〖医学〗精神分裂症七教材-课件.ppt

Chapter 25 Antipsychotic Drugs Antipsychotic drugs Schizophrenia 精神分裂症 literal translation “split mind” separate emotional side from intellectual side emotional cognitive processes dont function together a group of severe disorders characterized by: disorganized and delusional thinking（妄想） disturbed perceptions inappropriate emotions action Psychotropic Drugs 抗精神失常药 Classification： antipsychotic drugs 抗精神病药物 neurotropic drugs 神经安定剂 antimanic drugs 抗躁狂药物 antidepressants 抗抑郁药物 anxiolytics 抗焦虑药物 Nature of psychosis /schizophrenia The dopamine hypothesis excessive dopaminergic activity plays a role in the disorder. The enhancement of function of 5-HT2 Dopaminergic Systems The nigrostriatal pathway (coordination of voluntary movement ) Mesolimbic- mesocortical ( behavior ) Tuberoinfundibular- pituitary system (endocrine) The medulla oblongata (vomit) Medullary - periventricular pathway ( eating behavior) Antipsychotic drugs Classification： Phenothiazin 吩噻嗪类 (氯丙嗪 chloropromazine ) Thioxanthenes 硫杂蒽类 (chlorprothixene 氯普噻吨（泰尔登）) Butyrophenones 丁酰苯类 (haloperidol 氟哌啶醇) Others Antipsychotic/Neuroleptics Phenothiazin 吩噻嗪类 chlorpromazine 氯丙嗪 (wintermine 冬眠灵) Pharmacologic effects blocking DA2 、α 、 M 、 5HT2 、 H1 receptors neuroleptic effect (神经安定作用) Blocking Mesolimbic system and mesocortical D2-R More effective for treating positive symptom Substantia nigra- corpus striatum ---- extrapyramidal effects 锥体外系反应 Node-funnel --- endocrine system action powerful antiemetic action 镇吐作用 blocking CTZ 催吐化学感受区 D2-R (small dosage) directly inhibiting vomiting center 呕吐中枢 (large dosage) altering temperature-regulating mechanisms decrease temperature no matter normal or high temperature body temperature varies with the environment autonomic NS effects blocking α-R vasodilatation “epinephrine reversal” blocking M-R at