章解热抗炎药.pptxVIP

会计学第1页/共45页§1Introduction【Definition】 1. -have strong antipyretic effects 2. -have analgesic effects 3. -some have anti-inflammatory and anti-rheumatic effects. (一类具有解热、镇痛，且大多数 还有抗炎、抗风湿作用的药物)第2页/共45页【mechanism】白三烯等花生四烯酸膜磷脂PGF, PGE等PLA2环内过氧化物环氧化酶vessalPGI2(-)platelet(-)TXA2解热镇痛抗炎药糖皮质激素non-steroidal anti-inflammatory drugs甾体抗炎药 SAIDs非甾体抗炎药NSAIDs第3页/共45页PG:a group of autacoids- lead to inflammation, pain and fever.(是自体活性物质，可致炎、致痛、致热)NSAIDs → ㈠环氧化酶（COX） → 前列腺素（PG）合成? → 解热、镇痛、抗炎第4页/共45页【common pharmacological actions】一. Antipyretic action (解热作用)细菌毒素病毒等粒细胞吞噬、处理产生释放内热原CNSPG合成与释放?NSAIDs ㈠COX→ (-)PG合成体温调定点?370C发热第5页/共45页Properties : 1. temperature of patients with fever ? (只降发热者体温)2. independent of environment temperature (降温作用与环境温度无关) 3. increase heat dissipation mainly. (主要增加散热)第6页/共45页Meaning of pyretic (发热利弊) :Advantages : 1. -enhance the defense function. (提高机体防御功能) 2. diagnosis of diseases (热型是诊断的依据).第7页/共45页T稽留热40 0c弛张热低热37 0cday01 2 3 4 5第8页/共45页disadvantages ：　high fever? CNS function disorders e.g. convulsion(惊厥) durative fever ? consume physical energy 　(持续发热，消耗体能)第9页/共45页Uses ＆ notes1. T 39oc (especially for children)2. durative fever that has been diagnosed clearly.(诊断明确的持久发热)3. fever with obvious pain. (发热伴明显疼痛者)4. symptomatic treatment only (仅为对症治疗) 第10页/共45页二. Analgesic action (镇痛作用)（+）痛觉感受器局部释放组织损伤局部炎症致痛物质BK、PG等痛觉增敏NSAIDs㈠疼痛NSAIDs → ㈠ COX→ PG synthesis ↓ → PG致痛及痛觉增敏↓→analgesia (镇痛)第11页/共45页Properties :1）moderate analgesics (镇痛作用中等 )2）-be well for chronic pain and inflammatory pain （炎性疼痛及慢性钝痛效佳）3）no addiction and no respiratory depression (不成瘾，不抑制呼吸)第12页/共45页三. Anti-inflammatory action (抗炎作用)Prostaglandins (PG) ： 1. - dilate blood vessels. (扩血管) 2. ↑vascular permeability (血管的通透性↑) e.g. tissue edema 3. synergy with other inflammatory mediators. (协同其它炎症介质的作用 ) NSAIDs → ㈠ COX→ PG↓ → antiinflammation第13页/共45页Properties :1. symptomatic treatment only e.g. relieve r