《精神病学 Psychiatry》课程教学课件（PPT讲稿）抗精神失常药 Antipsychotic Drugs

Antipsychotic Drugs抗精神失常药

Antipsychotic Drugs 抗精神失常药

PsychotropicDrugsClassification:antipsychotic drugs 抗精神病药物neurotropic drugs 神经安定剂antimanicdrugs抗躁狂药物antidepressants抗抑郁药物anxiolytics抗焦虑药物

Psychotropic Drugs 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

AntipsychoticdrugsSchizophrenia精神分裂症literal translation “"split mind"separate emotionalsidefrom intellectual sideemotional&cognitiveprocessesdon'tfunctiontogether a group of severe disorders characterized by:disorganizedanddelusionalthinking（妄想）-disturbed perceptionsinappropriateemotions &action

Antipsychotic drugs Schizophrenia 精神分裂症 ◼ literal translation “split mind” ◼ separate emotional side from intellectual side ◼ emotional & cognitive processes don't function together ◼ a group of severe disorders characterized by: ◼ disorganized and delusional thinking（妄想） ◼ disturbed perceptions ◼ inappropriate emotions & action

Natureof psychosis/schizophreniaThe dopamine hypothesisexcessive dopaminergic activity playsa role in the disorder.The enhancement of function of 5-HT,Dopaminergic Systems The nigrostriatal pathway (coordination ofvoluntary movement)

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 ( eatingbehavior)

◼ Mesolimbic- mesocortical ( behavior ) ◼ Tuberoinfundibular- pituitary system (endocrine) ◼ The medulla oblongata (vomit) ◼ Medullary - periventricular pathway ( eating behavior)

Antipsychotic drugsClassification:Phenothiazin盼噻嗪类（氯丙嗪chloropromazine）Thioxanthenes 硫杂葱类（chlorprothixene氯普噻吨（泰尔登））Butyrophenones丁酰苯类(haloperidol氟哌啶醇）Others

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/NeurolepticsPhenothiazin吩噻嗪类chlorpromazine氯丙嗪CHCH,CH2N(CH3)2（wintermine冬眠灵）Pharmacologiceffectsblocking DA2 、α、M、5HT2、H, receptors

Antipsychotic/Neuroleptics Phenothiazin 吩噻嗪类 chlorpromazine 氯丙嗪 (wintermine 冬眠灵) Pharmacologic effects blocking DA2 、α 、 M 、 5HT2 、 H1 receptors

neurolepticeffect（神经安定作用）>BlockingMesolimbic system and mesocorticalD2-R> More effective for treating positive symptom> Substantia nigra- corpus striatum---extrapyramidaleffects锥体外系反应>Node-funnel ---endocrine system action

◼ 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

powerfulantiemeticaction镇吐作用blockingCTZ催吐化学感受区D2-R(small dosage)directly inhibiting vomiting center 呕吐中枢(large dosage)alteringtemperature-regulatingmechanismsdecrease temperature no matter normal or hightemperaturebody temperature varies with the environment

◼ 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

autonomicNS effectsblockinga-Rvasodilatation“epinephrine reversal"blockingM-Ratropine-like actionendocrinesystemactionincreasingprolactin催乳素 secretioninhibitinggonadotropichormone促性腺激素,growthhormone生长激素secretion

◼ autonomic NS effects ◼ blocking α-R vasodilatation “epinephrine reversal” ◼ blocking M-R atropine-like action ◼ endocrine system action increasing prolactin催乳素 secretion inhibiting gonadotropic hormone促性腺激素， growth hormone生长激素 secretion