支氣管擴(kuò)張劑的臨床及藥理doc(參考版)
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【正文】 330:117119.[8] Pauwels RA ,Lofdahl CG,Posma DS ,et al . Effect of inhaled formoterol and budesonide on exacerbations of asthma. New Engl J Med, 1997 ,337 (20) :14051411.[9] Disse B, Speck G, Rominger K, et al. Tiotropium (Spiriva?): Mechanistical considerations and clinical profile in obstructive lung disease. Life Sci. 1999。參考文獻(xiàn)[1] Ahlquist RP. A study of adrenotropic receptors [J] Am J Physiol ,1984 ,153(2) :586600.[2] Politiek MJ ,Boorsma M,Aalben R. Comparison of formoterol and salbutamol and salmeterol in methacholineinduced severe bronchoconstrictjon. Eur Respir J ,1999 ,13(5) :988992.[3] Palmqvist M, Persson G,Lazer L ,et al . Inhaled dry powder formoterol and salmeterol in asthmatic patients :onset of action, duration of effect and potency. Eur Respir J ,1997 ,10(11) :24842489.[4] Sitar DS. Clinical pharmacokinetics of bambuterol [J ] . Clin Pharmacokinet , 1996 , 31(4) :246256.[5] Ind P W,Dal Negro R , Colman NC ,et al . Addition of salmeterol to fluticasone propionate treatment in moderatetosevere asthma [J].[6] Dennis SM, Sharp SJ , Vickers MR, Frost CD, Crompton GK, Barnes PJ , et al. Therapy Working Group of the National Asthma Task Force and the MRC General Practice Research Framework. Lancet 2000。副作用主要為口干，癥狀輕微。在吸入90120分鐘后達(dá)到最大效應(yīng)，單次使用后，對肺功能的改善作用可延續(xù)24小時(shí)以上，因而僅需一日使用1次。Tiotropium和Ipratropium與M受體解離半衰期不同,前者對M受體亞型具有選擇性阻斷作用，與M1和M3受體的解離時(shí)間較后者長100倍，親和力較后者強(qiáng)10倍。肥厚性梗阻性心肌病、快速心律失常、對本品過敏者禁用。M受體分布在大、中氣道,而β2AR分布在終末小氣道，Anticholinergics與β2agonists有協(xié)同作用，聯(lián)合用藥的效果明顯優(yōu)于各自單用,而不增加副作用。于吸入后3060分鐘達(dá)最大效應(yīng)，持續(xù)時(shí)間約為46小時(shí)。Atrovent是季銨結(jié)構(gòu)，非脂溶性，難以被粘膜吸收，不通過血腦屏障；吸入后特異性地作用于呼吸道，血藥濃度極低，而副作用大大減少（口干、口苦、震顫、排尿困難等，青光眼、Atropine過敏者禁用）。常用藥物簡介：1．異丙托溴銨（Ipratropium bromide）：商品名為愛全樂（Atrovent），Boehringer Ingelheim公司生產(chǎn)。目前，共有5
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