浙江大学医学院：《药理学 Pharmacology》课程教学资源（PPT讲稿）Drugs for treatment of respiratory diseases

Drugs for treatment of respiratory diseases Huifang Tang Department of pharmacology Zhe jiang University,school of medicine tanghuifang@zju.edu.cn Research building C422 2012-3-28

Huifang Tang Department of pharmacology Zhejiang University, school of medicine tanghuifang@zju.edu.cn Research building C422 2012-3-28

Antiasthmatic drugs Why asthma makes it hard to breathe Bronchial asthma Air enters the respiratory syste inflammation from the nose and mouth and travels through the bronchial tubes bronchoconstriction airway hyperresponsiveness In a non-asthmatic person In an asthmatic person, the the muscles around the muscles of the bronchial tube bronchial tubes are relaxed tighten and thicken, and the and the tissue thin air passages decor allowing for easy inflamed and mucus airflow filled, making it difficult for air to move Pathophysiology Asthma Asthmatic Lung Inflamed bronchial tube of an asthmatic Normal bronchial tube

Bronchial asthma： inflammation; bronchoconstriction; airway hyperresponsiveness

Antiasthmatic drugs Immunological and non-immunological stimuli Airway inflammation bronchoconstriction glucocorticosteroids P2 receptor agonists disodium cromoglycate theophylline leukotriene modifiers muscarinic antagonists Airway hyperresponsiveness Wheezing(asthmatic symptoms)

Antiasthmatic drugs Blood vessel Decreased Mucus Trarsport Airway Cationic Proteins pithelrum Epitiigliail Cell [EIge Recruitment EdemA Increased Increased Release Mucus of Tachykinins a:/ Sensory C F Ibers E Inflammatory cellsas E(Mast Cells, Eosinophils 甲■■口■■■■■■_■■_■口■ Smooth muscle Cysteiny l Leukotriene ■ ■■■■口 ■ Contraction and Proliferation Airway pathological changes in pathogenesis of bronchial asthma

Antiasthmatic drugs

Antiasthmatic drugs Plasma leak and edema Goblet cell discharge Antigens t Epithelial shedding T lymphocyte Neutrophil Sensory nerve Eosinophil Efferent nerve Macrophage Airway pathological changes in pathogenesis of bronchial asthma

Antiasthmatic drugs

Drugs used in the treatment of asthma Classification in Grash Course: Respiratory system(2nd Edition) a Relievers Bronchodilators P2 agonists short-acting: salbutamol, terbutaline long-acting: salmeterol, formoterol Anticholinergics(muscarinic antagonists): ipratropine Xantines(theophyllines): aminophylline a Preventers- Anti-inflammatory drugs Glucocorticosteroids: Inhaled steroids: beclomethasone, budesonide, fluticasone oral steroids: hydrocortisone, prednisone, dexamethasone Leukotriene(LT) receptor antagonists (leukotriene modifiers) LT antagonists: montelukast(孟鲁司特), zafirlukast(扎鲁司特 5- lipoxygenase inhibitors: zileuton(齐留通 Inhibitors of mediator release: cromolyn sodium, nedocromil

Drugs used in the treatment of asthma - Classification in Grash Course: Respiratory system (2nd Edition) -

Antiasthmatic drugs Glucocorticosteroids Systemic hydrocortisone氩化可的松 prednisone波尼松 dexamethasone地塞米松 Inhaled: beclomethasone dipropionate二丙酸倍氯米松 budesonide布地奈德 triamcinolone acetonide曲安奈德 fluticasone propionate丙酿酸氟普卡松 flunisolide尼缩松

Antiasthmatic drugs

Adrenocorticoid drugs Adrenocortical hormones MG neralocorticoids lucocorticoids "(Glucocorticosteroids) 冷 Sex hormones

Adrenocorticoid drugs vAdrenocortical hormones v Mineralocorticoids v Glucocorticoids v (Glucocorticosteroids) v Sex hormones

条经 Zona Glomerulosa P450 aldo AⅡ Aldosterone K ACTH P450 Zonae 11B Fasciculata/ P450 170 Reticularis Cortisol Androgens Medulla &2a careEN OSE

A. Glucocorticoid drugs 1. Pharmacological effects Mechanisms of glucocorticoid actions (1) Effects on metabolisms .(2 Permissive action (3)Anti-inflammatory effects (4)Effects on immune and allergy ( 5)Anti-shock (6Other effects antipyretic effects effects on blood and blood-forming organs skeletal system CNS effects

A. Glucocorticoid drugs