Cholinesterase reactivators yog cov tshuaj tua kab mob uas pab txo cov organophosphate (OP) lom. Cov tshuaj lom neeg muaj phosphorus muaj xws li tshuaj tua kab mob xws li sarin, tabun. Txawm li cas los xij, nws muaj peev xwm tau txais intoxication nrog cov tshuaj sib xyaw ua ke hauv kev thaj yeeb nyab xeeb. Raws li lub hauv paus ntawm FOS, ntau yam txhais tau tias tau tsim los tiv thaiv kab mob phem ("Dichlorvos", "Thiophos", "Chlorophos"), thiab qee qhov muag tee ("Armin", "Phosfakol"). Cov tshuaj zoo sib xws kuj tau siv hauv kev lag luam hauv kev tsim cov yas thiab cov kua roj vanish. Nyob rau hauv cov ntaub ntawv ntawm kev huam yuaj ntawm xws li tshuaj mus rau hauv lub cev, hnyav heev lom tshwm sim. Thiab ces cholinesterase reactivators tuaj cawm.
FOS ua haujlwm ntawm lub cev li cas?
Ib pawg yog tsim nyob rau hauv tib neeg lub cevenzymes - cholinesterase. Lawv ua lub luag haujlwm tseem ceeb hauv cov txheej txheem metabolic thiab kev ua haujlwm ntawm lub paj hlwb. Phosphorus organic tebchaw, nkag mus rau hauv lub cev, inhibit qhov kev ua ntawm cov enzymes. Acetylcholine pib nkag mus rau hauv cov ntaub so ntswg. Qhov ntau dhau ntawm cov tshuaj no ua rau cov tsos mob hauv qab no ntawm kev qaug cawv:
- nce salivation;
- nrov ua pa nrog hawb pob vim phlegm nyob rau hauv lub bronchi;
- cov menyuam kawm ntawv;
- txhawj xeeb;
- cyanosis ntawm daim tawv nqaij;
- muscle paralysis;
- siab BP;
- " tshuaj" ua pa tsw tsw;
- tawm hws ntau dhau.
FOS ua rau lub cev ua tshuaj lom. Intoxication nrog cov tshuaj no yog qhov txaus ntshai heev. Muaj peev xwm tuag vim tuag tes tuag taw ntawm cov leeg ua pa. Hauv daim duab hauv qab no koj tuaj yeem pom qhov nqaim ntawm cov menyuam kawm ntawv thaum muaj tshuaj lom nrog FOS.
cholinesterase reactivators ua haujlwm li cas?
Thaum FOS lom, cholinesterase reactivating tshuaj ua raws li tshuaj tua kab mob. Qhov no txhais tau hais tias lawv yog cov tshuaj tua kab mob rau cov tshuaj lom phosphorus. Lawv tuaj yeem siv rau hauv kev kho mob lom. Lawv muaj peev xwm tshem tawm cov tshuaj lom sai sai thiab tshem tawm cov cim ntawm kev qaug dab peg.
Lub tshuab ua haujlwm ntawm cholinesterase reactivators nyob hauv lawv lub peev xwm los kho cov haujlwm ntawm cov enzymes. Cov tshuaj muaj pes tsawg leeg muaj ib pab pawg ntawm molecules -NOH, uas cuam tshuam nrog acetylcholinesterase blocked. Yog li ntawd, kev sib txuas ntawmFOS molecules thiab enzyme. Yog li, kev ua haujlwm ntawm cholinesterase tau rov qab ua tiav raws li kev ua ntawm cov tshuaj tua kab mob. Qhov no ua rau kom maj mam ploj ntawm cov tsos mob ntawm intoxication.
Type of drug
Cov tshuaj hauv qab no yog cov pab pawg ntawm cholinesterase reactivators:
- "Dipiroxime".
- "Dietixim".
- "Alloxim".
- "Carboxyme".
- Y"Isonitrosin".
Cov lus qhia rau lawv siv yog organophosphate lom. Txawm li cas los xij, kev thaiv cov cholinesterase kuj tshwm sim thaum qaug cawv nrog tshuaj los ntawm pab pawg cholinomimetics. Cov tshuaj saum toj no nyob rau hauv rooj plaub ntawm kev lom los ntawm lwm txoj kev tsis zoo. Lawv tsuas ua haujlwm tawm tsam FOS.
Tsis muaj contraindications rau kev siv cholinesterase reactivators.
Kev piav qhia tshuaj
FOS tshuaj tiv thaiv muaj nyob rau hauv cov tshuaj txhaj tshuaj. Cov no yog cov tshuaj ua kom ceev ceev. Cholinesterase reactivators pib thaiv cov enzymes 15-30 feeb tom qab tswj hwm. "Isonitrozin" yog ib qho tshuaj zoo dua. Nws muaj peev xwm nres qhov kev puas tsuaj rau lub hauv paus paj hlwb los ntawm FOS. "Dipiroxime" tsis nkag mus rau hauv lub hlwb. Vim li no, cov tshuaj tsuas muaj peev xwm ua rau cov tshuaj lom, tab sis tsawg dua cuam tshuam cov tsos mob ntawm intoxication.
