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Transcript
8 Choline receptor blockers Section 1 : Today, we have to learn is cholinergic receptor blockers . According to the subject that this is a drug capable of blocking cholinergic receptors . Cholinergic receptors , including M, N receptors. Since it is a description of these drugs and blocking cholinergic receptor binding does not have an effect . Section 2 : In this chapter the pharmacological effects of traditional Chinese medicine master atropine , clinical applications, mechanisms of action, adverse reactions. Also need to be familiar anisodamine and scopolamine role characteristics and clinical application . Section 3 : cholinergic receptor blockers include M cholinergic receptor blockers and N cholinergic receptor blockers . Section 4 : In the M cholinergic receptor blockers , in accordance with different sources, we again divided into natural alkaloids these drugs , on behalf of drug atropine and scopolamine ; semi-synthetic derivatives and synthetic drugs, in clinical homatropine drug representatives , pirenzepine equality. Section 5 : M cholinergic receptor blockers has several subtypes , soon to learn Atropine is a non-selective M cholinergic receptor blockers , M receptor subtypes it can stop a few broken . Section 6 : Next we focus to learn atropine and knowledge about this class of drugs. 1 Section 7 : You are now seeing these pictures is scopolamine , belladonna and datura , an alkaloid extracted from them with M receptor blocking effect. Which mandala in our school garden where you can see, it's taste is not very good . In ancient times, a number of aristocratic women would use the sap of these plants come eye drops , the purpose is to let the eye dilated pupils, prettier . Why ? Immediately give everybody talked about why. Section 8 : this picture is . Schools there are such plants . Interested students can go and see . Section 9 : Reading PPT Section 10 : M cholinergic receptor blockers action principle from this picture have a good understanding . Is actually very simple , originally acetylcholine receptor binding and produce an effect . However, these drugs such as atropine to acetylcholine position to account , so that can not acetylcholine receptor binding and M or N , while atropine can not have an effect . Section 11 : Understanding the mechanism of action , let's look at its pharmacological effects. Atropine M receptor , which will inhibit glandular secretion. And it can suppress the gland from this table that there is a strength difference. The dose can rarely on salivary glands, sweat glands produce a strong inhibitory effect , while the lacrimal gland, the gland respiratory inhibition is weaker more. Only the larger dose will 2 inhibit gastric secretion. Section 12 : This can better explain the inhibitory effect of atropine on the gland . Atropine on the salivary glands and sweat glands strongest inhibition , can cause dry mouth and dry skin. If you let the sweat glands inhibited fever, it is easy to cause heat stroke in the summer . Even in infants and young children can cause " atropine fever" , poisoning infant body temperature can reach 43 degrees Celsius. Followed by respiratory glands , can be used in pre-anesthetic administration , in order to prevent aspiration pneumonia . There was also this effect of scopolamine . Section 13 : We have talked about earlier in the iris sphincter has M receptor distribution . When this part of the M receptor blocked by atropine , the dominant open a large muscle , the outer periphery of the iris movement , making the pupil dilation . Meanwhile, the iris outer circumferential direction , its roots will thicken , and finally a narrow anterior chamber angle , hindering the return of aqueous humor , intraocular pressure caused by the accumulation of aqueous humor . In the ciliary muscle also has M receptor , when the ciliary muscle on the M receptor blocked by atropine , the outer periphery of the ciliary muscle relaxation relaxation, suspensory ligaments taut, the lens becomes flat , reducing refraction can not be close objects clearly imaged on the retina, to see near objects blurred, only suitable to see distant objects , this effect is called " adjustment paralysis " (mydriasis and cycloplegia). 