药物的肝脏毒性，消化系统用药（高分飞）教学材料.pptVIP

延髓呕吐中枢 高级中枢 催吐化学感受区 (5-HT3, D2, M1) 孤束核 (5-HT3, D2, M, H1) 咽喉 胃肠道 （5-HT3） 迷走神经 H1, M 小脑 内耳前庭 前庭神经 刺激 刺激 化学刺激物 晃动 Antagonists of Receptors of H1: Nucleus of tractus solitarius, vestibulocerebellar pathway—— Diphenhydramine, Dimenhydrinate M : Nucleus of tractus solitarius, CTZ——Scopolamine D2 : CTZ, Nucleus of tractus solitarius, Stomach, Small intestine——Thiethylperazine，Metoclopramide 5-HT3 : Stomach, Small intestine, CTZ, Nucleus of tractus solitarius——Ondansetron，Granisetron Prokinetics： Metoclopramide Blocking Gastrointestinal Domperidone D2-R Cisapride：Ach release↑ Antidiarrheal Drugs and Adsorbents Opium preparation and Derivatives Opiate receptors in Gastrointestinal tract → tone↑motility↓（μ），secretion↓（δ），Ach release ↓ Loperamide： Derivatives of Haloperidol Astringents Tannalbin Bismuth subsalicylate, Bismuth subcarbonate Adsorbants Medicinal Charcoal Kaolin Laxatives Contact cathartics Irritant or stimulant → intestinal motility↑ Phenolphthalein, Rhubarb, Senna, Castor oil Osmotic laxatives nonabsorbable → distending → peristalsis MgSO4, Na2SO4, Lactulose, Celluloses Surface-active agents Lubricating, Stool soften Liquid paraffin Choleretic drug Cholic Acid HMG-CoA reductase (rate limiting enzyme)↓ → bile salt↑，cholesterol ↑ Chenodiol (Chenodeoxycholic acid) MgSO4 cholecystokinin ↑ Cinametic acid Anethol trithione Review-Questions The classification of drugs used in the treatment of peptic ulceration. the mechanisms and the agents of each. Drugs Affecting Gastrointestinal Function Introduction of Ulcer Epidemiology incidence of a disease: 10%-12% Europe and America: DU GU; Japan: GU DU Etiology General consideration: No Acid No Ulcer Main Destroy Factors: ①HCl, ②Pepsin, ③Hp Protective Barrier: Mucus-HCO3- Pathogenesis of Peptic Ulcer Review How is the secretion of gastric acid adjusted ? What is the mechanism of secretion of gastric acid ? How to treat peptic ulcer ? Anti-ulcer Targets HCl Mucus Hp Anti-ulcer Classifica