Nsi anticholinesterase mmadụ. Gịnị bụ anticholinesterases?

na akwara ozi nnyefe pulses na-nyere site pụrụ iche bekee - ogbugbo. Otu n'ime ọgụgụ akwara mbufe ozi bụ acetylcholine. Ndị a elekọta mmadụ, ma na-synapses, emetụta cell membranes na-eme ka ha mgbochi ma ọ bụ mmalite ma na-eme dị iche iche mmetụta. Ngafe ọgụgụ akwara mbufe ozi rapara site kpọmkwem enzymes.

Anticholinesterase ọgwụ ọjọọ: atụmatụ na nzube

Site na anticholinesterase ọgwụ ndị ndị na inhibit enzyme cholinesterase. Nke a enzyme cleaves site hydrolysis nke ọgụgụ akwara mbufe ozi acetylcholine, nke Site n'ibu pulses na susceptible thereto synapses parasympathetic akwara, ganglia, na niile somatic emep uta eri. anticholinesterases e mere aka situational edinam nke acetylcholine akwara ozi, na mmetuta nke akụkụ ụfọdụ nke ụjọ usoro. The ihe ndị a ọgwụ ọjọọ nwere mmetụta dum organism.

Action anticholinesterases yiri mmetụta nke mmetuta nke cholinergic irighiri akwara. Ọgwụ a-emekọ na otu saịtị na ihe nnabata n'elu ọrụ dị ka acetylcholine, si otú eke ihe emereme nwere nke akwara ogwugwu. Cholinomimetics na anticholinesterase mmadụ bụ, n'ezie, otu ìgwè nke pharmacological bekee. E nwere ọtụtụ ụdị nke ọgwụ ndị na iche na ha chemical Ọdịdị na reversibility nke edinam. Cholinesterase blockers na-ekewa n'ime reversible na irreversible.

Pụtara a reversible edinam

Anticholinesterases - preparations reversible edinam bụ nke chemical Ọdịdị nke carbamic acid esters dị iche iche aminoalcohols. Mmeghachi omume akụrụngwa igbochi cholinesterase, ọ na-aghọ acidic ogwugwu, nke akọwaputa enzyme na a molekul ihe ọzọ mụ nkwurịta okwu karịa nke a kpụrụ site mmekọrịta acetylcholine. Mbibi zuru ezu nke a compound emee site hydrolysis maka 3-4 awa.

Site a reversible anticholinesterase mmetụta bụ "galantamine", "physostigmine", "Neostigmine" (ma ọ bụ "Neostigmine"), "pyridostigmine," "oksazil", "rivastigmine", "edrophonium."

Na phosphorous - a umi irreversible edinam

Formulations irreversible edinam nke otu a bụ organophosphorus ogige. Ndị bekee inhibit acetylcholinesterase maka a ogologo oge. Site, nke bụ na ihe ndị mejupụtara nke ụmụ irighiri Nleta a ufọk ufene compound na enzyme, nke nwere ike ndụ na ahụ ruo ọtụtụ ụbọchị ma ọ bụ ọbụna izu. Recovery chọrọ ego acetylcholinesterase emee site guzobere ọhụrụ ụmụ irighiri. Otu a nke ogige na-agụnye "phosphacol", "Armin", "trichlorfon", "Malathion", "dichlorvos" nsi, na-eji na N'ezie nke agha arụmọrụ - sarin na soman.

Organophosphate ọgwụ ọjọọ dị nsị dị elu. Ha na-ejikarị na-adị kwa ụbọchị ndụ dị ka ụmụ ahụhụ; nsi omume site ha na-ekwesịghị ịdị eji na-abụghị idebe nchekwa jikoro.

Mmetụta anticholinesterase ọgwụ

Na ụfọdụ myirịta dị n'etiti mmetụta ndị na-amị ahụ anticholinesterases, na-egosi onye ọ bụla n'ime ha bụ ndị pụrụ iche. Iji tụlee a bara uru mmetụta mgbe ndinọ n'ime ahu nwere ike ihe atụ, "neostigmine".

