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1、一、自主神經(jīng)藥物總論1.自主神經(jīng)的分類(1)每種自主神經(jīng)的組織?organization1.交感神經(jīng):節(jié)前神經(jīng)preganglionicneurons:lateralgrayhornsofspinalsegments脊髓外側(cè)灰質(zhì)?T1-L2神經(jīng)節(jié)ganglionicneurons→靶器官(1)交感干神經(jīng)元sympatheticchainganglia一對的→胸腔的內(nèi)臟器官(2)側(cè)副神經(jīng)節(jié)collateralganglia不成對→腹腔盆腔的內(nèi)臟器官(3)腎上腺髓質(zhì)2.副交感神經(jīng)節(jié)前神經(jīng)→神經(jīng)元→靶器官腦干發(fā)出的:第I
2、II對動眼神經(jīng)→睫狀神經(jīng)元→眼內(nèi)肌第IV對滑車神經(jīng)→翼腭神經(jīng)元&下頜下神經(jīng)元→鼻腺、淚腺、唾液腺第IX對舌咽神經(jīng)→耳神經(jīng)元→腮腺唾液腺第X對迷走神經(jīng)→intramuralganglia→內(nèi)臟器官(頸部、胸部、大部分腹部)骶椎發(fā)出的S2-S4→intramuralganglia→腹部盆部內(nèi)臟器官(2)雙重神經(jīng)支配dualinnervation的例外有哪些?1.只受交感神經(jīng)支配的:腎上腺髓質(zhì)、汗腺、豎毛肌、腎臟、肝臟(epinephrine);動脈(大部分收縮,骨骼肌可以dilate)2.是受副交感神經(jīng)支配的:睫狀肌、
3、陰莖/陰蒂的勃起、陰道潤滑2.自主神經(jīng)系統(tǒng)的受體(1)神經(jīng)遞質(zhì)有哪些?有哪兩類?膽堿的cholinergic(2)神經(jīng)遞質(zhì)的五個重要特征:合成、儲存、釋放、作用終止和作用:腎上腺能和膽堿能的(3)神經(jīng)傳導的信號傳導機制是?(4)受體有哪些?1.膽堿的cholinergic:Muscarinic受體1(neural)/2(cardiac)/3(glandular)和Nicotinic受體m(somaticneuromuscularjunctions)/n(autonomicganglia)2.腎上腺的adrenerg
4、ic:alpha1、2和β1、2、33.自主神經(jīng)系統(tǒng)的生理作用?交感和副交感的對比?交感神經(jīng)的作用:調(diào)配血液(從GI→骨骼肌肉),擴張肺部(增加氧氣),瞳孔擴大晶狀體拉伸(視力增大)副交感神經(jīng)的作用:血供給GI(保持吸收),縮肺部分泌(維持氣管),瞳孔縮小晶狀體壓縮(視力減退)4.藥物分類有哪些?Agonists…(1)
?Cholinergicagonists
–Bothreceptoragonists:ACh
–MuscarinicAChagonists:pilocarpine
–NicotinicAChago
5、nists:nicotine
?Anticholinesterases(increaselevelofACh)
–Reversible:neostigmine,donepezil
–Irreversible:organophosphates
?PAMAgonists…(2)
?Adrenoceptoragonists
–Alphareceptoragonists:
?Nonselectivealphareceptoragonists:norepinephrine,metaraminol
?Alpha1recepto
6、ragonists:phenylephrine,methoxamine
?Alpha2receptoragonist:oxymetazoline,apraclonidine
–Bothalphaandbetareceptoragonists:epinephrine,ephedrine,dopamineAgonists競爭者(興奮劑)…(3)
?Adrenoceptoragonists
–Betareceptoragonists:
?Nonselectiveagonists:isoproterenol
?Beta1r
7、eceptoragonist:dobutamine
?Beta2receptoragonist:salbutamol,etc.Antagonists…(1)
?Cholinoceptorblockingdrugs
–Muscarinicreceptorantagonists:
?Nonselective:atropine,scopolamine,ipratropium,homatropine,etc.
?Selective:pirenzepine,darifenacin,etc.
–Neuromuscularrec
8、eptorantagonists:
?Depolarizingagent
?Non‐depolarizingagentsAntagonists對抗者(拮抗劑)…(2)
?Adrenoceptorblockingdrugs
–Alphareceptorantagonists:
?Nonselective:phentolamine,phenoxybenzamin