交感舒血管神经纤维课件

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1、血管活性药物概述浙江大学医学院药理学系卢韵碧yunbi@zju.edu.cn影响血管舒张收缩的因素神经调节心血管中枢（延髓心血管中枢）心血管反射（baroreceptorreflex）交感神经系统副交感神经系统体液调节肾素-血管紧张素系统局部具血管舒缩活性的多肽等活性物质血管的神经支配缩血管神经纤维:交感缩血管纤维舒血管神经纤维：交感舒血管神经纤维：以乙酰胆碱为递质。副交感舒血管神经纤维：以乙酰胆碱为递质。脊髓背根舒血管纤维：以局部活性多肽如降钙素相关基因肽介导。BrainstemorspinalcordPre-ganglioni

2、cneuronGanglionictransmitterPost-ganglionicneuronNeuroeffectortransmitterEffectororganEfferentneuronsofANSAchN1receptorNE12receptorClonidine（可乐定）作用于血管运动中枢交感神经突出后膜2受体Centrallyactingsympathoplegicdrugs（中枢性降压药）可乐定激动延髓嘴腹外侧核I1咪唑啉受体激动孤束核2受体抑制外周交感神经活性抑制去甲肾上腺素释放抑制血管收缩降低血压

3、ClinicalusesHypertension:mildtomoderatehypertensionthathasnotrespondedadequatelytotreatmentwithdiureticsalone.minimalchangesinrenalbloodflowandglomerularfiltration,inhibitgastrointestinalsecretionandmobility.ToxicityCentralandatropine-likesideeffectsLong-termuses:wate

4、randsodiumretentionreboundphenomenonCentrallyactingsympathoplegicdrugs：ClonidineTheganglionblockingagentsblocknicotiniccholinoceptorsonpostganglionicneuronsinbothsympatheticandparasympatheticganglia.Sothetoxicitiesareintolerable.Trimethaphancamsilate（樟磺咪芬）:poolthebloo

5、dincapacitancevessels.使血管舒张，血压明显下降；仅用于手术中控制性降压。Ganglionblockingagents（神经节阻滞药）血管的神经支配缩血管神经纤维:交感缩血管纤维舒血管神经纤维：交感舒血管神经纤维：以乙酰胆碱为递质。副交感舒血管神经纤维：以乙酰胆碱为递质。脊髓背根舒血管纤维：以局部活性多肽如降钙素相关基因肽介导。BrainstemorspinalcordPre-ganglionicneuronGanglionictransmitterPost-ganglionicneuronNeuroeffec

6、tortransmitterEffectororganEfferentneuronsofANSAchN1receptorNE12receptorAdrenoceptoragonists,receptoragonistsepinephrine(adrenaline)，dopamine,ephedrine(2)receptoragonists12receptoragonists:norepinephrine（升压药）1receptoragonists:phenylephrine（升压药）2receptoragonis

7、ts:clonidine（抗高血压）(3)receptoragonists：12receptoragonists:isoproterenol1receptoragonists:dobutamine2receptoragonists:salbutenolDrugactionsandclassificationAdrenoceptorantagonists（1）receptorantagonists12receptorantagonists:short-acting:phentolaminelong-acting:ph

8、enoxybenzamine（用于外周血管痉挛性疾病）1receptorantagonists:prazosin（抗高血压）2receptorantagonists:yohimbineDrugactionsandclassificationMe