藥理導(dǎo)論詳解演示文稿

藥理導(dǎo)論詳解演示文稿當(dāng)前第1頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)（優(yōu)選）藥理導(dǎo)論當(dāng)前第2頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)WhatisthePharmacology?研究藥物和機(jī)體（包括病原體）相互作用的規(guī)律及其原理的一門(mén)科學(xué),也是一門(mén)實(shí)踐科學(xué)，主要研究藥效學(xué)和藥動(dòng)學(xué)。當(dāng)前第3頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)

HistoryofPharmacologyWhataredrugs？

用于防治或診斷疾病的物質(zhì)能影響機(jī)體器官生理功能和/或細(xì)胞代謝活動(dòng)的化學(xué)物質(zhì)與毒物沒(méi)有本質(zhì)的區(qū)別無(wú)藥不毒!當(dāng)前第4頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Variousmixturesofplantandanimalsubstanceswereusedtotreatsickness.Bytheendofthe18thcentury,itwaspossibletoisolateactiveingredientsfromcrudedrugsandsynthesizechemicalcompoundsthatproducedpredictablebiologicresults

HistoryofPharmacology當(dāng)前第5頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)

HistoryofPharmacologyMorphinewasextractedfromopiumin1806AspirinwasdevelopedbyBayerCompanyin1899當(dāng)前第6頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)

HistoryofPharmacologyInthe20thcentury,explosiveadvancesinthefieldofpharmacologyoccurred.InsulinANSdrugsAntibioticsandantineoplasticsGeneticallyengineereddrugs當(dāng)前第7頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)DevelopmentofPharmacology

由器官水平→細(xì)胞水平→分子水平多學(xué)科發(fā)展：心血管藥理學(xué)生殖藥理學(xué)免疫藥理學(xué)分子藥理學(xué)腫瘤藥理學(xué)時(shí)辰藥理學(xué)精神神經(jīng)藥理學(xué)臨床藥理學(xué)等分支學(xué)科當(dāng)前第8頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)藥理學(xué)的內(nèi)容Pharmacokinatics（藥代學(xué)）Pharmacodynamics（藥效學(xué)）當(dāng)前第9頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)研究在藥物作用下機(jī)體生命活動(dòng)過(guò)程的變化規(guī)律，即藥物對(duì)機(jī)體的作用PharmacodynamicsPharmacokinatics研究機(jī)體對(duì)進(jìn)入體內(nèi)的藥物的處置規(guī)律，即藥物的體內(nèi)過(guò)程當(dāng)前第10頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Pharmacodynamics藥物作用：治療效應(yīng)對(duì)因治療和對(duì)癥治療急則治其標(biāo)，緩則治其本不良反應(yīng)副作用毒性作用過(guò)敏反應(yīng)繼發(fā)反應(yīng)后遺效應(yīng)當(dāng)前第11頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)參與或干擾細(xì)胞代謝影響生理物質(zhì)轉(zhuǎn)運(yùn)影響酶的活性影響膜上離子通道影響核酸代謝影響免疫功能激活或阻斷受體Actingmechanismsofdrugs當(dāng)前第12頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Actingmechanismofdrugandreceptor

Receptor：細(xì)胞膜上或細(xì)胞內(nèi)的特殊蛋白組分，能識(shí)別周?chē)h(huán)境中某種微量化學(xué)物質(zhì)，首先與之結(jié)合，并通過(guò)中介的信息轉(zhuǎn)導(dǎo)與放大系統(tǒng)，觸發(fā)相應(yīng)的生理反應(yīng)或藥理效應(yīng).當(dāng)前第13頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Classificationofreceptors

腎上腺素受體、膽堿受體、多巴胺受體、糖皮質(zhì)激素受體等?？缒ぜっ富钚允荏w、G蛋白耦聯(lián)受體、離子通道受體、胞內(nèi)受體（核受體）Na+Na+Inthisfigure,thesubunitisomittedGate當(dāng)前第14頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)ReceptorBinding–

“KeyinLock”Mode當(dāng)前第15頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Drug-ReceptorInteractions

k1k2DrugReceptorEffectDrug-ReceptorComplexLigand-bindingdomainEffectordomain當(dāng)前第16頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)ReceptorProteinsTypesofreceptor-effectorlinkage.(R,receptor;G,G-protein;E,enzyme;ACh,acetylcholine.)

當(dāng)前第17頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)藥物的藥理效應(yīng)與劑量在一定范圍內(nèi)成正相關(guān)關(guān)系以效應(yīng)為縱坐標(biāo)，藥物濃度為橫坐標(biāo)所作的曲線如將濃度取對(duì)數(shù)值，曲線為典型的對(duì)稱(chēng)“S”型.

