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1、第三十一章 作用于呼吸系统的药物,Drugs act on respiratory system,平 喘 药,Antiasthmatic drugs,Asthma Prevalence* by Age United States: 19801996,Source: National Health Interview Survey * 12-month prevalence,Under 18,Total,18+,Diagnosing Asthma: Medical History,Symptoms Coughing Wheezing Shortness of breath Chest tight
2、ness Patterns to Symptoms Severity Family History,Pathogenesis of asthma,Pathogenesis of asthma,Pathology of Asthma,Normal Lungs,Asthma,Source: “What You and Your Family Can Do About Asthma” by the Global Initiative For Asthma Created and funded by NIH/NHLBI,Classification,Bronchodilators,Anti-infla
3、mmatory drugs,Anti-allergic drugs,一、肾上腺素受体激动药,肾上腺素 Epinephrine,沙丁胺醇 Salbutamol,麻黄碱 Ephedrine,克仑特罗 Clenbuterol,二、茶碱类 theophylline,氨茶碱 (aminophylline) 药理作用机制 临床应用 不良反应, inhibit phosphodiesterase, increase cAMP antagonize adenosine increase the release of endogenous catecholamine immunomodulatory actio
4、n Antiinflammatory action,central sleep apnea syndrome CSAS,Asthma,COPD,Cyclic Nucleotide Metabolism - cAMP,三、M胆碱受体阻断药,阿托品(atropine),异丙托溴胺(ipratropium bromide),四、糖皮质激素,倍氯米松 抗炎、抗过敏 全身、吸入,五、肥大细胞膜稳定药,色甘酸二钠 sodium cromoglycate,六、抗白三烯药物 Leukotriene Blockers,扎鲁司特 zafirlukast,Medications to Treat Asthma: L
5、ong-Term Control,Taken daily, over a long period of time Used to reduce inflammation, relax airway muscles, and improve symptoms and pulmonary function Inhaled corticosteroids Long-acting beta2-agonists Leukotriene modifiers,Medications to Treat Asthma: Quick-Relief,Used in acute asthma episodes Gen
6、erally they are short-acting beta2-agonists,镇咳药,分类 * 中枢性镇咳药，直接抑制延髓咳嗽中枢而发挥镇咳作用； * 外周性镇咳药，通过抑制咳嗽反射弧中的感受器、传入神经、传出神经或效应器中任何一环节而发挥镇咳作用。 有些药物兼有中枢和外周两种作用。,镇咳药,中枢性镇咳药 * 依赖性中枢性镇咳药 磷酸可待因，对咳嗽中枢有很强的作用。临床用于支气管癌或主动脉瘤引起的剧烈咳嗽和急性肺梗死或急性左心衰竭伴有的剧烈咳嗽。 * 非依赖性中枢性镇咳药 氢溴酸右美沙芬，镇咳作用与可待因相似或较强，起效快，无镇痛作用亦无依赖性，用于各种原因引起的干咳。,镇咳药,外周性镇咳药 盐酸那可汀抑制肺牵张反射引起的咳嗽，兼具兴奋呼吸中枢作用,祛痰药,祛痰药(expectorants)包括刺激性祛痰药和黏液溶解剂。 * 刺激性祛痰药氯化铵口服后刺激胃粘膜引起恶心，反射性促进支气管腺体分泌，稀释痰液使易于排出。 * 黏液溶解剂乙酰半胱氨酸使痰液中黏液分解或黏度下降，使易于排出。,
