双精神失常药.pptVIP

Chapter 18Drugs for Psychiatric Disorders ; Contents; Classification of Psychosis;Symptoms of Schizophrenia;Properties of Affective disorders;基底神经节;DA-R及其亚型：; DA Pathway;①黑质—纹状体通路（D1、D2样受体）：是锥体外系运动功能的高级中枢。 DA↓——帕金森病（帕金森综合症） DA↑——不自主运动（手足徐动症、舞蹈病） ②中脑边缘系统通路 ③中脑皮质通路 ④结节—漏斗通路（ D2样受体）; Classification of Psychotropic agents;§1 Antischizophrenia drugs;药理作用;PHARMACOKINETICS ; Chlorpromazine（Wintermine);氯丙嗪; Central nervous system Antipsychotic Effect MECHANISM: blockade of the postsynaptic D2–like receptors in the mesolimbic and mesocortical pathways. Antiemetic（止吐） Effect Low doses: blocking D2-like receptors in the Chemoreceptor Trigger Zone (CTZ) of medulla（催吐化学感受区） High doses: directly inhibition of the vomiting centre （呕吐中枢） No effect on vomiting caused by vestibular（前庭） stimulation. Inhibit the Hiccough Centre near the CTZ.（呃逆）;;Effect on Body-Temperature Regulation Inhibit the regulation center of body temperature in hypothalamia （下丘脑）and make the body-temperature regulation malfunction. Characteristics: Cause body temperature shift towards the ambient周围环境temperature. Lower the body temperature both in febrile 发热and normal states. Induce hypothermia by lowering the ambient temperature. Effects on Autonomic Nervous System blockade of a-adrenergic, histamine (H1-) and M-cholinergic receptors;autonomic nerve system ; Effects on endocrine system ;endocrine system;THERAPEUTIC USES; Hibernation therapy;Clinical uses; 配合物理降温?使体温降至34℃以下? 机体进入“冬眠”状态。BMR?，对各种病理刺激的反应性?，组织对缺氧的耐受力 ? 。;氯丙嗪阻断的受体种类;ADVERSE REACTIONS ;ADVERSE EFFECTS;ADVERSE EFFECTS;ADVERSE EFFECTS; Extrapyramidal reactions ① Parkinsons syndrome ② Akathisia (静坐不能) ③ Acute dystonia (急性肌张力障碍) ④ Tardive dyskinesia Allergic response skin rash, photosensitive dermatitis（光敏性皮炎）, hepatic injury, agranulocytosis (粒细胞缺乏) Emotional disturbance induced by drugs Convulsion and epilepsy induced by drugs Acute toxic reaction