3 Section 14 : atropine eye for these pharmacological effects of any use in clinical practice it ? Pupil dilation can miotics , such as pilocarpine treatment of iridocyclitis used interchangeably and fundus examination , but can also cause blurred vision , glaucoma disabled. Section 15 : atropine many visceral smooth muscle relaxation . For the best relief of gastrointestinal smooth muscle spasm , but note a very important point , biliary colic , renal colic occurs in combination with the needs and analgesics . Section 16 : The role of smooth muscle relaxation with atropine organs different and differences , but also to excessive spasm of visceral smooth muscle relaxation effect more pronounced. Therefore, in clinical biliary colic , renal colic to and pethidine in combination with pethidine reason alone would make smooth muscle spasm , and atropine on excessive spasm gentle and relaxing effect more apparent. Atropine to treat by relaxing the bladder detrusor bladder irritation , reducing the number of urine . But disabled in BPH patients . Section 17 : atropine can generate excitement for the heart , because the lifting of vagal inhibition of the heart , a larger dose of atropine causes increased heart rate . If a young man vagal control particularly strong , given a larger dose of atropine after the excitement of the heart 's performance will be more obvious . Section 18 : This is increased with the dose of atropine on the heart . You 4 can see the increase in heart rate after a dose increase . Section 19 : atropine on vascular dilatation can play , so when large doses of atropine causes skin vasodilation, manifested as skin flushing, warm and so on. But note that this effect is independent of M receptor and blocking . So in the end is what causes it ? There are two possible reasons : one , atropine itself can vasodilator ; Second, because atropine inhibit glandular secretion , fever occurs after the body's compensatory heat . Section 20 : atropine mainly excited for the main hub , only when the poisoning by the excitement into depression, generally reach toxic dose will happen after coma and respiratory paralysis, and finally died of circulatory and respiratory failure. Transition : According to the pharmacological effects of learning to see what are some of the clinical use of atropine . Section 21 : Reading PPT Section 22 : In the iridocyclitis when combined miotic so inflamed tissue adequate rest , is conducive to anti-inflammatory and analgesic ; atropine eye drops could make full paralysis of the ciliary muscle , lens fixed , testing out the exact diopter , with to optometry. But the effect of atropine on the eye for a long time , but in children with atropine optometry. Section 23 : atropine used to treat shock, large doses of atropine can 5 relieve vasospasm, peripheral vascular relaxation , but accompanied by high fever or rapid heart rate should not be used in patients. Section 24 : This is one of the pharmacological effects of atropine and clinical application of the summary. Section 25 : In fact, the pharmacological effects of atropine also converted to adverse reactions. Such as pupil dilation will be blurred vision, confusion caused by central nervous excitement , relaxation of visceral smooth muscle causes constipation and urinary retention. Section 26 : atropine has many uses in clinical , but when large doses can also cause poisoning after using . When atropine poisoning , how to save it ? According to Read ( Article 3 has been the attention to need to add two sentences ) one can not be excessive, so as atropine and central inhibition produced by these drugs synergy ; two , can not use phenothiazine drugs, because these drugs have M receptor blocking effects of atropine may aggravate symptoms of poisoning. Section 27\28 : Reading PPT Section 29 : atropine and anisodamine Anisodamine organ selectivity is better. Therefore, relatively small adverse reactions. Section 30 : that is derived from this plant alkaloids scopolamine , Chinese medicine is the main component of the Yangjinhua scopolamine . 6 Scopolamine and atropine on the central different, it is the inhibition of central , to have sedative and hypnotic effect, so we put it together in the clinical diphenhydramine motion sickness pills made use , the effect is better. It can not only inhibit glandular secretion and on central inhibition , so before anesthesia administration than atropine for good . Because it has a central role , so it can be used to treat Parkinson's disease. Section 31 : atropine and scopolamine on the central What is the difference ? Atropine is excited hub , and scopolamine is inhibited hub. Section 32 : This is a comparison of atropine. Section 33 : There is a problem to ask you , in the wild if ingested a poisonous mushroom , what will happen after poisoning symptoms, how to deal with ? Poisonous mushrooms are cholinergic receptor agonists , makes the body appear glandular secretion , restlessness, blurred vision, diarrhea and other symptoms of cholinergic receptors excited . Cholinergic receptor blockers can be used to fight , and wild plants have these alkaloids hyoscyamine , or mandala , can come to the rescue poisonous mushroom poisoning. Section 34 : The following drugs are synthetic. 7