神经系统药理3肾上腺素能神经系统宣讲培训.ppt

Classification of CNS drugs Antipsychotic drugs depression－mania Dementia Sedative-hypnotics Epilepsy and convulsion Parkinson disease Analgesics Central stimulants Neurological（general and special） Psychological Sedative-Hypnotic Drugs Sedatives （镇静药）： 能缓和激动，消除躁动，恢复安静情绪的药物 Hypnotics （催眠药）： 能促进和维持近似生理睡眠的药物 中枢抑制药多数随剂量增加而出现镇静、催眠等中枢抑制作用，故合称为镇静催眠药（sedative-hypnotics） -----prescribed to cause sedation (for patients with anxiety) -----prescribed to encourage sleep (for patients with insomnia) Molecular Neuropharmacology Stage 3 4, 统称为慢波睡眠 Sleep histogram shows a normal pattern of sleep in a young adult. A schematic drawing showing key components of the ascending reticular activating system (ARAS) 网状结构上行激活系统 Circadian rhythm Circadian control SCN: suprachiasmatic nucleus 视交叉上核 Benzodiazepines (BZ / BDZ, 苯二氮卓类) Barbiturates (巴比妥类) Others Sedative-Hypnotic Drugs A. Benzodiazepines Diazepam 地西泮（安定） R1 R2 R3 R4 R7 1. Pharmacological effects and clinical uses (1) Antianxiety at small doses acting on limbic system（边缘系统，杏仁核、海马） (2) Sedative-hypnotic effects（作用于脑干） at relatively larger doses, no anesthetic effect; not remarkably affect on REM used for insomnia（失眠） and preanesthetic medication A. Benzodiazepines (3) Antiepileptic and anticonvulsant effects Convulsion due various causes; status epilepticus (i.v.) (4) Centrally acting muscle relaxant effect Relaxing the spasticity of skeletal muscle, probably by increasing presynaptic inhibition in the spinal cord. Used for the treatment of skeletal muscle spasms caused by central or peripheral diseases. (5) Others Amnesia (短暂性记忆缺失, i.v.） Respiratory and CVS effects A. Benzodiazepines 2. Mechanisms of actions (1) Sites of action: mainly acts on limbic system and midbrain reticular formation. (2) Interaction with GABAA receptor Benzodiazepines bind to specific, high affinity sites on the cell membrane, which are separate from but adjacent to the receptor for ?-am