Chiphe wothandizila anticholinesterase. anticholinesterases ndi chiyani?

pa manyuroni kufala nyemba amaperekedwa ndi zinthu zapadera - nkhoswe. Imodzi mwa mtundu uli acetylcholine. Makampaniwa, pamene pa synapses ndi, bwanji nembanemba selo kuchititsa chopinga awo kapena kukondoweza ndi kuchititsa zotsatira zosiyanasiyana. The mtundu owonjezera lamamatira ndi michere yeniyeni.

mankhwala Anticholinesterase: mbali ndi zolinga

Ndi mankhwala anticholinesterase ndi amene ziletsa enzyme cholinesterase. cleaves Izi enzyme ndi hydrolysis wa mtundu acetylcholine, yomwe transmits nyemba mu atengeke thereto synapses misempha parasympathetic, ganglia, ndipo ulusi onse somatic. anticholinesterases zinalengedwa kumapangitsanso kanthu situational wa manyuroni acetylcholine, ndi kukondoweza zina ya ubongo. Kugwiritsa ntchito mankhwala awa ali zimakhudzanso lake lonse.

Action anticholinesterases ndi ofanana ndi zotsatira za kukondoweza kwa mitsempha cholinergic. Mankhwalawa kucheza ndi malo omwewo pa lilime ntchito pamwamba monga acetylcholine, potero kulenga angathe kanthu kwa mitsempha kutha. Cholinomimetics ndi wothandizila anticholinesterase Kwenikweni, gulu lomweli zinthu pharmacological. Pali mitundu ingapo ya mankhwala amasiyana mankhwala kapangidwe awo ndi reversibility kanthu. blockers Cholinesterase anawagawa kusintha ndipo sizingasinthe.

Zikutanthauza kanthu kusintha

Anticholinesterases - kukonzekera kuchitapo kanthu kusintha ndi a dongosolo mankhwala esters carbamic acid ndi aminoalcohols zosiyanasiyana. Chisoni chigawo kutsekereza cholinesterase, kumakhaladi acidic mapeto, amene inakhazikitsa enzyme ndi molekyulu zambiri khola kulankhulana kuposa zimene aumbike mwa mogwirizana ndi acetylcholine. Complete chiwonongeko pawiri izi zimachitika ndi hydrolysis kwa maola 3-4.

Kudzera kusintha zotsatira anticholinesterase ndi "galantamine", "physostigmine", "Neostigmine" (kapena "Neostigmine"), "pyridostigmine," "oksazil", "rivastigmine", "edrophonium."

Mu phosphorous - chinthu kanthu sizingasinthe

Formulations sizingasinthe kanthu kwa gulu ili ndi organophosphorus mankhwala. zinthu izi ziletsa acetylcholinesterase kwa nthawi yaitali. Phosphorus umene uli zikuchokera mamolekyulu ndi ndipamene pawiri khola ndi enzyme, amene kupulumuka mu thupi kwa masiku angapo mwinanso masabata. Kuchira chofunika kuchuluka acetylcholinesterase kumachitika mwa mapangidwe tinthu latsopano. Gulu la mankhwala zikuphatikizapo "phosphacol", "Armin", "trichlorfon", "Malathion", "dichlorvos" poizoni, ntchito mu njira ya ntchito asilikali - sarin ndi soman.

mankhwala Organophosphate amapatsa poizoni. Mankhwalawa amagwiritsidwa ntchito pa moyo wa tsiku ndi tsiku monga tizirombo; poyizoni zotheka mwa ntchito zawo lolakwika ndi sanali kusunga miyeso chitetezo.

Zotsatira anticholinesterase mankhwala

Pa kufanana ena pakati pa mavuto amene mudameretsa anticholinesterases thupi, zikuonetsa aliyense wa iwo ndi wapadera. Kuganizira zotsatira wothandiza kutumikiridwa mu thupi akhoza mwachitsanzo, "neostigmine".

"Neostigmine" likupezeka ampoules mu mawonekedwe a 0,05% njira ndi jekeseni subcutaneously kapena kudzera m'mitsempha. Pamene jekeseni magazi izo facilitates Ndime ya nyemba mu kufala neuromuscular ndi ganglia wa mantha dongosolo autonomic. alili akuwonekera motere:

• chifukwa zozungulira minofu chidule cha Iris mwana ali mwapang'ono;
• kumachitika kuphipha a malawi, disolo adzatenge mawonekedwe otukukira kunja chifukwa zosangalatsa Zinn mitolo cholinga amamasulidwa ku mtunda pafupi, luso kusiyanitsa zinthu kutali ndi inachepetseratu;
• utachepa mlingo mtima;
• kumawonjezera kamvekedwe ka minofu yosalala ziwalo - kupuma thirakiti, m'mimba ndipo matumbo, chiberekero, chikhodzodzo;
• kumatheka chigoba contractions minofu chifukwa bwino ndime ya zikhumbo pa synapses;
• kuchuluka katulutsidwe wa zopangitsa exocrine - thukuta, malovu, bronchial, muzituluka.

ntchito

Zimenezi udindo ntchito gulu la mankhwala mankhwala milandu yosiyanasiyana. Zikuonetsa anticholinesterase wothandizila si matenda enieni, popeza zimakhudzanso dongosolo chapakati ndi zotumphukira mantha, kuchititsa zotsatira chonse pa chamoyo wonse. Nthawi zambiri iwo amaikidwa mu kuphwanya innervation ndi kamvekedwe ka minofu chigoba kapena yosalala.

