神经系统药理—吴希美(解热镇痛药VIP免费

Chapter27Chapter27Antipyretic-AnalgesicandAntipyretic-AnalgesicandAntiinflammatoryDrugsAntiinflammatoryDrugsA.A.GeneralPharmacologicalpropertiesGeneralPharmacologicalproperties1.1.InhibitionofprostaglandinsynthesisInhibitionofprostaglandinsynthesisinhibitinginhibitingcyclooxygenasecyclooxygenase(COX(COX，环氧酶，环氧酶),),decreasingthesynthesisofPGsandTXAdecreasingthesynthesisofPGsandTXA22,,resultingantipyretic,analgesic,andanti-inflaresultingantipyretic,analgesic,andanti-inflammatoryeffectsmmatoryeffectsnon-steroidalanti-inflammatorydrugs(NSAIDnon-steroidalanti-inflammatorydrugs(NSAIDs,s,非甾体抗炎药非甾体抗炎药）。）。2.2.AntipyreticeffectsAntipyreticeffectsInhibitionofPGEInhibitionofPGE22productioninthehypothalproductioninthehypothalamusinducedbyendogenouspyregensafterpamusinducedbyendogenouspyregensafterpathologicalstimuliathologicalstimulitemperaturetemperaturenotes:notes:symptomaticcontrolonly,notbeindicatedisymptomaticcontrolonly,notbeindicatedinallpatientswithfever.nallpatientswithfever.TheeffectonbodytemperatureisdifferentfromtTheeffectonbodytemperatureisdifferentfromthatofchlorpromazine.hatofchlorpromazine.A.A.GeneralPharmacologicalpropertiesGeneralPharmacologicalproperties解热镇痛药氯丙嗪作用机制抑制前列腺素合成，使散热增加而解热抑制下丘脑体温调节中枢，使其调节功能减弱，不能随外界温度变化而调节体温作用只能使升高的体温降到正常氯丙嗪配合物理降温，不仅可使升高的体温降到正常，也可使正常体温降到正常以下用途用于各种发热用于低温麻醉、人工冬眠不良反应胃肠道反应等锥体外系统反应等ComparisonofpropertiesoftwotypesofdrugsComparisonofpropertiesoftwotypesofdrugs3.3.AnalgesiceffectsAnalgesiceffectsAnalgesiceffectisresultedfrominhibitionofPGEAnalgesiceffectisresultedfrominhibitionofPGE22production.production.EffectiveonthepainoflowtomoderateintensityreEffectiveonthepainoflowtomoderateintensityrelatedtoinflammatoryresponses.latedtoinflammatoryresponses.PGEPGE22::apainstimulantandhyperalgesicagentapainstimulantandhyperalgesicagentTheanalgesiceffectisdifferentfromopioidanalgesiTheanalgesiceffectisdifferentfromopioidanalgesics.cs.A.A.GeneralPharmacologicalpropertiesGeneralPharmacologicalproperties解热镇痛药阿片类镇痛药作用抑制前列腺素合成起效；对慢性钝痛有效，对剧烈疼痛或内脏绞痛无效兴奋阿片受体起效；对各种疼痛均有效用途头痛、牙痛、神经痛、肌肉或关节痛、痛经等用于其他药物无效的急性锐痛，晚期肿瘤的剧烈疼痛不良反应胃肠道反应等，但无成瘾性有成瘾性ComparisonofpropertiesoftwotypesofdrugsComparisonofpropertiesoftwotypesofdrugs4.4.Anti-inflammatoryeffectsAnti-inflammatoryeffectsPGsinduceinflammatoryresponses.PGsinduceinflammatoryresponses.InhibitionofPGproductioncanrelieveinflamInhibitionofPGproductioncanrelieveinflammatoryresponses,suchascongestion,exudatimatoryresponses,suchascongestion,exudation,pain.on,pain.TheeffectisdifferentfromthatofglucocorticTheeffectisdifferentfromthatofglucocorticosteroids.osteroids.A.A.GeneralPharmacologicalpropertiesGeneralPharmacologicalproperties非甾体抗炎药糖皮质激素作用抑制前列腺素合成起效；缓解软组织、骨骼、关节的炎症抑制炎症细胞、炎症分子，多环节炎症炎症病变用途风湿性、类风湿性炎症，外伤损伤可用于多种炎症，作用强不良反应胃肠道反应等抑制机体防御反应，干扰代谢，不良反应广泛ComparisonofpropertiesoftwotypesofdrugsComparisonofpropertiesoftwotypesofdrugs5.5.COX-1/COX-2andselectivityofthedrugsCOX-1/COX-2andselec...