抗寄生虫药(Anti-parasite_drugs)——方三华VIP免费

FangSanhuaAnti-parasitedrugsHumanparasite•Protozoa（原虫）：孢子虫－疟原虫鞭毛虫－阴道毛滴虫叶足虫－阿米巴原虫纤毛虫－结肠小袋纤毛虫•Helminth（蠕虫）：吸虫－血吸虫绦虫－链状带绦虫线虫－蛔虫、丝虫•Arthropod（节肢动物）：蛛形纲－蜱、螨昆虫纲－蚊、蝇、虱AntimalarialdrugsAntimalarialdrugs•Themalarialparasite,Plasmodium,isaverysmall,Themalarialparasite,Plasmodium,isaverysmall,single-cellorganism.single-cellorganism.•Itlivesasaparasiteinotherorganisms,namelyItlivesasaparasiteinotherorganisms,namelymanmanandmosquitoandmosquito..•TheparasiteisthecauseofthetropicalorsubtropicalTheparasiteisthecauseofthetropicalorsubtropicaldiseasediseasemalaria.malaria.AntimalarialdrugsAntimalarialdrugs-Malarialparasite-MalarialparasiteFourspeciesofplasmodiumcanproducethediseaseiFourspeciesofplasmodiumcanproducethediseaseinitsvariousforms:nitsvariousforms:•PlasmodiumfalciparumPlasmodiumfalciparum（（恶性疟原虫）恶性疟原虫）•PlasmodiumvivaxPlasmodiumvivax（（间日疟原虫）间日疟原虫）•PlasmodiumovalePlasmodiumovale（（卵形疟原虫）卵形疟原虫）•PlasmodiummalariaPlasmodiummalaria（（三日疟原虫）三日疟原虫）AntimalarialdrugsAntimalarialdrugs--ParasiteLifeCycleParasiteLifeCycle红细胞外期红细胞内期按蚊－有性繁殖人体－无性繁殖•NooneavailableagentcanreliablyeffectaradicalcuNooneavailableagentcanreliablyeffectaradicalcure,ie,eliminatebothexo-re,ie,eliminatebothexo-erythrocyticerythrocyticanderythrocyticsanderythrocyticstages.tages.•Fewavailableagentsarecausalprophylacticdrugs,iFewavailableagentsarecausalprophylacticdrugs,ie,capableofpreventingerythrocyticinfection.e,capableofpreventingerythrocyticinfection.AntimalarialdrugsAntimalarialdrugs控制复发Primaquine（伯氨喹）迟发病因预防Pyrimethamine（乙胺嘧啶）速发控制症状Chloroquine（氯喹）Quinine（奎宁）Mefloquine（甲氟喹）Artemisinin（青蒿素）阻止传播Pyrimethamine（乙胺嘧啶）阻止传播Primaquine（伯氨喹）Chloroquine（氯喹）Quinine（奎宁）（恶性疟无效）红细胞外期红细胞内期按蚊－有性繁殖AntimalarialdrugsAntimalarialdrugs––ChloroquineChloroquine（氯喹）（氯喹）•Chloroquineisasynthetic4-aminoquinolinederivateChloroquineisasynthetic4-aminoquinolinederivate控制症状Chloroquine氯喹Quinine奎宁Mefloquine甲氟喹Artemisinin青蒿素红细胞内期PharmacologicaleffectsPharmacologicaleffects1.Antimalarialeffects1.Antimalarialeffects•RapidschizonticidalactivityRapidschizonticidalactivity（（裂殖体杀灭剂）裂殖体杀灭剂）aagainstallinfectionsofmalariaspeciesgainstallinfectionsofmalariaspecies..•AlsogametocytocidalAlsogametocytocidal（（杀配子体）杀配子体）againstP.vivaagainstP.vivax,P.malariaeandP.ovale.x,P.malariaeandP.ovale.•Itisnotactiveagainstexo-erythrocyticform,andshoItisnotactiveagainstexo-erythrocyticform,andshouldthereforebeusedwithprimaquineuldthereforebeusedwithprimaquine（（伯氨喹）伯氨喹）totoeffectradicalcureofP.vivax.effectradicalcureofP.vivax.AntimalarialdrugsAntimalarialdrugs--ChloroquineChloroquinePharmacologicaleffectsPharmacologicaleffects2.Immuneinhibition2.Immuneinhibition•Treatmentofrheumatoidarthritis,lupuserTreatmentofrheumatoidarthritis,lupuserythematosusythematosus3.3.ExtraintestinalamebiasisExtraintestinalamebiasis•AmoebatrophozoiteamebicliverabscessAmoebatrophozoiteamebicliverabscessAntimalarialdrugsAntimalarialdrugs--ChloroquineChloroquineMechanismofactionsMechanismofactions•Accumulationinerythrocyte→pH↑→malarialpigAccumulationinerythr...