药理学教学课件：Chapter 18 Drugs Used for Treatment of Mental Disorders.ppt

【Adverse Reaction】 A Nausea、Vomitting、Diarrhea and Limb Fibrillation etc； B Thyroid Enlargement； C Poisoning → Muscular Fibrillation、Ataxia and Coma etc. Safety range： 0.8-1.2 mmol/L（Therapeutic Concentration） 1.5 mmol/L （Emergence of Poisoning） 2.0 mmol/L （Severe Poisoning） Antidepressant Drugs I Tricyclic Antidepressant Drugs Imipramine 【Pharmacological Effect】 A Effects on CNS Hearten spirit， Block the retake of NE、5-HT at the ending of nerve. Antidepressant，Show effects slowly. Effects on Autonomic Nervous System Block M R obviously. Effects on Cardiovascular System Induce orthostatic hypotension、arrhythmia etc. 【 The In Vivo Process 】 Absorption: Absorbed well by P.O. Distribution: Distributed extensively Elimination: Metablized in liver and Excreted by kidney. 【 Clinical Application 】 A Depression Good effects to endogenous depression、 climacteric depression. B Enuresis C Anxiety and Phobia 【Adverse Reaction】 A Anti-choline Symptoms Dry mouth、Constipation、Blurred vision and Palpitations. B Dysorder in liver function 、Orthostatic Hypotension、Agranulocytosis C Others：Hyperhidrosis、Dizzyness、Insomnia、Ataxia etc. Doxepin Having strong effects of antianxiety. Especially suitble to the treatment of depression with anxiety. Others: Amitriptyline Clomipramine Comparison of characteristics of commonly used TCAs Drugs t1/2(h) Inhibition Effects on Reuptake 5-HT NE Sedation Anticholinergic Action Imipramine 　 9~24 ++ ++ ++ ++ Desipramine 　 14~76 0 +++ + + Amitrptyline　17~40 +++ + +++ +++ Doxepin 8~2