量效關(guān)系量效曲線當(dāng)前第18頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)量反應(yīng)量效曲線ECminEC50EmaxPotencyEfficacy當(dāng)前第19頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)質(zhì)反應(yīng)量效曲線累加量效曲線

EDmin

ED50

TD50

LD50頻數(shù)分布曲線當(dāng)前第20頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)動(dòng)物：TI=LD50/ED50臨床：TI=TD50/ED50治療指數(shù)(TherapeuticIndex,TI)

安全范圍(SafetyMargin,SM)動(dòng)物：SM＝ED95→LD5的距離臨床：SM＝ED95→TD5的距離

當(dāng)前第21頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)%RespondingDoseTherapeuticandToxicEffect當(dāng)前第22頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)DrugSafety–ThearapeuticWindowVERYVERYIMPORTANTCONCEPT.THISALSOAFFECTSDOSE.當(dāng)前第23頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)PharmacokinaticsAbsorption–takenintothebodyDistribution–movedintotissuesMetabolized–changedsocanbeexcreted(biotransformation),butnotall.Excreted–removedfromthebody＊Briefly!當(dāng)前第24頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)DISTRIBUTION當(dāng)前第25頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)RouteofdrugadministrationAccordingtothedrug’sPropertiesandthetherapeuticobjectives,therearethreetypesofrouteEnteralParenteralOtherOralSublingualRectalIntravascularIntravenousintra-arteriallyIntramuscularSubcutaneousInhalationIntranasalIntrathecal/IntraventricularTopicalTransdermal當(dāng)前第26頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)DrugDistributionHowdrug,onceabsorbed,getstotissuesandfluidsofthebodyDependsonseveralfactorsBloodflowSolubility(cellpermeability)BloodBrainBarrierProteinBinding(血漿蛋白結(jié)合)當(dāng)前第27頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)BloodBrainBarrier當(dāng)前第28頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)DrugMETABOLISMReactionof

drugmetabolisminLiverDrugsEnzymesPhaseIPhaseIIExcretionIncreasingpolarizationOxidation,Reduction,Hydrolysis(Active,Unchange,Inactive)Conjugation(Inactive)DirectlyUnchanged當(dāng)前第29頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Biotransformation(Metabolism)當(dāng)前第30頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)DrugEXCRETIONBrowmann’scapsuleAfferentarteriolefromrenalarteryEfferentarteriolefromglomerulusGlomerulusProximaltubulePeritubularcapillariesDistaltubuleCollectingductLoopofHenleBranchofrenalveinDescendinglimbAscendinglimbVasarecta當(dāng)前第31頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Time-concentrationandtime-effectrelationshipofdrugs

當(dāng)前第32頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Theplasmaconcentration-timecurvefollowingasingleoraldoseofformulationA,BandC.Theextentsofabsorptionofthethreeformulationaresimilar(i.e.,theareaofAUCissimilar).Buttherateofabsorptiondiffers.TherateofabsorptionofformulationAisthefastest;therateofabsorptionofformulationCistheslowest;therateofabsorptionofformulationBisbetweenAandC.當(dāng)前第33頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)

傳出神經(jīng)藥理常用藥物藥理當(dāng)前第34頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)傳出神經(jīng)對(duì)內(nèi)臟器官的調(diào)節(jié)作用當(dāng)前第35頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)Questions:通過(guò)上圖可見(jiàn)，假如迷走神經(jīng)過(guò)度興奮，出現(xiàn)胃部痙攣引起胃痙攣時(shí)，你如何用藥物緩解？

假如對(duì)支配心臟的交感神經(jīng)過(guò)度興奮時(shí)，心跳的很快（180次/分），你如何用藥來(lái)治療？當(dāng)前第36頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)藥物分類(lèi)

擬膽堿藥物抗膽堿藥物擬腎上腺素藥物：

α受體激動(dòng)藥β受體激動(dòng)藥

抗腎上腺素藥物：

α受體阻斷藥β受體阻斷藥

當(dāng)前第37頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)

中樞神經(jīng)藥理

鎮(zhèn)靜催眠藥

巴比妥類(lèi)苯二氮卓類(lèi)

抗癲癇和抗驚厥藥

抗精神失常藥

抗精神病藥抗抑郁藥抗躁狂藥當(dāng)前第38頁(yè)\共有40頁(yè)\編于星期日\(chéng)14點(diǎn)中樞神經(jīng)藥理

抗帕金森病藥

擬多巴胺藥中樞抗膽堿藥多巴受體激動(dòng)藥

鎮(zhèn)痛藥