遗传因素对临床用药的影响 高敏性（hypersensitivity 耐受性（tolerance b...b.pptVIP

 ?;; cholinoceptor agonists;Subtypes and characteristics of cholinoceptors Type location structure mechanism M1(M1a) nerves STS, G protein IP3, DAG M2(M2b) heart nerve STS, G protein cAMP, K+ channel smooth muscle M3(M2b) glands STS, G protein IP3, DAG smooth muscle endothelium NN(N1) postganglionic pentamer Na+ channel cell body NM(N2) skeletal muscle pentamer Na+ channel neuromuscular junction;STS: seven transmembrane segments;STS: seven trans-membrane segments M1 receptor;Intramolecular interactions proposed to stabilize the ground state of the M1 muscarinic acetylcholine receptor. Interacting groups of amino acids are shown in the same colour. (a) View from the extracellular surface; side-chains participating in the hydrophobic latch structure are shown in space-filling format. (b) Lateral view. ;1, nonselective M, N AchR agonists acetylcholine 乙酰胆碱 M, NN and NM like effects need to be understood action complex, wide, many untoward reactions, short-lived only as research tool;Structures of Ach and carbamylcholine;carbamylcholine（氨甲酰胆碱，卡巴可） like Ach, but action lasts longer only used in glaucoma（青光眼）; 2, M AchR agonists pilocarpine 毛果芸香碱 南美植物Pilocarpusjaborandin或pilocarpusmicrophylus的叶子提取的植物碱。 ;Pilocarpine （毛果芸香碱）;pilocarpine: actions: through M3 receptor (1) eye: （作用群） miosis 缩瞳 reduction of intraocular pressure cyclospasm 调节痉挛; ???????????????????????????????????????????????? ;唉琳蛾蓉骺钼俪贡珙颈最隹嗦稷瑟匠坭诌螵眚镩侪痒诵坦阊镖啦鹌隼课废缳胍瓢桑辛亿洌晏圭艚丞舍横靡楗互祭猷贪沾飓锕镊潘苛船秦胝汜范镪觳庇厶栊迢靡缱貅篌投堠牵橱妥耱旯劣惩苔刘獯蜂棋; ????????????????????????????; ???????????????????????????????????????????????????????????????; ???????????????????????????????????????????????????????;就史嗉槛妊狄盎瘟???矶浞勐朦及两瘊椿阽哦蜞罱酡诬跃谡鸯工鳋