《神经系统药理—魏尔清(镇痛药》.ppt

神经系统药理—魏尔清(镇痛药;General Considerations;Pain Classification;;;Pain generation and reactions;Stimulation and depolarization of sensory nerve endings;Pain: peripheral sensory reflex ;Peripheral mechanisms of pain;Peripheral mechanisms of pain;Primary & secondary hyperalgesia;The perception of somatic pain;The perception and conduction of somatic pain;Conduction pathways of pain;Cortical locations of pain ;The fMRI imaging of pain;Classification of analgesics： Opioid analgesics (centrally acting) opiates synthetic agents Antipyretic, analgesic, and anti-inflammatory drugs (peripherally acting) aspirin, indomethacin Other drugs (for special types of pain) carbamazepine, atropine, nitroglycerin, etc.;;Opium;Morphine: Morphus, the Greek god of dreams;1. Pharmacological effects (1) Mechanisms of actions Acting on central opioid receptors ? receptors ? receptors δ receptors;ATP;;Mechanisms of morphine actions;Peripheral mechanisms of morphine actions;Central mechanisms of morphine actions: Pain inhibitory system;(2) Central nervous system effects A. Analgesia：maximal analgesic efficacy； relieving unpleasant sensation; euphonia and potential of dependence B. Depression of respiration: reducing the sensitivity of respiratory center to CO2 C. Depression of cough reflex D. Other central effects: miosis, emesis;(3) Cardiovascular effects A. Postural hypotension： Releasing histamine; depressing CVS centers B. Increase of intracranial pressures： Respiratory depression ? brain CO2 increase ? vasodilatation in the brain;(4) Effects on smooth muscles A. GI tract： Contispation: increasing resting tone of smooth muscles and sphincters, decreasing propulsive peristalsis and secretions; Biliary tract：Oddi’s sphincter contraction, increasing the pressure in the biliary tract B. Respiratory tract：bronchoconstriction C. Urinary tract：increasing