[医学]抗PD和治疗AD药.pptVIP

抗帕金森病 The best results are obtained in the first few years of treatment. The benefits of levodopa treatment often begin to diminish after 3 or 4 years of therapy. given in combination with carbidopa. 非自主扭体运动: 使用左旋多巴两年后逐渐出现 出现在脸和四肢，治疗效果达高峰时出现。 “开－关现象” VB6 increases peripheral breakdown of levodopa MAO inhibitors decrease dopamine inactivation and produce a hypertensive crisis Antipsychotic drugs block dopamine receptors and produce a parkinsonian syndrome by themselves Not cross the blood-brain barrier inhibits decarboxylases in periphery decreases dose of Levodopa by 75%; reduces or prevents the side effects of levodopa increases the availability of levodopa to the CNS selegiline 司来吉兰 MAOI 单胺氧化酶抑制剂 , selective inhibitor of monoamine oxidase B (MAO-B) retards the breakdown of dopamine, increases therapeutic effects of levodopa decreases the dose of levodopa , reduces the adverse effects. nitecapone 硝替卡朋 COMT儿茶酚氧位甲基转移酶 inhibitor Bromocriptine 溴隐亭 D2-R agonist, across the blood-brain barrier easily Combination with levodopa Have an important role as first-line therapy Lower incidence of the adverse effects with long-term levodopa therapy Amantadine 金刚烷胺 enhance the release of dopamine from the surviving neurons side effects are few 中枢神经系统退行性疾病 cognitive disorder in progress 进行性认知障碍 memory impairment 记忆力损害 Main course: cholinergic insufficiency （胆碱能神经丢失） Logo * Logo Add Your Company Slogan 第 十九 章抗PD和治疗AD药 2010-11-15 Department of Pharmacology, Medical School of Nankai University 掌握左旋多巴的药理作用，机制，用途及不良反应等。了解抗胆碱药与拟胆碱药在治疗神经退行性疾病中的应用。 目 的 简介帕金森氏病和阿尔茨海默氏病。 左旋多巴：在中枢经多巴脱羧酶催化，转变为多巴胺而发挥补充递质的作用，从而缓解症状，也用于治疗肝昏迷；与甲基多巴肼合用的效果及原理。不良反应（包括胃肠，心血管及神经精神反应，禁忌症。 内 容 抗胆碱药治疗巴金森氏病的作用及原理与不良反应。 其它：金刚烷胺（金刚胺）和司来吉林（次甲优降宁）的作用特点。 抗老年痴呆症药物的种类及作用。 内 容 帕金森病的临床表现 1. 运动症状 静止时震颤 肌强直 运动迟缓（自主活动抑制） 姿势步态异常 2. 精神症状 反应迟缓 执行能力差 痴呆 短期记忆能力丧失 抑郁、焦虑 3. 睡眠紊乱 帕金森病的临床表现 帕金森病的病理变化 HT 多巴胺的合成 (DOPAC) (HVA) (二羟苯乙酸)