《医学专题—第16章-外周神经系统药理概念(传出神经药理)3604.ppt》由会员分享，可在线阅读，更多相关《医学专题—第16章-外周神经系统药理概念(传出神经药理)3604.ppt（22页珍藏版）》请在taowenge.com淘文阁网|工程机械CAD图纸|机械工程制图|CAD装配图下载|SolidWorks_CaTia_CAD_UG_PROE_设计图分享下载上搜索。
1、Chapter 5 summarization of Autonomic Nervous System Drugs第五章 传出神经系统(xtng)(xtng)药理概论TAISHAN medical universityzhangfeng第一页，共二十二页。传出神经系统传出神经系统植物植物(zhw)(zhw)神经系统神经系统(vegetative nervous system)自主神经系统自主神经系统(autonomic nervous system)：主要支配心肌、平滑主要支配心肌、平滑肌和腺体等效应器。肌和腺体等效应器。运动神经系统运动神经系统：支配骨骼肌。支配骨骼肌。I.Anatomy（解
2、剖学）and neurotransmitter（神经递质）chemistry of the autonomic nervous system第二页，共二十二页。A.Cholinergic FibersA.Cholinergic Fibers（胆碱能神经（胆碱能神经(shnjng)(shnjng)）n n1.All 1.All preganglionic preganglionic efferentefferent（传传出出的的）autonomic autonomic fibers fibers and somatic motor fibers and somatic motor fibers
3、n n2.All parasympathetic postganglionic fibers2.All parasympathetic postganglionic fibersn n3.A few sympathetic postganglionic fibers 3.A few sympathetic postganglionic fibers -sweat gland -sweat gland -skeletal muscle vascular dilating nerves -skeletal muscle vascular dilating nervesn n4.The nerve
4、innervate to adrenal medulla 4.The nerve innervate to adrenal medulla B.B.Noradrenergic Fibersadrenergic Fibers（去甲肾上腺素能神经）（去甲肾上腺素能神经）n nMost of the sympathetic postganglionic fibersMost of the sympathetic postganglionic fibers 第三页，共二十二页。第四页，共二十二页。Transmitter and receptor递质和受体递质和受体vAcetylcholine,ACh（
5、乙酰胆碱（乙酰胆碱）M1、M2、M3、M4、M5;N1、N2 -receptor cholinesterase,AChE（胆碱酯酶）vNoradrenaline,NA（去甲（去甲(q ji)肾上腺素）肾上腺素）1、2;1、2、3-receptor uptake-1(neuronal uptake);uptake-2(non-neuronal uptake)COMT,MAO 第五页，共二十二页。Discover of transmitter1921，Loewi的离体双蛙心灌流实验的离体双蛙心灌流实验 提示迷走神经可释放一种(y zhn)抑制性物质，1926年证实为ACh。第六页，共二十二页。Sy
6、napse突触突触第七页，共二十二页。第八页，共二十二页。乙酰胆碱的合成、释放、贮存乙酰胆碱的合成、释放、贮存(zhcn)和消除和消除 第九页，共二十二页。NANA合成、贮存、释放、消除合成、贮存、释放、消除(xioch)(xioch)基本过程基本过程第十页，共二十二页。胞裂外排（exocytosis)要点(yodin)：Ca2+内流 形成裂孔量子化释放（quantal release)要点：每个囊泡释放的Ach量即为一个“量子”；静息(jn x)时即有少数囊泡释放Ach形成终板电位；神经冲动传到末梢时，200300个以上囊泡同时释放，形成动作电位。共同传递(chund)（cotransmis
7、sion)要点：神经末梢贮存有二种或三种递质可供释放第十一页，共二十二页。.Locations of Autonomic Receptors A.Cholinergic ReceptorsnM1 CNS nervous,sympathetic ganglia（神经节）,some presynaptic sites cerebral cortex（大脑皮层(dno-pcng)）,hippocampus（海马）,corpus striatum（纹状体）,parietal cell（壁细胞）of stomachnM2 heart,smooth muscle,some presynaptic site
8、snM3 exocrine glands（外分泌腺）,smooth muscle and endothelium（内皮）nNN(N1)postganglionic neurons（节后神经元）,some presynaptic cholinergic terminalsnNM(N2)skeletal muscle,neuromuscular end-plates 第十二页，共二十二页。B.Adrenoceptors1 postsynaptic effector cells,especially smooth muscle2 presynaptic adrenergic nerve termin
9、als,platelets,lipocytes（脂肪(zhfng)细胞）,smooth muscle1 postsynaptic effector cells,especially heart,lipocytes,brain,kidney,presynaptic adrenergic and cholinergic nerve terminals.2 postsynaptic effector cells,especially smooth muscle,liver.3 postsynaptic effector cells,especially lipocytes.第十三页，共二十二页。第十