Recommended dosage
Tshuaj yog tshuaj lom yuav tsum tau muab tshuajsai li sai tau thaum cov tsos mob tshwm sim. Lawv siv tau tsuas yog thawj teev tom qab cov tshuaj lom nkag mus rau hauv lub cev. Lawv qhov ntau npaum li cas nyob ntawm qhov hnyav ntawm intoxication:
- Ntawm cov cim qhia ntawm kev lom, 2-3 ml ntawm cov tshuaj atropine (0.1%) thiab FOS antidotes raug txhaj rau hauv qab ntawm daim tawv nqaij, lawv qhov ntau npaum li cas yog txiav txim los ntawm cov lus qhia rau kev siv ntawm txhua yam tshuaj. Yog tias qhov tshwm sim ntawm kev qaug cawv tsis ploj mus, tom qab ntawd kev qhia txog cholinesterase thiab atropine reactivators rov ua dua.
- Hauv kev lom hnyav, 3 ml ntawm atropine thiab FOS tshuaj tiv thaiv raug txhaj rau hauv cov hlab ntsha. Atropine yog muab tshuaj txhua txhua 5 feeb kom txog thaum hawb pob ploj mus thiab cov hnoos qeev hauv cov pa hauv nruab nrog cev txo qis. Kev txhaj tshuaj raug tso tseg thaum lub qhov ncauj qhuav tshwm thiab cov menyuam kawm ntawv dilate. Cov no yog cov cim qhia txog kev cuam tshuam ntawm atropine ntawm lub cev. Yog tias tsim nyog, cov enzyme reactivators raug muab tshuaj ntxiv.
Hnub thib ob tom qab tshuaj lom, tsis siv tshuaj. Qhov no tuaj yeem ua rau kev txhim kho ntawm cov kev mob tshwm sim thiab rov ua rau cov tsos mob ntawm intoxication. Thaum lub sij hawm kho antidote, nws yog ib qho tsim nyog los tswj cov qib ntawm cholinesterase kev ua ub no. Feem ntau, 2-3 hnub tom qab pib kho, kev ua haujlwm enzymatic pib rov zoo. Ib lub lim tiam tom qab, kev ua cholinesterase ob npaug.
Side effects
FOS tshuaj tua kab mob yog cov tshuaj nruj me ntsis. Lawv tsis tsuas yog tsis tuaj yeem noj yam tsis tau teem sijhawm los ntawm tus kws tshaj lij, tab sis yuav tsum tsis txhob siv hauv tsev. Cov tshuaj no tsuas yog siv tau hauv tsev kho mob hauv kev saib xyuas xwb.kws kho mob. Lawv tsuas yog siv rau kev kho mob hauv tsev kho mob ntawm organophosphate lom.
Ob txoj kev kho mob muaj kev phiv loj heev. Lawv tuaj yeem ua rau poob ntshav siab, tachycardia, thiab lub siab ua haujlwm tsis zoo. Ib qho mob hnyav hu ua "cholinergic arousal" tuaj yeem tshwm sim nrog kev ntxhov siab, kev xav, thiab kev xav tsis thoob.
Yog tias ib tug neeg tau nqos cov tshuaj organophosphorus yuam kev, nws yuav tsum hu rau tus kws kho mob sai li sai tau thiab muab kev pab thawj zaug rau tus neeg raug tsim txom. Tus neeg mob lub plab yog ntxuav nrog ib tug daws ntawm poov tshuaj permanganate thiab activated charcoal. Yog tias cov khoom nkag mus rau hauv lub cev los ntawm kev ua pa, koj yuav tsum coj tus neeg mus rau huab cua ntshiab thiab yaug qhov ntswg. Yog tias muaj tshuaj lom nyob rau ntawm daim tawv nqaij, ces nws yuav tsum tau ntxuav nrog xab npum thiab dej.
Kev pab ntxiv yuav muab rau tus neeg mob hauv tsev kho mob, tsuas yog nyob rau hauv kev saib xyuas ntawm kws kho mob tuaj yeem kho tau siv tshuaj tua kab mob. Qhov no txhais tau hais tias nws tsis tuaj yeem tshem tawm tag nrho cov cim ntawm FOS lom hauv tsev. Nws yuav tsum nco ntsoov tias cov tshuaj tua kab mob tsuas yog siv tau rau thawj teev tom qab haus cawv. Lub tsheb thauj neeg mob sai dua, qhov muaj feem ntau dua rau kev kho thiab rov zoo.
