Antipsychotic Drugs 抗精神失常药
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
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
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 ( eating behavior)
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/Neuroleptics Phenothiazin 吩噻嗪类 chlorpromazine 氯丙嗪 (wintermine 冬眠灵) Pharmacologic effects blocking DA2 、α 、 M 、 5HT2 、 H1 receptors
◼ 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
◼ 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
◼ 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