九肾上腺素受体激动药.pptVIP

* Guangdong University of Technology 轻工化工学院 Chapter 9 Adrenoceptor agonists 肾上腺素受体激动药 § 1 Introduction basic chemical structure: β-苯乙胺 catecholamines（CA类、儿茶酚胺类 ） : adrenaline 肾上腺素 noradrenaline 去甲肾上腺素 isoprenaline 异丙肾上腺素 dopamine 多巴胺 非CA类： ephedrine 麻黄碱 metaraminol 间羟胺 Classification （一）according to the structure mainly (+) ?-R noradrenaline 去甲肾上腺素 mainly(+) ?-R isoprenaline 异丙肾上腺素 (+)?、?-R adrenaline 肾上腺素 （二）according to the receptor § 2 ?-R agonists noradrenaline NA norepinephrine NE 去甲肾上腺素 1、 chemical characteristic is unstable： ineffective when given orally , should be given intravenous infusion 2、the effect is quick , strong and short： metabolism mainly in the liver（COMT、MAO ） characteristics （＋）?-R ＞＞ (+) ?1-R cannot stimulate ? 2-R mechanism Pharmacological effect 1、Blood vessel： （＋） ?1-R →constrict the vessel of the skin, mucous membrane, viscus→increase the peripheral resistance(外阻) （＋）?1-R → （＋）heart→ dilation(扩张) of coronary blood vessels 2、Heart： （＋）?1-R → Force↑、 HR↑、conduction ↑ → cardiac output(CO)↑ In intact(整体) animal or human being ： NA → ?1-R → peripheral resistance ↑↑ → HR↓ NA → ?1-R → peripheral resistance ↑↑ → CO is unchangeable or degressive(下降) 窦弓反射 3、blood pressure ：BP ↑ heart(+)→ CO↑ → systolic blood pressure (SBP收缩压)↑ constriction of blood vessel → peripheral resistance↑ → diastolic blood pressure(DBP舒张压)↑ low dosage： 血管收缩不剧烈 → 外阻略↑ → DBP略↑ －increase the pulse pressure(脉压) larger dosage： 血管剧烈收缩 → 外阻↑ → DBP↑ ↑ －decrease the pulse pressure(脉压) 1、Early phase of shock （休克早期） 2、Hypotension(低血压