Raws li koj paub, muaj ntau cov synapses hauv lub paj hlwb. Lawv tsim nyog rau kev sib kis ntawm impulses. Ob peb hom kev kho kom haum xeeb tau koom nrog hauv cov txheej txheem no. Ntawm lawv yog acetylcholine, norepinephrine, GABA, serotonin, thiab lwm yam. Mediators (transmitters) yog tsim nyog rau kev taw qhia ntawm neurons. Tsis tas li ntawd, ua tsaug rau lawv, excitation los yog inhibition ntawm cov leeg yog nqa tawm. Nrog ntau yam pathologies ntawm lub paj hlwb, kev ua haujlwm ntawm neurotransmitters tuaj yeem cuam tshuam. Qhov no tshwm sim vim atrophic thiab degenerative txheej txheem hauv lub hlwb. Nyob rau hauv cov ntaub ntawv no, tshuaj yog siv uas tsim nyog los txhim kho los yog attenuate signaling. Ib pawg kws tshuaj zoo sib xws suav nrog cholinesterase inhibitors. Lawv siv rau myasthenia gravis, neuritis, amyotrophic sclerosis, Alzheimer's kab mob, puas hlwb pathologies.
Kev ua ntawm cholinesterase inhibitors
Cholinesterase inhibitors yog cov tshuaj uas tau siv dav hauv kev mob hlwb thiab kev puas siab puas ntsws. Lawv muab faib ua ob pebpab pawg, txhua tus uas yog siv rau hauv ib rooj plaub tshwj xeeb. Qhov kev txiav txim ntawm cov tshuaj no yog ua raws li thaiv cov cholinesterase. Cov enzyme no muaj nyob rau hauv cov neeg noj qab haus huv thiab nyob rau hauv cov neeg txom nyem los ntawm ntau yam kab mob. Nws yog ib qho tsim nyog rau kev tawg ntawm neurotransmitter acetylcholine. Raws li qhov tshwm sim ntawm nws qhov kev ua, lub transmitter raug rhuav tshem rau choline thiab acetic acid. Nrog rau ntau yam pathologies ntawm lub hlwb, maj mam atrophy ntawm lub cortex tshwm sim. Yog li ntawd, qee cov qauv tuaj yeem raug rhuav tshem tag nrho, suav nrog cov kab mob cholinergic. Ntxiv nrog rau lub hlwb atrophy, cov txheej txheem degenerative ntawm autoimmune, kis kab mob, kab mob ua rau qhov no. Vim yog kev puas tsuaj ntawm cov nuclei ntawm lub forebrain, muaj ib tug pronounced tsis muaj ib tug neurotransmitter - acetylcholine. Txhawm rau kom tsis txhob muaj qhov tsis txaus ntawm cov tshuaj no ntev li ntev tau, nws yog qhov tsim nyog los cuam tshuam cov enzyme uas rhuav tshem nws. Rau lub hom phiaj no, cholinesterase inhibitors yog siv. Ua tsaug rau lawv, cov haujlwm ntawm neurotransmitter tuaj yeem khaws cia tau ntau xyoo.
Cholinesterase inhibitors: faib cov tshuaj
Muaj ntau hom tshuaj anticholinesterase. Lawv raug cais raws li cov tshuaj pharmacological ntawm cov enzymes. Qee tus ntawm lawv thaiv cholinesterase irreversibly, lwm tus ib ntus. Muaj 3 pawg tshuaj. Ntawm lawv:
- thim rov qab blockers. Cov cholinesterase inhibitors cuam tshuam rau postsynaptic signaling. Ua tsaug rau lawv, qhov kev txiav txim ntawm enzyme yog cuam tshuam ib ntus. Cov pab pawg no suav nrog acridines thiab piperidines.
- Pseudo-irreversible cholinesterase blockers. Cov txheej txheem ntawm lawv qhov kev ua yog ua ke nrog cov dos ib feem ntawm cov enzyme molecule. Tsis tas li ntawd, lawv muaj peev xwm khi rau acetylcholine receptors. Cov pab pawg carbamates muaj cov khoom zoo sib xws.
- Irreversible cholinesterase inhibitors. Kev npaj ntawm pab pawg no yog hu ua organophosphorus agents. Tus neeg sawv cev yog cov tshuaj "Metrifonat".
Pab pawg ntawm acridines suav nrog tshuaj "Takril" thiab "Velnakrin". Cov neeg sawv cev ntawm carbamates - tshuaj "Rivastigmine", "Epistatigmine"
Cov lus qhia rau kev siv cholinesterase inhibitors
Cholinesterase inhibitors yog siv los kho cov kab mob hauv nruab nrab cov leeg nqaij, atrophic thiab degenerative hlwb pathologies. Tsis tas li ntawd, qee cov tshuaj muaj nyob rau hauv daim ntawv ntawm tee. Lawv yog siv los ua kom muaj zog intraocular siab - glaucoma. Cov tshuaj uas inhibit cholinesterase reversibly yog muab rau kev kho mob ntawm dementia, Pick's disease, thiab Alzheimer's. Kev nyiam yuav tsum tau muab rau cov pab pawg ntawm piperidines, vim tias lawv ua haujlwm xaiv thiab muaj kev phiv tsawg dua. Tsis ntev los no, cov lus qhia rau kev siv tshuaj tau nthuav dav. Qhov no yog vim muaj kev kawm ntxaws ntxiv ntawm lawv cov khoom. Cov kab mob uas cov tshuaj anticholinesterase tau sau tseg suav nrog myasthenia gravis, plab hnyuv atony, muscular dystrophy, amyotrophic lateral sclerosis, tuag tes tuag taw ntawm qhov chaw ntawm degenerative keeb kwm. Irreversible inhibitors yog siv rau lom.
Contraindications rau kev siv tshuaj anticholinesterase
Tshuaj uas koom nrog pab pawg no tsis yog siv rau cov mob convulsive, hyperkinesis ntawm ib qho etiology. Lawv kuj yog contraindicated nyob rau hauv cov neeg mob uas muaj mob plawv tsis ua hauj lwm, bronchial hawb pob, thyrotoxicosis. Nws yog ib qho tsim nyog yuav tau noj cov tshuaj anticholinesterase nrog concomitant gastric ulcer, enteritis. Cov tshuaj tsis qhia rau cov poj niam cev xeeb tub thiab lactating.
Cholinesterase inhibitors: tshuaj xaiv rau Alzheimer's disease
Alzheimer's disease yog ib qho mob atrophic ntawm lub hauv nruab nrab paj hlwb, uas muaj amnesia, tus cwj pwm tsis meej thiab dementia. Cov kws tshawb fawb thoob plaws ntiaj teb tab tom sim nrhiav kev kho rau tus kab mob no. Nrog me me mus rau nruab nrab qhov hnyav ntawm tus kab mob, cov tshuaj ntawm kev xaiv yog Donepezil. Nws belongs rau reversible cholinesterase inhibitors, muaj cov nyhuv xaiv. Cov tshuaj yog siv rau lub hom phiaj ntawm kev kho mob pathogenetic. Nws tsis muaj peev xwm kho tau tus neeg mob tag nrho, tab sis ua rau kev loj hlob ntawm Alzheimer's tsos mob.
