神经系统药理—魏尔清(抗帕金森病药.ppt

Part10DrugsTreatingParkinsonDiseaseandAlzheimerDisease,LevodopaandrelateddrugsCholinoceptorantagonistsDrugstreatingdementia,DrugsfortreatmentofParkinsondisease(PD)LevodopaandrelateddrugsCholinoceptorantagonists,Parkinsondiseaseandtherapeuticdrugs,Rigidity:oneofthecommonsymptomsofPD,Tremor:oneofthecommonsymptomsofPD,Pyramidalandextrapyramidalpathways,Striatum,黑质-纹状体通路,中脑-皮层通路,结节-漏斗通路,Substantianigro-striatumdopaminergicpathwayisinvolvedinPDpathogenesis,ParkinsondiseaseDopaminergicneurondegenerationinsubstantianigroandstriatum,Normal,Dopamine,Acetylcholine,AbnormalbalanceofDA/AChneuronalfunctionsinextrapyramidalsystemofParkinsondisease,Levodopa,Muscarinicantagonists,Normal,Parkinsondisease,(-),(-),injured,relativelypotentiated,PD:GABA,HD:GABA,(+),(-),(-),(+),(-),(-),(-),Levodopaandrelateddrugs,Levodopa,L-dopa左旋多巴,DrugsfortreatmentofParkinsondisease,Levodopa,Dopamine,Levodopa1.ADMEPenetratingintothebrain,transformedtoDAorNE(less)Distributedinperipheraltissue(most)2.EffectsandusesParkinsondisease:decreasestherigidity,tremors,andothersymptoms3.Adverseeffects(1)CNS:abnormalinvoluntary;hallucinations;etc.(2)GI:nausea,vomiting,etc.(3)CVS:hypotension,arrhythmia,etc.,DrugsfortreatmentofParkinsondisease,InhibitorsofaromaticL-aminoaciddecarboxylaseCarbidopa卡比多巴cannotcrossBBB,butcaninhibitperipheraldopaminesynthesis.increasesavailabilityoflevodopatotheCNSanddecreasesperipheraleffects,DrugsfortreatmentofParkinsondisease,Levodopaalone,Levodopa+Carbidopa,Otherdrugs1.DAreceptoragonistsBromocriptine溴隐亭Pergolide培高利特Pramiperole普拉克索Ropinirole罗平尼咯,DrugsfortreatmentofParkinsondisease,2.MAOinhibitorsdecreasingDAmetabolismintheCNSSelegiline司来吉兰Rasagiline雷沙吉兰3.COMTinhibitorsdecreasingDAmetabolismintheCNSNitecapone硝替卡朋4.Amantadine金刚烷胺increasingDArelease,DrugsfortreatmentofParkinsondisease,MuscarinicantagonistsTrihexyphenidyl（苯海索，artane,安坦）DecreasingCNScholinergicfunctionsAdjuvantofParkisondiseasetreatment,DrugsfortreatmentofParkinsondisease,Drugsfortreatmentofdementia(Alzheimerandrelateddiseases)AnticholinesterasedrugsCholinoceptoragonistsNeurotrophicfactor-likedrugs,AnticholinesterasedrugsTarcrine他克林Huperzine石杉碱甲（哈伯因）Galantamine加兰他敏CholinoceptoragonistsXanomeline占诺美林Milameline米拉美林Neurotrophicfactor-likedrugsAIT082Propentofylline丙戊茶碱,Drugsfortreatmentofdementia,PathologicalcharacteristicsofAD,Atrophyofthebrain,SenileplaquesNeurofibrillarytangles,Senileplaquesandneurofibrillarytangles,Regionsrelat