解热抗炎药(中英双语)PPT课件.ppt
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1、1,解热镇痛抗炎药,Antipyretic-analgesic and anti-inflammatory drugs,2,Teaching goals,1、简述阿司匹林的作用、用途、不良反应。 2、简述对乙酰氨基酚的作用特点。 3、比较解热镇痛药与氯丙嗪在降温方面的 作用和应用。 4、比较解热镇痛药与镇痛药在镇痛方面的 作用和应用。,3,1 Introduction,【Definition】 1. -have strong antipyretic effects 2. -have analgesic effects 3. -some have anti-inflammatory and an
2、ti-rheumatic effects. (一类具有解热、镇痛,且大多数 还有抗炎、抗风湿作用的药物),4,膜磷脂,PLA2,花生四烯酸,白三烯等,环内过氧化物,环氧化酶,糖皮质激素,(-),解热镇痛抗炎药,(-),甾体抗炎药 SAIDs,非甾体抗炎药NSAIDs,【mechanism】,vessal,PGI2,PGF, PGE等,platelet,TXA2,non-steroidal anti-inflammatory drugs,5,PG:,a group of autacoids,- lead to inflammation, pain and fever.,NSAIDs 环氧化酶(C
3、OX) 前列腺素(PG)合成 解热、镇痛、抗炎,(是自体活性物质,可致炎、致痛、致热),6,细菌毒素 病毒等,粒细胞 吞噬、处理,产生 释放,内热原,CNS PG合成与释放,体温调定点,370C,发热,NSAIDs COX (-)PG合成,【common pharmacological actions】,一. Antipyretic action (解热作用),7,Properties :,1. temperature of patients with fever (只降发热者体温) 2. independent of environment temperature (降温作用与环境温度无关)
4、 3. increase heat dissipation mainly. (主要增加散热),8,Meaning of pyretic (发热利弊) :,Advantages : 1. -enhance the defense function. (提高机体防御功能) 2. diagnosis of diseases (热型是诊断的依据).,9,0,40 0c,37 0c,1 2 3 4 5,day,低热,稽留热,弛张热,T,10,disadvantages : high fever CNS function disorders e.g. convulsion(惊厥) durative fev
5、er consume physical energy (持续发热,消耗体能),11,Uses notes,1. T 39c (especially for children) 2. durative fever that has been diagnosed clearly.(诊断明确的持久发热) 3. fever with obvious pain. (发热伴明显疼痛者) 4. symptomatic treatment only (仅为对症治疗),12,组织损伤 局部炎症,局部释放,致痛物质 BK、PG等,(+),痛觉 感受器,疼痛,痛觉增敏,NSAIDs,NSAIDs COX PG sy
6、nthesis PG致痛及痛觉增敏analgesia (镇痛),二. Analgesic action (镇痛作用),13,Properties :,1)moderate analgesics (镇痛作用中等 ) 2)-be well for chronic pain and inflammatory pain (炎性疼痛及慢性钝痛效佳) 3)no addiction and no respiratory depression (不成瘾,不抑制呼吸),14,三. Anti-inflammatory action (抗炎作用),Prostaglandins (PG) : 1. - dilate
7、blood vessels. (扩血管) 2. vascular permeability (血管的通透性) e.g. tissue edema 3. synergy with other inflammatory mediators. (协同其它炎症介质的作用 ),NSAIDs COX PG antiinflammation,15,Properties :,1. symptomatic treatment only e.g. relieve redness, swelling, heat and pain (对症治疗,可明显改善红、肿、热、痛) 2. -do not arrest the p
8、rogression of pathological injury to tissue and occurrence of complications. (不能阻止病程进展及合并症的发生) 3. Acetaminophen has no anti-inflammatory action. (苯胺类药无抗炎作用),16,COX:,COX,COX-1:,COX-2:,结构型,血管、胃、肾等,诱导型,损伤性刺激诱导其作用,NSAIDs,非选择性环氧酶抑制药,选择性环氧酶抑制药,17,Classification of drugs:,水杨酸类: aspirin(阿司匹林) 苯胺类:acetaminop
9、hen(对乙酰氨基酚) 吲哚类:indomethacin(吲哚美辛) 芳基丙酸类:ibuprofen(布洛芬) 其它类:双氯芬酸、保太松等,2 Non-selective COX inhibitors,18,I. Salicylates (水杨酸类),Aspirin (阿司匹林) Acetylsalicylic acid(乙酰水杨酸),19,【pharmacokinetics】,-be absorbed rapidly. distribution wide - salicylate (水杨酸盐分布广泛) 3. elimination(消除) : doses 1g : zero order ki
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