第13章 镇静催眠药 SEDATIVE-HYPNOTICS DRUGS
1 第13章 镇静催眠药 SEDATIVE- HYPNOTICS DRUGS
§1 Introduction 失眠(insomnia) 失眠分类 30 (①)按病程的长短分： ①暂时性失眠 ②短期失眠 ③慢性失眠 Mr.Insomnia (2)按病因分： 原发性失眠症 继发性失眠症
2 失眠(insomnia) 失眠分类 (1) 按病程的长短分: ①暂时性失眠 ②短期失眠 ③慢性失眠 (2) 按病因分: 原发性失眠症 继发性失眠症 §1 Introduction
What is insomnia? Insomnia inability to fall or remain asleep Struggle to fall asleep at night (initial insomnia), Wake in the middle of the night and struggle to fall asleep again(middle insomnia). Wake in the early hours of the morning,long before they need to get up(terminal insomnia)
3 What is insomnia? Insomnia, inability to fall or remain asleep Struggle to fall asleep at night (initial insomnia), Wake in the middle of the night and struggle to fall asleep again (middle insomnia). Wake in the early hours of the morning, long before they need to get up (terminal insomnia)
失眠的病因 1 环境因素 2 生活习惯因素 3 躯体因素 4 精神心理因素 5精神疾病 6 药物原因 7 年龄因素 8 与睡眠相关疾病
4 失眠的病因 1 环境因素 2 生活习惯因素 3 躯体因素 4 精神心理因素 5 精神疾病 6 药物原因 7 年龄因素 8 与睡眠相关疾病
■Anxiety is the sense of threat that danger and bad events is coming. ■Anxiety can be thought of as consisting of anxious thinking plus nervous tension. Mr.Anxiety
5 ◼ Anxiety is the sense of threat that danger and bad events is coming. ◼ Anxiety can be thought of as consisting of anxious thinking plus nervous tension. Mr. Anxiety
Causes of Anxiety 1)Medical: a)Respiratory b)Endocrine c)Cardiovascular d)Metabolic e)Neurologic
6 Causes of Anxiety 1) Medical: a) Respiratory b) Endocrine c) Cardiovascular d) Metabolic e) Neurologic
Causes of Anxiety 2).Drug-Induced: ■Stimulants Amphetamines,cocaine,caffeine. ■Sympathomimetics Ephedrine,epinephrine Anticholinergics\Antihistaminergics benztropine,meperidine Dopaminergics Amantadine,L-Dopa
7 Causes of Anxiety 2). Drug-Induced: ◼ Stimulants ◼ Amphetamines, cocaine, caffeine. ◼ Sympathomimetics ◼ Ephedrine, epinephrine ◼ Anticholinergics\Antihistaminergics ◼ benztropine, meperidine ◼ Dopaminergics ◼ Amantadine, L-Dopa
焦虑症状，除烦躁不安、紧张焦虑、恐惧失眠等精 神异常外，还出现植物神经功能紊乱，心悸、多汗 呼吸急促、尿频尿急等 焦虑障碍 广泛性焦虑障碍(GAD) 社交焦虑障碍(SP) 惊恐障碍(PD) 强迫障碍(OCD) 创伤应激障碍(PTSD)
8 焦虑症状，除烦躁不安、紧张焦虑、恐惧失眠等精 神异常外，还出现植物神经功能紊乱，心悸、多汗 ，呼吸急促、尿频尿急等 焦虑障碍 广泛性焦虑障碍（GAD） 社交焦虑障碍（SP） 惊恐障碍（PD） 强迫障碍（OCD） 创伤应激障碍（PTSD）
Sedative 缓解烦躁不安→安静 小剂量 剂量 入睡困难/容易 ↑觉醒次数/减少 ↑剂量 睡眠时间短/延长 Hypnotics:改善睡眠障碍 →促进与维持近似生理睡眠
9 Sedative : 缓解烦躁不安→安静 剂量 入睡困难/ 容易 ↑觉醒次数/ 减少 睡眠时间短/ 延长 Hypnotics : 改善睡眠障碍 →促进与维持近似生理睡眠 小剂量 ↑剂量
Normal Relief from Anxiety 创 SEDATION (Drowsiness/decrease reaction time) 》 HYPNOSIS Confusion,Delirium,Ataxia 创 Surgical Anesthesia 剑 Depression of respiratory and vasomotor center in the brainstem COMA DEATH 10
10 Normal Relief from Anxiety _________ _________________ SEDATION (Drowsiness/decrease reaction time) HYPNOSIS Confusion, Delirium, Ataxia Surgical Anesthesia Depression of respiratory and vasomotor center in the brainstem COMA DEATH