cholinergic antagonist课件

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1、LinYuanPh.DProf.CholinergicantagonistM胆碱受体阻断药阿托品Atropine（1）药理作用;（2）临床应用;（3）不良反应及中毒期末考试/临床执业医师药理学考试大纲期末考试/药理学考试大纲选择题：后马托品，山莨菪碱，琥珀胆碱，筒箭毒碱Objective:Tounderstandtheclassificationofcholinergicantagonists;pharmacologicaleffects,majorclinicaluses,andADRofAtropinedrugchoi

2、ceinclinicaluses:Anisodamine,Homatropine,Succinylcgoline,andTubocurarine.(relationshipbetweendruglipidsolubilityanddrugselectivity)ExtendedAnalysis:(1)howtodifferentiateNAandAtropineinducedmydriasis.(2)explainthephenomenonthatlowdoseofAtropinedecreasesandthehighdo

3、seincreasescardiacrates.(3)CommentsonwhybothAChandatropinecandilatevascularsmoothmuscle.(4)Whetheratropinecanbeusedforthepatientwithgastriccolicalsosufferedfromasthmaoranginapectoris(Anaerobicmetabolism)ormyastheniagravis.Q-1WhatisthecommonfeatureofMantagonist(Atr

4、opine阿托品)Intherapeuticdosage,antimuscarinicagentsantagonizethemuscarinicactionsofacetylcholineandrelatedcompounds,byselectivelyandcompetitivelybindingtoMreceptor.Inhigherdoses,antimuscarinicagentsshowanti-nicotiniceffects,blockN2receptoratmotornerveendingsandN1rec

5、eptorintheganglionincsynapse.Q-2PleasedescribepharmacologicaleffectsandclinicalusesofMantagonist(1)inhibitionofexocrineglandssecretions（抑制腺体分泌）(a)Inhibitionofsweating;Clinicuses:e.g.,treatmentofseveresweatingintuberculosis.(b)Suppressionofbronchialandsalivarysecre

6、tions.Clinicuses:givenbeforesurgerytodecreaserespiratorytractandsalivarysecretion.(c)Decreaseofgastricsecretion,butthemaincontributiontopepticulcerisreliefofspasm(2)Mydriasis((扩瞳，dilationofthepupil)Clinicuses:(a)Treatmentofiritisbydecreasingtheactivityofciliary(睫状

7、肌)muscle,whichpreventtheadhesionbetweenirisandlensandhelprelievetheinflammation.Cycloplegia(调节麻痹，paralysisofaccommodation).Clinicuses:accuratemeasurementofeyerefraction(眼屈光)。Increasinginintraocularpressure（增加眼内压）,especiallyineyeswithanarrowanglebetweenirisandcorne

8、a(角膜)andattackacuteglaucomawithpotentialhazardofensuingblindness.(3)Relaxationofsmoothmuscleingastrointestinaltract,biliarytract(weak),andbronchi.Clinic