"Neostigmine" dị na ampoules n'ụdị 0,05% ngwọta na agbara subcutaneously ma ọ bụ intravenously. Mgbe agbara ndi mmadu n'ime ọbara ya mmemmem Itie pulses na neuromuscular nnyefe na ganglia nke autonomic ụjọ usoro. Ọrịa na-arịa na-egosipụta dị ka ndị a:

• n'ihi na okirikiri muscle mkpi nke iris nwa akwụkwọ na-narrowed;
• emee spasm nke ulo, na oghere na-eburu a convex udi ruru ka ntụrụndụ Zinn n'ùkwù n'ùkwù nke na-elekwasị anya ga-adị na nso anya, ikike ịmata ọdịiche dị anya ihe a na-adi belata;
• ebelata obi ọnụego;
• enwekwu ụda ezigbo uru nke esịtidem akụkụ - akụkụ okuku ume na tract, afo na eriri afọ ya, akpanwa, eriri afo;
• enwekwukwa skeletal muscle contractions ruru ka mma Itie gboo na synapses;
• ụba secretion nke exocrine glands - ajirija, asọ, bronchial, gastric.

ngwa

Mmetụta ndị a na-ahụ maka ojiji nke otu a ọgwụ ọjọọ eme ihe na nkà mmụta ọgwụ na dị iche iche ikpe. Egosi anticholinesterase mmadụ na ọ bụghị nanị kpọmkwem ọrịa, ebe ọ bụ na ha nwere mmetụta Central na elu ụjọ usoro, na-eme n'ozuzu utịp ke ofụri organism. Ọtụtụ mgbe ha na-ahọpụta mebiri nke innervation na ụda skeletal ma ọ bụ ezigbo muscle.

Tụlee ekwe omume nke ọgwụgwọ na anticholinesterase mmadụ nwere ike ịbụ ihe atụ nke "neostigmine". Nke a na ọgwụ bụ a reversible edinam etinyere na myasthenia - ihe autoimmune ọrịa, nke na-apụta ìhè na adịghị ike na skeletal uru. The ọrịa na-egosipụta onwe na mbụ ebelata ụda ọdịdị ihu mọzụlụ, mgbe ahụ esighịzi ike uru n'olu, elu na nke ala na nsọtụ; n'oké ikpe, akụkụ okuku ume na odida ruru ka erughị eru ọrụ nke diaphragm. "Neostigmine" symptomatic omume na ozu, eweghachiri nnyefe nke gboo na neuromuscular nnyefe, rụọ Akwara ụda ma moto ọrụ na-facilitated.

Ọzọkwa, a ọgwụ na-nyere na postoperative oge mgbe digestive tract ma ọ bụ atony nke urinary eriri afo. Na ophthalmology ya na-adịkarịghị gosiri maka glaucoma iji belata intraocular nsogbu. Dị ka ihe na-eti ọkpọ na-eji na ihe ovadozu nke muscle relaxants na ọgwụ ọjọọ antidepolyarizuyuschego edinam. Mgbe ụfọdụ "Neostigmine" a na-eji akpali muscle contractions na-adịghị ike ọrụ mmanye.

Alzheimer ọrịa

Preparations reversible edinam e ji mee ihe maka ọrịa nke Central ụjọ usoro, ọ bụ ike na-emeso. Ọrịa Alzheimer na-họpụtara "galantamine" - ihe alkaloid enwetara site na tubers nke snowdrops ụdị Galantus ( "Rivastigmine", aka "Exelon"), ma ihe kasị therapeutically irè ghọrọ "donepezil", na bibiri nkanka na acetylcholinesterase na ụbụrụ synapses na fọrọ nke nta adịghị emetụta ya elu ụjọ usoro.

contraindications

Dabere na mmetụta nke cholinesterase ọgwụ ọjọọ reversible edinam, contraindications ka ha na-aga bụ Akwụkwụ na-adọ, ụkwara ume ọkụ, rịaworo pectoris, ọrịa Parkinson dị iche iche ọrịa nke gbasara obi conduction usoro.

