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
Parkinson disease
1817 British doctor James Parkinson
described and reported:
“It’s a kind of degenerative disease S, causing tremor at rest, muscle rigidity and hypokinesia, often with dementia ”
Aetiology
mostly unknown;
toxin induced: MPTP, CO, Mn2+…
drug induced: DA-R(-)…
rare causes:
cerebral ischaemia; encephalitis , stroke……
Description and Causes
Most cases of idiopathic Parkinson’s are believed to be due to bination of ic and environmental factors.
At both ends of the spectrum are rare cases that appear to be due solely to one or the other.
Environmental risk factors associated with the development of PD include:
use of pesticides,
living in a rural environment,
consumption of well water, exposure to herbicides,
and proximity to industrial plants or quarries.
Pathophysiology
theory of Dopamine:
in the nigrostriatal pathway
dopaminergic neurons degeneration.
DA concentration
Why is balance significant?
Dop
Ach
Dopaminergic neurons:
Tonic inhibitory control
of neuronal activity
Dopaminergic neurons:
excitatory effects on
neuronal activity
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