Drugs that act in the central nervous system (1). Introduction to the pharmacology of CNS drugs. Cortex （ 皮质 ）. evolutionally formed last receiving and processing information, control of sight, listening, movement, memory, wake, autonomic function. Limbic system （ 边缘系统 ）.
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Drugs that act in the central nervous system
Introduction to the pharmacology of CNS drugs
A group of interconnected deep brain structures, common to all mammals, and involved in olfaction, emotion, motivation, behavior, and various autonomic functions.
hippocampus海马、amygdala杏仁、septal area膈区、basal ganglia基底节
responsible for the regulation and coordination of complex voluntary muscular movement as well as the maintenance of posture and balance.
The cerebellum has been reported to play a role in psychiatric conditions such as schizophrenia, autism, mood disorders, dementia, and attention deficit hyperactivity disorder(ADHD).
The diencephalon is a complex of structures within the brain, whose major divisions are the thalamus and hypothalamus. It functions as a relay system between sensory input neurons and other parts of the brain, as an interactive site for the central nervous and endocrine systems, and works in tandem with the limbic system.
central part of the brain, under the cortex and basal ganglion and above the hypothalamus
relay station of senses
hypothalamus下丘脑 ：integrative area of autonomic nerve
regulation of temperature, water balance, metabolism, blood pressure, circadian rhythm, sex activity, sleeping, etc
Midbrain and brain stem：
tegmentum(被盖），ascending reticular activating system, NTS, area postrema
regulation of sleeping, wake, eye movement, vomiting, cardiovascular and respiratory reflex
pathways of senses and movement；autonomic reflex
mesolimbic pathway: memory and motivating behaviors
mesocortical pathway: thinking and schizophrenia
nigrostriatal pathway: motor control
tuberoinfundibular pathway: hormones secretion
Cellular organization of the brain
Ion channels and receptors
1, voltage-gated channels: fast responses
2, ligand-gated channels (ionotropic receptors 离子型受体）
3，metabotropic receptors（促代谢型受体）, G protein related, indirectly modulate the voltage-gated channels: slow, diversity
The synapse and synapse potentials
Pre-synaptic action potential→voltage-sensitive calcium channels → Ca2+ into the terminals → transmitter release → acting at the receptors post-synaptically → EPSP or IPSP
Sites of drug action
1, presynaptic action potential
3, storage 7, degradation
4, metabolism 8, receptor
5, release 9, ionic conductance
Cellular organization of the brain
neurotransmitters at central synapses
5-HT: serotonin; 5-hydroxytrptamine
GABA: γ-aminobutyric acid
Opioid peptides 阿片样肽
Modulators 调质: to modulate the response of a neuron to a neurotransmitter or hormone
Transmitter and modulator, action changeable sometimes
Chapter 11 General anesthetics
General anaesthesia全麻: a state characterized by unconsciousness, analgesia, amnesia, skeletal muscle relaxation and loss of reflexes.
different from pain relieving
Any other method for pain-relieving for operation?
blood:gas partition coefficient
blood/gas partition coefficient is the ratio of the amount dissolved in blood to the amount in the same volume of gas in contact with that blood.
The more blood-soluble the agent (high blood-gas partition coefficient), the slower the onset of effect and the slower the patient goes to sleep
new inhaled anesthetics have low partition coefficient
MAC(minimum alveolar concentration):the anesthetic concentration that produces immobility in 50% of patients exposed to a noxious stimulus.
To be demonstrated
action: depressing spontaneous and evoked activity of neurons
Advantages of inhaled anesthetics:
short induction period (in seconds)
almost no local irritation and side effects
satisfactory muscular relaxation
easy to adjust depth of anesthesia
Clinical uses: combined use with intravenous anesthetics for operation anesthesia
Intravenous anesthetics: thiopental, midazolam, opioid anagesics, propofol, ketamine
1, induction of anesthesia
2, small operation when used only
widely used in the middle of last century; rapid intravenous administration may lead to inhibition of breathing
抑制丘脑- 新皮质系统, 选择性地阻断痛觉
dissociative anaesthesia 分离麻醉
2004.7 SFDA 一类精神药品管理
Concepts of combined anesthesia