北京協(xié)和醫(yī)學(xué)院基礎(chǔ)醫(yī)學(xué)院藥理學(xué)系(參考版)
2025-01-03 13:52本頁面
【正文】 鎮(zhèn)痛 藥 阿片生物堿類 嗎啡 不良反應(yīng) 不良反應(yīng) 反復(fù)應(yīng)用（一般劑量連用 1w左右）引起成癮 ！ 鎮(zhèn)痛 藥 阿片生物堿類 成癮性 鎮(zhèn)痛 藥 阿片生物堿類 成癮性 戒斷綜合癥狀 SYMPTOMS OF WITHDRAWAL 腹瀉 出汗 抑郁 震顫 衰弱 肌痙攣 寒戰(zhàn) 渴求藥物 頭痛、 鎮(zhèn)痛 藥 阿片生物堿類 鴉片戰(zhàn)爭 鎮(zhèn)痛 藥 阿片生物堿類 嗎啡成癮機(jī)制 嗎啡成癮機(jī)制 Nucleus ceruleus:intensive opioid and NA receptors Morphine and endogenous opioid peptides inhibit the firings of nucleus ceruleus ， the firings of addicts are decrease firings of nucleus ceruleus are increase when addicts stop using morphine, naergic neurons are hyperfunction， withdrawal symptom appearance. 鎮(zhèn)痛 藥 人工合成類 哌替啶 哌替啶 pethidine (dolantin, 度冷?。? Pharmacologic action Application succedaneum of morphine analgesia 、 preanesthetic medication and induced hibernation、 cardiac asthma It interacts predominantly with the μopioid receptor. CNS effects is similar with morphine but weaker than morphine,action time is 2~4h less than is weaker than morphine. 度冷丁 dolantin （哌替啶 pethidine） Artificial Untoward reaction ? Addiction ? Respiratory depression 可待因 codeine（ 3omethyl derivative of morphine） Characteristics： ? Analgesia:1/12 of morphine ? Preventing cough:1/4 of morphine ? Addiction is weaker than morphine. Application： ? central antitussive ? Moderate analgesics:simple recipe or mixture（ 如氨酚待因片 ） 二氫埃托啡 dihyentophine Characteristics: ? Strong opioid agonists,1000 times of morphine ? IM10 μg 5~15 min → analgesia last 6 hr ? Hypoglossis20 μg 5~20 min ? Use to traumatic occlusion pain， TCA， postop. analgesia ? tolerance， addiction ? overdose→Respiratory depression 鎮(zhèn)痛 藥 人工合成類 哌替啶 美沙酮 methadone Pharmacologic action Application succedaneum of morphine detoxificatio
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