藥理學第二章ppt課件-資料下載頁
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【正文】 opaminergic/cholinergic balance by one of a number of ways as follows: ? 1. Reducing cholinergic activity with antimuscarinic (anticholinergic) drugs。 this approach is most effective in the acute treatment of rigidity (including iatrogenic, caused by dopamine receptor antagonists)。 ? 2. Enhancing dopaminergic activity with dopaminergic drugs by prolonging the action of dopamine through selective inhibition of its metabolism ( selegiline ), activating dopamine receptors ( bromocriptine, lysuride, apomorphine), and modulating the release of dopamine from stores and the reuptake of dopamine (amantadine). This approach is most effective against hypokinesia and rigidity, and less effective in the treatment of tremor. ? 3. Replenishing neuronal synthesis of dopamine by supplying levodopa, its natural precursor。 administration of dopamine itself is ineffective as it does not pass into the brain from the blood. ? Alzheimer39。s disease (AD) is a kind of dementia associated with a progressive decrease of cholinergic function in CNS. The tangle of neurofilments, deposition of amyloid protein, and superphosphorylation of Tau protein are the three main characteristics of AD. A major approach to the pharmacotherapy of AD is aimed at augmenting cholinergic function in the brain. One strategy is to use inhibitors of acetylcholinesterase ( AChE) , the hydrolytic enzyme for acetylcholine. These inhibitors include physostigmine, tacrine, donepezil and galantamine. ? Other drugs currently used for treatment of AD include muscarinic agonists, nerve growth factor, enhancers of nerve growth factor, and some metabolic activators. In order to optimize therapeutic results, drugs acting through different mechanisms should be used in bination in the treatment of AD. ? Two balanced systems are important in the extrapyramidal control of motor activity at the level of the corpus striatum and substantia nigra： one is a cholinergic system, in which the neurotrammitter is acetylcholine。 the other is a dopaminergic system, in which the neurotransmitter is dopamine. Parkinsonism is caused by degeneration of dopaminergic neurons in the substantia nigra in the hindbrain, and consequent loss of dopaminergic/cholinergic balance in the nigrostriatal pathway.
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