文档介绍：Chater 17
Treatment S
degenerative diseases
治疗中枢神经系统退行性疾病药
objective
掌握左旋多巴药动学特点、临床应用与不良反应;苯海索的作用特点等。
熟悉抗帕金森病药的分类,卡比多巴的作用特点和应用。
了解其他抗帕金森病药及治疗阿尔茨海默病的药物作用与应用。
classification
1、Parkinson’s disease, PD
帕金森病
2、Alzheimer ’ s disease, AD
阿尔茨海默病
3、Huntington disease, HD 亨廷顿病
4、Amyotrophic lateral sclerosis, ALS
肌萎缩侧索硬化症
Introduction ----§1 anti PD agents
Parkinson disease 帕金森病
(paralysis agitans 震颤麻痹)
1817 British doctor James Parkinson
described and reported;
It’s a kind of degenerative disease S, causing tremor(震颤) at rest, muscle rigidity (僵直) and hypokinesia, often with dementia (痴呆).
Aetiology(病因学)
mostly unknown;
toxin induced: MPTP, CO, Mn2+…
drug induced: DA-R(-)…
rare causes:
cerebral ischaemia(脑缺血);
encephalitis (脑炎) , stroke (脑卒中)…
Pathophysiology
theory of Dopamine:
in the nigrostriatal pathway
(黑质纹状体通路) dopaminergic neurons degeneration.
(多巴胺能神经元变性)
DA concentration
ACh
DA
ACh
normal
Parkinson’s disease
therapy
㈠
(+)
相对
DA
DA
ACh
Supply DA
Anti ACh
Dopamine mimetic drug :
L-dopa
Treatment of
Parkinson ’ s disease
Cholinoceptor blocking drug:
artane
Usual drugs
(一) Dopamine mimetic drug
levodopa, L-dopa 左旋多巴
[ ics ]
1、po---absorb rapidly from small bowel,
influence factors:
1)gastric emptying
2)gastric acid
3)food of high protein
absorption
F