浙江大学医学院：《药理学 Pharmacology》课程教学资源（PPT课件）呼吸系统疾病治疗药物 Drugs for treatment of respiratory

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

vc arrows d seases Alveoli fill with thick fluid making gas exchange difficult. respiratory ystem Fibrous connective tissue builds lungs, reducing their Common tubercle symptoms: sputum Tubercles encapsulate bacteria, and elasticity of lungs is reduce wheezing mucus Emphysema Bronchiti Alveoli burst and fuse into Airways are inflame enlarged air spaces, Surface area to infection(acute for gas exchange is reduce Asthma imitant(chronic). Coughing brings Airways are inflamed due to up mucus and pus

Classification of drugs acting on respirator ory system Cough: I. Antitussive drugs Sputum: II. Expectorant drugs Asthma: II. Antiasthmatic drugs

Cough: Ⅰ. Antitussive drugs Sputum: Ⅱ. Expectorant drugs Asthma: Ⅲ. Antiasthmatic drugs

Classification of drugs acting on respiratory system I. Antitussive drugs Centrally acting Codeine Peripherally acting: Benzonatate II. Expectorant, drugs iputum-diluting g drugs:NH4c、Kr Mucolytic drugs: Ambroxol Ill. Antiasthmatic drugs Bronchial dilators B receptor agonists: Salbuterol heophyllines: Aminophylline muscarinic antagonists: Ipratropine 2. Anti-inflammatory drugs lucocorticosteroids: Budesonide editor release inhibitors Disodium cromoglycate

Ⅰ. Antitussive drugs: 1. Centrally acting: Codeine 2. Peripherally acting: Benzonatate Ⅱ. Expectorant drugs: 1. Sputum-diluting drugs: NH4Cl、KI 2. Mucolytic drugs: Ambroxol Ⅲ. Antiasthmatic drugs: 1. Bronchial dilators (1) receptor agonists: Salbuterol (2)theophyllines: Aminophylline (3)muscarinic antagonists: Ipratropine 2. Anti-inflammatory drugs (1)glucocorticosteroids: Budesonide (2)mediator release inhibitors: Disodium cromoglycate Classification of drugs acting on respiratory system

A. Antitussives Central antitussives Narcotic drugs codeine可待因 pholcodine福尔可定 Drotebanol羟蒂巴酚 ◆ Non-Narcotic drugs dextromethorphan右美沙芬 pentoxyverine喷托维林(咳必清) o Peripheral antitussives benzonatate苯佐那酯

A. Antitussives

物理、化 感受器(刺激感受器、牵张感 学刺激 +受器等) 传入神经(迷走、喉上神经) 咳嗽中枢(延髓) 传出神经(迷走、喉返、膈神经) 效应器(声门、 咳嗽反射 呼气肌) 咳嗽反射示意图

物理、化 学刺激 感受器（刺激感受器、牵张感 受器等） 传入神经（迷走、喉上神经） 咳嗽中枢（延髓） 传出神经（迷走、喉返、膈神经） 效应器（声门、 呼气肌） 咳嗽反射 咳嗽反射示意图

The structures labeled The structures labeled on the left are to be on the right are to be associated with inspiration respiratory associated with expiration center Respiratory center motor Centrally acting pathways vagus nerve antitussives sensory pathway phrenic nerve external ptors intercostal of alveoli muscles Sensory nerves intercostal nerve lly acting Peripherally antitussives Motor nerves diaphrag

Motor nerves Centrally acting antitussives Peripherally acting antitussives

Narcotic Antitussives Codeine可待因 HcO CH3 HO

Narcotic O N CH3 HO H3CO

Narcotic Antitussives 1. Pharmacological effects suppression of cough(1/4 of morphine) analgesia(1/7-1/10 of morphine) 2. Clinical uses Cough without sputum 3. Adverse effects Respiratory depression(at larger doses) Addiction Contraindicated in patients with thick sputum

Narcotic

Narcotic Antitussives Other narcotic antitussives 今 Dihydrocodeine(双氢可待因) Drotebanol(羟蒂巴酚) Pholcodine(福尔可定)

Other narcotic antitussives: v Dihydrocodeine（双氢可待因）; v Drotebanol（羟蒂巴酚）; v Pholcodine（福尔可定） Narcotic