浙江大学医学院：《药理学 Pharmacology》课程教学资源（PPT讲稿）支气管扩张药 Bronchodilators

Bronchodilators 支气管扩张药) 2013-4-3

Bronchodilators (支气管扩张药) 2013-4-3

Drugs acting on respiratory system Cough antitussive drugs centrally acting peripherally acting Sputum expectorant drugs sputum-diluting drugs mucolytic drugs Asthma antiasthmatic drugs bronchodilators 阝 receptor agonists theophyllines muscarinic antagonists anti-inflammatory drugs glucocorticosteroids mediator release inhibitors

Drugs acting on respiratory system Cough antitussive drugs centrally acting peripherally acting Sputum expectorant drugs sputum-diluting drugs mucolytic drugs Asthma antiasthmatic drugs bronchodilators  receptor agonists theophyllines muscarinic antagonists anti-inflammatory drugs glucocorticosteroids mediator release inhibitors

Antiasthmatic drugs Immunological and non-immunological stimuli Airway inflammation bronchoconstriction glucocorticosteroids B2receptor agonists disodium theophylline cromoglycate muscarinic antagonists leukotriene modifiers Airway hyperresponsiveness Wheezing(asthmatic symptoms)

Antiasthmatic drugs Airway inflammation bronchoconstriction Airway hyperresponsiveness Immunological and non-immunological stimuli Wheezing (asthmatic symptoms) glucocorticosteroids disodium cromoglycate leukotriene modifiers 2 receptor agonists theophylline muscerinic antagonists

Antiasthmatic drugs Blood Vessel ucus Transp Ire Cationic Proteins Epithelium Epitiglail Cell D:g9) Recruiting Edg ncreased ■■■圆口■■■圆口■口口 Increased Release of Tachykinins secretion Sensory C Fibers E Inflammatory Cells, E(Mast Cells, Eosinophils ■■■■口■■■■■■■■■■■ Smooth muscle Cysteinyl Leukotrienes ■■■■口■■■■ Contraction and Proliferation Airway pathological changes in pathogenesis of bronchial asthma

Antiasthmatic drugs Airway pathological changes in pathogenesis of bronchial asthma

Antiasthmatic drugs Plasma leak and edema Goblet cell discharg Antigens、 Epithelial shedding T lymphocyte Neutrophil Sense Eosinophil Effete Macrophage Airway pathological changes in pathogenesis of bronch

Antiasthmatic drugs Airway pathological changes in pathogenesis of bronchial asthma

3 Antiasthmatic drugs Why asthma makes it hard to breathe Air enters the respiratory system from the nose and mouth and travels through the bronchial tubes In a non-asthmatic person, In an asthmatic person, the the muscles around th muscles of the bronchial tubes bronchial tubes are relaxed tighten and thicken, and the and the tissue thin air passages become allowing for easy inflamed and mucus. airflow difficult for air to move Inflamed bronchial tube of an asthmatic Normal bronchial tube

3. Antiasthmatic drugs

3 Antiasthmatic drugs Alertor macrophage dendritic ce 新 Mast cell 8少 Mucus plug Epthelial shedding nm mmm nn m ghm Nerve h n m n o activation oOOO Subepithelial fibrosis s Fibroblast Sensory nerve MurIS activation hypersecretion Plasma leakage Hyperplasia Edema cholinergic angiogenesis Bronchoconstriction Airway Hypertrophy/hyperplasia smooth musce Subcutaneous layer

3. Antiasthmatic drugs

Antiasthmatic drugs 口 Bronchodilators β Receptor agonists o Non-selective adrenaline, isoprenaline β2- selective: D moderate-acting: salbutamol, terbutaline D long-acting: salmeterol, formoterol D Theophyllines: aminophylline D Muscarinic antagonists: ipratropium bromide

Antiasthmatic drugs Bronchodilators  Receptor agonists Non-selective：adrenaline, isoprenaline 2-selective: moderate-acting: salbutamol, terbutaline long-acting: salmeterol, formoterol Theophyllines: aminophylline Muscarinic antagonists: ipratropium bromide

Drugs used in the treatment ofasthma Classification in Grash Course: Respiratory system (2nd Edition) Relievers Bronchodilators 阝 e agonists short-acting: salbutamol, terbutaline long-acting: salmeterol, formoterol Anticholinergics(muscarinic antagonists) ipratropium bromide Xantines(theophyllines): aminophylline

Drugs used in the treatment of asthma - Classification in Grash Course: Respiratory system (2nd Edition) - Relievers - Bronchodilators 2 agonists short-acting: salbutamol, terbutaline long-acting: salmeterol, formoterol Anticholinergics (muscarinic antagonists): ipratropium bromide Xantines (theophyllines): aminophylline

支气管扩张药 主要是解除支气管痉挛,控制哮喘急性发作,但无抗炎 作用。 由于支气管扩张剂作用快而明显,易被患者接受,但不 能过度依赖这些缓解症状的药物。 中重症哮喘患者在用β2受体激动剂时,应和皮质激素同 时吸入,双管齐下,才能取得较好的疗效

主要是解除支气管痉挛，控制哮喘急性发作，但无抗炎 作用。 由于支气管扩张剂作用快而明显，易被患者接受，但不 能过度依赖这些缓解症状的药物。 中重症哮喘患者在用β2受体激动剂时，应和皮质激素同 时吸入，双管齐下，才能取得较好的疗效。 支气管扩张药