Kuganiza kuti mankhwala ndi wothandizila anticholinesterase angakhale chitsanzo cha "neostigmine". mankhwala ndi kanthu kusintha ntchito myasthenia - matenda autoimmune, amene kumaonekera kufooka kwa minofu chigoba. Matendawa kumaonekera poyamba utachepa kamvekedwe nkhope minofu, ndiye chifooke minofu malekezero khosi, chapamwamba ndipo m'munsi; Zikavuta, kulephera kupuma chifukwa ntchito kuchepa kwa chifundamtima. "Neostigmine" zochita symptomatic pa thupi, kubwezeretsa kufala kwa zikhumbo kuti ndimakokedwe neuromuscular, kuwongolera minofu kamvekedwe ndi ntchito galimoto ndi ntchito.

Komanso, mankhwala zapatsidwa mu postoperative nthawi pamene kachigawo m'mimba kapena atony wa chikhodzodzo mkodzo. Mu pochiza matenda a maso kuti sikawirikawiri anasonyeza kuti khungu yochepetsera mavuto intraocular. Monga antagonist ndi ntchito mu ambiri osokoneza wa relaxants minofu ndi mankhwala antidepolyarizuyuschego kanthu. Nthawi zina "Neostigmine" ntchito yotithandiza contractions minofu ndi ntchito ofooka.

matenda Alzheimer

Kukonzekera kanthu kusintha akhala akugwiritsidwa ntchito kwa matenda a chapakati mantha dongosolo, n'zovuta kuchitira. matenda a Alzheimer Amasankhidwa "galantamine" - ndi alkaloid kuwapeza tubers a snowdrops mtundu Galantus ( "Rivastigmine" Aka "Exelon"), koma kwambiri therapeutically ogwira anakhala "donepezil", kuti kusankha midadada ya acetylcholinesterase mu synapses ubongo ndi pafupifupi sikumangotikhudza ake zotumphukira mantha dongosolo.

contraindications

Yachokera pa zotsatira za mankhwala cholinesterase kusintha kanthu, contraindications kuti kopita kwawo ndi khunyu, mphumu, angina pectoris, matenda Parkinson ndi matenda osiyanasiyana a dongosolo mtima conduction.

Zizindikiro cha mankhwala osokoneza bongo ndi poyizoni mukupweteka

Chiphe anticholinesterases amapereka zizindikiro mwachindunji ndi kukondoweza kwambiri ya maselo tcheru acetylcholine. Pupillary anati, liwiro mlingo mtima (bradycardia), bronchial kuphipha ndipo - chifukwa - dyspnea zizindikiro hyperperistalsis thirakiti m'mimba mpaka kusanza ndi kutsekula m'mimba, pafupipafupi pokodza. Pang'onopang'ono mpaka kusanduka magazi monga chotsatira cha braking zotsatira za mitsempha vagal. Zimachitika contractions wachisokonezo ndi twitch chigoba minofu ndi lilime chifukwa matenda conduction ku HIV neuromuscular.

chiphe FOS

Ingestion wa Organophosphorus mankhwala kuchititsa chithunzi matenda ofanana ndi poyizoni wothandizila kusintha anticholinesterase kanthu. Zizindikiro angaoneke wowala chifukwa cha kawopsedwe apamwamba mankhwala. Pakuti zizindikiro za poyizoni pa mlingo somatic akuwonjezeka zotsatira pa chapakati mantha dongosolo mlingo - chisokonezo, disorientation, kupuma maganizo.

Organophosphorus mankhwala chifukwa omangana lakuthwa, kusawona bwino, dyspnea, thukuta, kusanza kwambiri, mukubwadamuka - wodwala wayamba mantha, kumakhaladi unmanageable. Chifukwa cha yosalala minofu kuphipha kuwawa lakuthwa mu mimba yake. Pamene kuwonongeka zimachitika omangana, kuthamanga kwa magazi akugwa, chikomokere akufotokozera. Imfa kumachitika chifukwa ziwalo za pakati kupuma.

zizindikiro zofanana ndi anamuona pa milandu chiphe Amanita muscaria. Ichi ndi chifukwa amanena za muscarinic - ululu ndi kanthu cholinomimetic.

Zochita vuto la poizoni

chithandizo ngati poyizoni ndi wothandizila anticholinesterase akhoza kukhala yekha katswiri. Mu milandu, yankho umayamba "atropine" subcutaneous jekeseni n'zotheka perekani "Metacin" kapena anticholinergics ena. M'pofunika kukhala kupuma pa mlingo yoyenera. Angagwiritsidwe ntchito tracheotomy, makina mpweya ndi oxygenation.

Pamene poyizoni banja FOS kudziwa gwero la poizoni kulowa m'thupi. Ngati chinthu aloŵa kudzera pakhungu, ndi rinsed 3-5 njira% koloko kapena ndi madzi ndi sopo. Ngati kumene mankhwala wakhala ingested, achite chapamimba lavage, enemas angapo, kupereka adsorbents kapena mankhwala ofewetsa tuvi. Ngati organophosphorus pawiri wakhala nthawi kugwa mokulirapo mu m'magazi, akapatsidwa diurez ntchito mankhwala diuretic. Nthawi zina, kugwiritsa ntchito njira za imathandiza magazi ndi hemodialysis ndi hemosorption.

Komanso, ngati FOS chiphe yoikidwiratu Reaktivatory cholinesterase, chimene kutumikiridwa mu maora pang'ono choyamba pambuyo kuledzera angathe kubwezeretsa michere oletsedwa. Kungakhale "Izonitrozin", "Trimedoksim", "Dipiroksim". Ngati magazi ndi mkulu, symptomatically Kwalamulidwa mankhwala antihypertensive. Zokonda zapatsidwa kwa anthu amene sikungawononge chapakati mantha dongosolo. Ndi chifooke kupuma mowiriza ndi makina mpweya wabwino ndi kupereka oxygen.