2018年9第九章肾上腺素受体激动药-文档资料.ppt
《2018年9第九章肾上腺素受体激动药-文档资料.ppt》由会员分享,可在线阅读,更多相关《2018年9第九章肾上腺素受体激动药-文档资料.ppt(30页珍藏版)》请在三一文库上搜索。
1、 1 Introduction,basic chemical structure: -苯乙胺,catecholamines(CA类、儿茶酚胺类 ) : adrenaline 肾上腺素 noradrenaline 去甲肾上腺素 isoprenaline 异丙肾上腺素 dopamine 多巴胺 非CA类: ephedrine 麻黄碱 metaraminol 间羟胺,Classification (一)according to the structure,mainly (+) -R noradrenaline 去甲肾上腺素 mainly(+) -R isoprenaline 异丙肾上腺素 (+)、-
2、R adrenaline 肾上腺素,(二)according to the receptor, 2 -R agonists noradrenaline NA norepinephrine NE 去甲肾上腺素,1、 chemical characteristic is unstable: ineffective when given orally , should be given intravenous infusion 2、the effect is quick , strong and short: metabolism mainly in the liver(COMT、MAO ),cha
3、racteristics,()-R (+) 1-R cannot stimulate 2-R,mechanism,Pharmacological effect,1、Blood vessel: () 1-R constrict the vessel of the skin, mucous membrane, viscusincrease the peripheral resistance(外阻),()1-R ()heart dilation(扩张) of coronary blood vessels,2、Heart: ()1-R Force、 HR、conduction cardiac outp
4、ut(CO),In intact(整体) animal or human being : NA 1-R peripheral resistance HR NA 1-R peripheral resistance CO is unchangeable or degressive(下降),窦弓反射,3、blood pressure :BP heart(+) CO systolic blood pressure (SBP收缩压) constriction of blood vessel peripheral resistance diastolic blood pressure(DBP舒张压),lo
5、w dosage: 血管收缩不剧烈 外阻略 DBP略 increase the pulse pressure(脉压) larger dosage: 血管剧烈收缩 外阻 DBP decrease the pulse pressure(脉压),1、Early phase of shock (休克早期) 2、Hypotension(低血压) induced by drug toxication 3、Upper gastrointestinal tract bleeding : PO 粘膜血管收缩止血,clinical use,2、acute renal failure(too long and to
6、o large dose) 用药间尿量应 25ml / h,1、 local necrosis(坏死) :静滴过久、药浓过高、外漏,Side effects,Contraindications 高血压、动脉硬化症、器质性心脏病、 少尿、无尿、严重微循环障碍病人,防治: 1)局部热敷 2)普鲁卡因局部浸润注射 3) R阻断剂:酚妥拉明,1、(+)-R ,effect is similar to NA, but weak and long 2、stimulates the release of NA : can cause tachyphylaxis(快速耐受性) 3、升压作用久、可靠,不易引起肾
7、衰,Metaraminol 间羟胺(Aramine阿拉明),Clinical Use 各种休克早期、术后或脊椎麻醉后休克 NA代用品,缩血管药中首选,characteristics,Phenylephrine 去氧肾上腺素又名 新福林、苯肾上腺素,1. (+) 1-R 反射性HR下降 paroxysmal supraventricular tachycardia(阵发性室 上性心动过速) constrict smooth muscle of vessel antishock 2. (+) 1-R (+)瞳孔开大肌扩瞳(无调节麻痹) 作用快、短-检查眼底, 3 、R agonists,1、hea
8、rt:() 1Rforce、HR、conduction overdose: 心肌兴奋性提高、心肌耗氧 arrhythmia(可致室颤),adrenaline (Adr ) epinephrine 肾上腺素,mechanism,() 、1、 2 R,Pharmachological action,blood vessel (+)2R dilate the blood vessel of skeletal muscle and coronary artery (+) R constrict the blood vessel of skin, mucous membrane and viscus,2
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 2018 第九 肾上腺素 受体 激动 文档 资料
链接地址:https://www.31doc.com/p-1915346.html