Lub Mechanism Ntawm Kev Ua Ntawm Antipyretic, Analgesic Thiab Anti-inflammatory Drugs

Lub mechanism ntawm kev txiav txim ntawm antipyretic thiab analgesic tshuaj yog inhibit lub biosynthesis ntawm prostaglandins (PG) nyob rau hauv lub cev. PG yog ib tsev neeg ntawm 20 carbon unsaturated fatty acids uas muaj tsib lub nplhaib thiab ob sab chains, dav nyob rau hauv ntau yam ntaub so ntswg tseem ceeb thiab lub cev kua ntawm tib neeg thiab tsiaj txhu, thiab tuaj yeem tsim los ntawm ntau lub hlwb. Arachidonic acid (AA) yog lipid khi rau phospholipids hauv cell membrane, thiab nyob rau hauv qhov kev txiav txim ntawm phospholipase A2, AA tuaj yeem tso tawm los ntawm phospholipids. Muaj ob txoj hauv kev rau kev hloov pauv ntawm AA dawb: ib qho yog cov catalytic ntau lawm ntawm PGs, xws li PGE2, PGF2, PGI2, thiab thromboxane A2 (TXA2), los ntawm PG synthase (cyclooxygenase, COX) nyob rau hauv intracellular hais. Lawv koom nrog kev tswj hwm ntawm ntau yam kev noj qab haus huv thiab cov txheej txheem pathological, xws li mob, ua npaws, mob, coagulation, gastric acid secretion, nrog rau kev so thiab contraction ntawm cov leeg du hauv cov hlab ntsha, bronchi, thiab uterus; Lwm txoj hauv kev metabolic ntawm AA yog qhov catalysis ntawm lipoxygenase hauv cytoplasm los tsim cov leukotrienes (LTs), uas koom nrog kev tsis haum tshuaj, ua rau mob, txhim kho leukocyte thiab macrophage chemotaxis, thiab cov leeg nqaij leeg hauv bronchi thiab plab hnyuv. Cov khoom ntawm ob txoj kev metabolic ntawm AA muaj kev sib koom ua ke thiab kev txwv tsis pub muaj kev cuam tshuam (Daim duab 19-1). Tsis ntev los no, ob lub isoenzymes ntawm cyclooxygenase (COX), hu ua COX-1 thiab COX-2, tau raug tshawb pom (Table 19-1). COX-1 koom nrog hauv kev tswj hwm vascular nro thiab lwm cov lus teb ntawm lub cev. Ntau yam kev puas tsuaj kuj ua rau muaj kev sib txuas ntawm ntau yam cytokines, xws li IL-1, IL-6, IL-8, TNF, thiab lwm yam. Cov khoom no tuaj yeem ua rau COX-2 qhia, nce PGs synthesis, thiab koom nrog cov txheej txheem pathological xws li mob hauv lub cev. Nyob rau hauv xyoo tas los no, cov kev tshawb fawb tau pom tias qhov kev qhia ntawm adhesion molecules xws li E-selectin, P-selectin, thiab L-selectin los ntawm endothelial hlwb, nrog rau intracellular adhesion molecule -1 (ICAM-1) , vascular cell adhesion molecule-1 (VCAM-1), thiab cellular integrins, muaj feem xyuam rau cov inflammatory thaj chaw ntawm cov qe ntshav dawb thiab platelets.