（Chapter 20 antipyretic antiphlogistic drugs） 4.1 pharmacological action, action mechanism and common adverse reactions of antipyretic analgesics 4.1.1 pharmacological action (1) the antipyretic effect 1. Only hypothermia can be reduced to normal and no effect on normal body temperature. 2. It only affects the heat dissipation process and does not affect the heat production process. 3. The mechanism of heat release is to inhibit the activity of hypothalamic body temperature regulating central cyclooxygenase (prostaglandin synthase), thereby inhibiting the synthesis of prostaglandins (PG). (2) analgesia 1. For non-narcotic (non-addictive) analgesics, no euphoria, tolerance, and respiratory depression. 2. The analgesic strength is weaker than that of pethidine, which is effective for chronic blunt pain, which is not effective for traumatic severe pain and internal cramping. The pain area is mainly in the outer week. 4. The analgesic mechanism is to inhibit local PG synthesis, reduce PGs pain effect, and reduce the sensitivity of pain receptors to the pain of bradykinin. (3) anti-inflammation and anti-rheumatism In addition to aniline, other drugs have this effect, which can inhibit local PG synthesis and reduce or eliminate inflammation. (4) others NSAIDs can inhibit PG synthase and reduce thrombane A2 (TXA2) formation, thereby inhibiting platelet aggregation and thrombosis. The occurrence, development and metastasis of tumor may have inhibitory effect. In addition to inhibiting the production of PGs, the antitumor effect is associated with the activation of casp-3 and casp-9, inducing apoptosis of tumor cells, inhibiting tumor cell proliferation, and the formation of resistant angiogenesis. In addition, it has the effect of preventing and delaying alzheimers disease and delaying corneal aging. 4.1.2 mechanism of action The anti-inflammatory effect of NSAIDS is mainly related to inhibiting the activity of COX and inhibiting the generation of PGs. In addit