第17章-治疗中枢神经系统退行性疾病.pptVIP

PD大鼠旋转跟踪记录系统示意图 * * 第17章 治疗中枢神经系统 退行性疾病药 Chapter 17 Drugs for the treatment of degenerative disease in central nervous system degenerative disease in central nervous system 帕金森病（Parkinson’s disease，PD） . 阿尔茨海默病（Alzheimer’s disease，AD） There is no cure for PD and AD. Deng Xiao Ping Former president of USA 基础部药理学教研室 Pathogenesy exitotoxicity: glutamic intracellular calcium overload apoptosis: deficiency of growth factor oxidative stress: lipid peroxidation of cellular membrane nerve cell death 基础部药理学教研室 第一节 抗帕金森病药 Part Ⅰ Anti-Parkinson’s disease Agents Parkinson‘s disease (PD) is a chronic, progressive function disorder of extracorticospinal tract of the nervous system. Parkinson’s disease affects a person‘s muscular coordination. Symptoms of PD include resting tremor, rigidity in some muscles, bradykinesia, and defective coordination. The disease is caused by the death of cells in one of the movement control centers of the brain. 纹状体（壳核、尾核） DA(-) 脊髓前角运动N 基础部药理学教研室 putamen caudate nucleus striatumn 基础部药理学教研室 Substantia nigra (SN)——striatum pathway regulate extracorticospinal tract function 基础部药理学教研室 Synthesis of norepinephrin (NA/NE) DA is precursor of NA TH: tyrosine hydroxylase AAD: amino acid decarboxylase DBH dopa-βhydroxylase MAO mono-amine oxidase COMT: catechol-o-methyltransferase Classification 1. precursor of dopamine (L-dopa，左旋多巴) 2. enzyme inhibitors amino acid decarboxylase inhibitors(carbidopa，卡比多巴) MAO inhibitors （ selegiline，司来吉兰） COMT inhibitors （ tocapone，托卡朋） 3. DA receptor agonists selective D2 receptor（ bromocriptine，溴隐停） nonselective（pergolide，培高利特） 4. drug that release dopamine （amantadine，金刚烷胺） 5. anticholinergic drugs（ benzhexol，苯海索，安坦） 基础部药理学教研室 一、拟 多 巴 胺 药 （一）多巴胺前体药 左旋多巴（levodopa or L-dopa ） 基础部药理学教研室 Pharmacological Action and Clinical Uses supply DA in SN-stritum pathway 治疗各型PD 用药早期：80%病人明显改善，其中20%恢复近正常； 用药后期；疗