Mgbaàmà nke ovadozu na nsi mgbu

Nsi anticholinesterases enye mgbaàmà ozugbo metụtara na oké mmetuta nke anabata chebaara acetylcholine. Pupillary hụrụ, ibelata obi ọnụego (bradycardia), bronchial spasm na - mmọdo - dyspnea mgbaàmà hyperperistalsis eriri afọ tract ruo mgbe vomiting na afọ ọsịsa, Ugboro urination. Nwayọọ nwayọọ belata ọbara mgbali dị ka a n'ihi braking mmetụta nke vagal akwara. Ime jupụtara contractions na tuwichi skeletal muscle na asụsụ ruru conduction ọrịa na neuromuscular nnyefe.

nsí FOS

Ingestion nke Organophosphorus ogige eme a na-adakarị picture yiri nsi mmadụ reversible anticholinesterase edinam. Mgbaàmà nwere ike iyi ayama n'ihi na elu toxicity nke ọgwụ ọjọọ. N'ihi mgbanwe nke nsi na somatic larịị agbakwunyere na mmetụta na Central ụjọ usoro larịị - aghara, mgbagwoju anya, akụkụ okuku ume na ịda mbà n'obi.

Organophosphorus ogige ime ka a nkọ cramps, bịara ikiri ọhụụ, dyspnea, sweating, oké vomiting, n'ahụhụ - ọrịa amalite masịrị, ọ na-aghọ unmanageable. N'ihi na nke ezigbo muscle spasm chere a nkọ mgbu ya afo. Mgbe arịa ọrịa ime cramps, ọbara mgbali dara, amaghị onwe-amalite. Ọnwụ ike ime n'ihi na mkpọnwụ nke akụkụ okuku ume center.

Yiri mgbaàmà na-hụrụ ikpe nsi Amanita muscaria. Nke a bụ n'ihi na ha ọdịnaya nke muscarinic - nsi na cholinomimetic edinam.

Omume na ikpe nke na nsi

Medical elekọta bụrụ na nke nsi na anticholinesterase mmadụ nwere ike inwe naanị a ọkachamara. Na ndị a, ihe ngwọta na-ẹkenam "Atropine" subcutaneous injection bụ omume na-ekenye "Metacin" ma ọ bụ ndị ọzọ anticholinergics. Ọ dị mkpa ịnọgide na-enwe ume na n'ọkwa kwesịrị. Ike ga-eji tracheotomy, n'ibu ventilashion na oxygenation.

Mgbe ezinụlọ nsi FOS mata isi iyi nke nsi abanye ahu. Ọ bụrụ na umi nke penetrated site na anụ ahụ, ọ na-rinsed 3-5% soda ngwọta ma ọ bụ na mmiri na ncha. N'ihe ebe ọgwụ e ingested, mepụta gastric lavage, multiple enemas, nye adsorbents ma ọ bụ laxatives. Ọ bụrụ na ndị organophosphorus compound nwere oge na-ada ka ukwuu n'ime n'ọbara, na-kenyere diurez iji mamịrị ọgwụ ọjọọ. Mgbe ụfọdụ, na-amalite ụzọ nke nzacha ọbara site hemodialysis na hemosorption.

Ọzọkwa, na ikpe nke na nsí FOS họpụtara Reaktivatory cholinesterase, nke mgbe ndinọ ke akpa awa ole na ole mgbe igbu egbu nwere ike iweghachi egbochi enzymes. O nwere ike ịbụ "Izonitrozin", "Trimedoksim", "Dipiroksim". Ọ bụrụ na ọbara mgbali dị elu, symptomatically kenyere antihypertensive ọgwụ ọjọọ. Mmasị na-enye ndị na-adịghị emetụta Central ụjọ usoro. Na-agwụ ike nke n'amaghi ume bụ a n'ibu ventilashion ma na-enye oxygen.