(精选)【医学课件】 帕金森及其药物治疗教学课件.ppt

Drugs enhancing DA release Amantadine(金刚烷胺) 1.↑release DA from dopaminergic terminals. 2.↓reuptake of DA. 3. dopamine receptor agonism Clinical Uses Parkinson’s disease, less effective than levodopa, and more effective than anticholinergic agents. Onset rapidly; synergised by L-dopa. II.Central Anticholinergic Drugs Actions Blocking the M-R ,↓cholinergic neurons in the nigrostriatal. Trihexyphenidyl(苯海索) Benzatropine(苯扎托品) Improve the tremor and rigidity of PD, little effect on bradykinesia. Drug Therapy in  Alzheimer’s Disease Alzheimer’s disease（AD） 3/4 Vascular dementia（VD） 1/4 Dr.Alois Alzheimer, a German doctor, diagnosed Alzheimer’s disease in 1906 Incidence 65y 5.0% 75y 19% 85y 47% 95y 90% Course of disease: 3~20y International Symposium for Alzheimer’s Disease 2000 “If the effective methods for AD treatment is not found, the AD patients will be 22 000 000 in 2025; 45 000 000 in 2050 in whole world.” Clinical Features Dementia, cognition dysufficiency, memory damage Pathological Features Brain atrophy (脑萎缩) Senile plaque (SP, 老年斑) Neurofibrillary tangles (NFT, 神经元纤维缠结) Selective death of neuron. Pathological Features 1.Neuron toxication of amyloidβ-protein(Aβ) 。 Aβ cholinergic function AchE Aβ CHAPTER 19 ANTIPARKINSONISM DRUGS AND DRUG THERAPY IN ALZHEIMER’S DISEASE CNS degenerative disease Parkinson’s disease (PD)帕金森病 Alzheimer’s disease (AD)阿尔茨海默病 Huntington disease (HD)亨廷顿病 Amyotrophic lateral sclerosis(ALS) 肌萎缩侧索硬化症 Mechanisms Excitotoxicity Apoptosis Oxidative stress Parkinson’s disease Parkinson’s disease (PD) Paralysis agitans(震颤麻痹） Classification Primary PD Parkinsonism cerebral arteriosclerosis