平喘药-作用于呼吸系统的药物

第三十一章

作用于呼吸系统的药物

Drugsactonrespiratorysystem平喘药AntiasthmaticdrugsAsthmaPrevalence*byAge

UnitedStates:1980–1996Source:NationalHealthInterviewSurvey*12-monthprevalenceUnder18Total18+DiagnosingAsthma:

MedicalHistorySymptomsCoughingWheezingShortnessofbreathChesttightnessPatternstoSymptomsSeverityFamilyHistoryPathogenesisofasthmaPathogenesisofasthmaPathologyofAsthmaNormalLungsAsthmaSource:“WhatYouandYourFamilyCanDoAboutAsthma”bytheGlobalInitiativeForAsthmaCreatedandfundedbyNIH/NHLBIClassificationBronchodilatorsAnti-inflammatorydrugsAnti-allergicdrugs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]•inhibitphosphodiesterase,increasecAMP•antagonizeadenosine•increasethereleaseofendogenouscatecholamine•immunomodulatoryaction•AntiinflammatoryactioncentralsleepapneasyndromeCSAS

Asthma

COPD

CyclicNucleotideMetabolism-cAMP

三、M胆碱受体阻断药阿托品(atropine)异丙托溴胺(ipratropiumbromide)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sodiumcromoglycate六、抗白三烯药物LeukotrieneBlockers扎鲁司特zafirlukastMedicationstoTreatAsthma:

Long-TermControlTakendaily,overalongperiodoftimeUsedtoreduceinflammation,relaxairwaymuscles,andimprovesymptomsandpulmonaryfunctionInhaledcorticosteroidsLong-actingbeta2-agonistsLeukotrienemodifiersMedicationstoTreatAsthma:

Quick-ReliefUsedinacuteasthmaepisodesGenerallytheyareshort-actingbeta2-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