神经系统药理-魏尔清抗帕金森病药

神经系统药理—魏尔清(抗帕金森病药第一页，共28页。Part10

DrugsTreatingParkinsonDiseaseandAlzheimerDiseaseLevodopaandrelateddrugsCholinoceptorantagonistsDrugstreatingdementia第二页，共28页。DrugsfortreatmentofParkinsondisease(PD)LevodopaandrelateddrugsCholinoceptorantagonists第三页，共28页。ParkinsondiseaseandtherapeuticdrugsRigidity:oneofthecommonsymptomsofPD第四页，共28页。Tremor:oneofthecommonsymptomsofPD第五页，共28页。PyramidalandextrapyramidalpathwaysStriatum第六页，共28页。黑质-纹状体通路中脑-皮层通路结节-漏斗通路Substantianigro-striatumdopaminergicpathway

isinvolvedinPDpathogenesis第七页，共28页。ParkinsondiseaseDopaminergicneurondegenerationinsubstantianigroandstriatumNormal第八页，共28页。PDControlProducedopamine第九页，共28页。第十页，共28页。DopamineAcetylcholineAbnormalbalanceofDA/AChneuronalfunctionsinextrapyramidalsystemofParkinsondiseaseLevodopaMuscarinicantagonists第十一页，共28页。NormalParkinsondisease(-)(-)injuredrelativelypotentiated第十二页，共28页。PD:GABAHD:GABA(+)(-)(-)(+)(-)(-)(-)第十三页，共28页。LevodopaandrelateddrugsLevodopa,L-dopa左旋多巴DrugsfortreatmentofParkinsondiseaseLevodopaDopamine第十四页，共28页。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第十五页，共28页。InhibitorsofaromaticL-aminoaciddecarboxylaseCarbidopa卡比多巴cannotcrossBBB,butcaninhibitperipheraldopaminesynthesis.increasesavailabilityoflevodopatotheCNSanddecreasesperipheraleffectsDrugsfortreatmentofParkinsondisease第十六页，共28页。LevodopaaloneLevodopa+Carbidopa第十七页，共28页。Otherdrugs1.DAreceptoragonistsBromocriptine

溴隐亭Pergolide

培高利特Pramiperole

普拉克索Ropinirole

罗平尼咯DrugsfortreatmentofParkinsondisease第十八页，共28页。2.MAOinhibitorsdecreasingDAmetabolismintheCNSSelegiline

司来吉兰Rasagiline

雷沙吉兰3.COMTinhibitorsdecreasingDAmetabolismintheCNSNitecapone

硝替卡朋4.Amantadine金刚烷胺increasingDAreleaseDrugsfortreatmentofParkinsondisease第十九页，共28页。MuscarinicantagonistsTrihexyphenidyl（苯海索，artane,

安坦）DecreasingCNScholinergicfunctionsAdjuvantofParkisondiseasetreatmentDrugsfortreatmentofParkinsondisease第二十页，共28页。Drugsfortreatmentofdementia(Alzheimerandrelateddiseases)AnticholinesterasedrugsCholinoceptoragonistsNeurotrophicfactor-likedrugs第二十一页，共28页。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第二十二页，共28页。PathologicalcharacteristicsofADAtrophyofthebrain第二十三页，共28页。SenileplaquesNeurofibrillarytangles第二十四页，共28页。