10、四页，共二十二页。第十五页，共二十二页。.Functional Organization of Autonomic Activity 见P55-57：表5-2及表5-4双重支配双重支配(zhpi)相互拮抗相互拮抗Sympathetic（交感神经（交感神经(jiogn-shnjng)(jiogn-shnjng)）和和parasympathetic（副交感神经）（副交感神经）的生理功能：的生理功能：Dually innervatedDually innervated（支配（支配(zhpi)(zhpi)）organs.organs.How will the response be if gangli
11、onicHow will the response be if ganglionic（神经节的）（神经节的）blockade?blockade?The answer is predictable if one know which system is The answer is predictable if one know which system is dominant.dominant.第十六页，共二十二页。.Coupling Mechanism of Receptor-effect M受体属于(shy)鸟核苷酸结合调节蛋白（G蛋白）藕联的超级家族受体(superfamily of G-
12、protein-coupled receptors)，M受体激动后与G蛋白藕联，进而激活磷酯酶C，增加第二信使的形成产生效应;N受体属于配体门控离子通道型受体；及受体与M受体结构相似，也属于G蛋白藕联受体。第十七页，共二十二页。受体受体-腺苷酸环化酶偶联和受体腺苷酸环化酶偶联和受体-磷脂酶偶联示意图磷脂酶偶联示意图 第十八页，共二十二页。A.Effect on receptors -combine with receptors-combine with receptors -blockade or mimicking -blockade or mimickingB.Effect on neur
13、otransmitters 1.Biosynthesis(carbidopa 1.Biosynthesis(carbidopa 卡比多巴)2.Metabolism(neostigmine 新斯的明新斯的明)3.Release(ephedrine 3.Release(ephedrine 麻黄碱)4.Storage(reserpine 4.Storage(reserpine 利舍平利舍平).Mode of Action of Autonomic Nervous System Drugs 第十九页，共二十二页。.Classification of Autonomic Nervous System D
14、rugs A.Cholinergic nerve agonistsA.Cholinergic nerve agonists1.Mimetics with direct effect on cholinergic receptor 1.Mimetics with direct effect on cholinergic receptor M,N-receptor agonist(carbachol M,N-receptor agonist(carbachol 卡巴胆碱卡巴胆碱)M-receptor agonist(pilocarpine M-receptor agonist(pilocarpin
15、e 匹鲁卡品匹鲁卡品)N-receptor agonist(nicotine N-receptor agonist(nicotine 烟碱烟碱(yn jin)(yn jin)w w2.Anticholinesterase2.Anticholinesterase (neostigmine(neostigmine新斯的明新斯的明,organophosphate,organophosphate有机磷酸酯类有机磷酸酯类)wB.Cholinergic nerve antagonistsB.Cholinergic nerve antagonistsw w1.Anticholinergic drugs1.A
16、nticholinergic drugs M-receptor blocker(atropine)M-receptor blocker(atropine)N-receptor blocker(d-tubocurarine N-receptor blocker(d-tubocurarine筒箭毒碱筒箭毒碱)w w2.Cholinesterase reactivator(pralidoxime,PAM)2.Cholinesterase reactivator(pralidoxime,PAM)第二十页，共二十二页。C.Adrenergic nerve agonists 1.Mimetics with
17、 direct effect on adrenergic receptor1.Mimetics with direct effect on adrenergic receptor -receptor agonist(NA)-receptor agonist(NA),-receptor agonist(adr),-receptor agonist(adr)-receptor agonist(isoprenaline)-receptor agonist(isoprenaline)2.2.Mimetics Mimetics with with indirect indirect effect eff
18、ect on on adrenergic adrenergic receptor receptor(ephedrine(ephedrine 麻黄碱麻黄碱,aramine,aramine 阿拉阿拉(l)(l)明明)D.Adrenergic nerve antagonists 1.Antiadrenergic drugs1.Antiadrenergic drugs -blockers(phentolamine -blockers(phentolamine 酚妥拉明酚妥拉明,phenoxybenzamine,phenoxybenzamine 酚苄酚苄明明)-blocker(propranolol -
19、blocker(propranolol 普萘洛尔普萘洛尔),-blockers(labetalol ,-blockers(labetalol 拉贝洛尔拉贝洛尔)w w2.Anti-adrenergic nerve drug(reserpine 2.Anti-adrenergic nerve drug(reserpine 利舍平利舍平)第二十一页，共二十二页。内容(nirng)总结Chapter 5 summarization of Autonomic Nervous System Drugs第五章 传出神经系统药理概论。uptake-2(non-neuronal uptake)COMT,MAO。乙酰胆碱的合成(hchng)、释放、贮存和消除。NA合成(hchng)、贮存、释放、消除基本过程。受体-腺苷酸环化酶偶联和受体-磷脂酶偶联示意图第二十二页，共二十二页。