Nyob rau hauv kev puas siab puas ntsws, ib pab pawg neeg loj ntawm cov tshuaj siv tshuaj. Psychiatry siv tranquilizers ntau dua li lwm yam kev kho mob. Tab sis lawv tsis yog siv los kho cov kab mob psychopathic xwb.
Yog li dab tsi yog cov tshuaj tranquilizers, anxiolytics ua haujlwm li cas, thiab lawv siv qhov twg?
hom tshuaj no, ua ke nrog cov neuroleptics, belongs rau cov chav kawm ntawm cov tshuaj psychotropic ntawm ib hom kev tsim txom.
keeb kwm keeb kwm
Kev txhim kho thawj cov tshuaj ntawm pab pawg no tau pib thaum xyoo 1950. Nyob rau tib lub sij hawm, scientific psychopharmacology tau yug los. Lub mechanism ntawm kev txiav txim ntawm tranquilizers ces tsuas yog pib kawm. Keeb kwm ntawm daim ntawv thov pib nrog kev qhia txog Meprotan (Meprobamate) rau hauv kev kho mob hauv xyoo 1958 thiab Elenium (Chlordiazepoxide) hauv xyoo 1959. Hauv xyoo 1960, "Diazepam" tau tso tawm hauv khw muag tshuaj, nws kuj yog"Sibazon" or "Relium".
Tam sim no, pab pawg neeg tranquilizers suav nrog ntau dua 100 tshuaj. Hnub no lawv tab tom txhim kho.
Tranquilizers (anxiolytics) yog siv los txo qis kev aggression, ntxhov siab vim, ntxhov siab vim, kev nyuaj siab. Lawv feem ntau raug sau rau kev kho mob neuroses, raws li kev kho mob ua ntej kev phais. Benzodiazepines yog cov pab pawg neeg coob tshaj plaws ntawm cov tshuaj tranquilizers uas siv tau zoo los txo cov leeg mob thiab kho mob qaug dab peg.
Mechanisms of action of tranquilizers tseem tsis tau meej txaus. Tab sis qhov no tsis tiv thaiv lawv txoj kev siv dav. Tsis tas li ntawd xwb, lawv tau muab faib zoo.
Tranquilizers: classification
Lub tshuab ua haujlwm yog thawj qhov xwm txheej raws li cov neeg mob ntshav qab zib tau muab faib ua peb pawg:
1. Benzodiazepines (benzodiazepine receptor agonists). Cov tranquilizers yog nyob rau hauv lem muab faib raws li lawv mechanism ntawm kev txiav txim thiab lub sij hawm ntawm kev txiav txim:
a.
- lub sijhawm luv (tsawg dua 6 teev);
- ncua sijhawm nruab nrab (6 txog 24 teev);
- Ntev ntev (24 txog 48 teev).
b.
Txoj kev ntawm biotransformation (nrog thiab tsis muaj FAM tsim).
v.
Raws li qhov hnyav ntawm cov nyhuv sedative-hypnotic (siab tshaj lossis tsawg kawg).
g.
nqus tau hauv plab hnyuv (ceev, qeeb, nqus nruab nrab).
2. Serotonin receptor agonists.
3. Cov tshuaj ntawm ntau hom kev ua.
Kev piav qhia ntawm cov txheej txheem ntawm kev ua haujlwm ntawm cov tshuaj tranquilizers nyob rau hauv cov ntaub ntawv kho mob feem ntau npau taws rau qhov tseeb tias cov no yog cov tshuaj psychopharmacological tsim los txo kev ntxhov siab, ntshai, thiab kev ntxhov siab. Txawm li cas los xij, tsis yog txhua yam. Tranquilizers yog tsim los tsis tsuas yog kom txias. Cov txheej txheem ntawm kev ua ntawm tranquilizers yog txuam nrog lawv lub peev xwm los ua kom tsis muaj zog cov txheej txheem ntawm kev muaj zog excitation ntawm lub hypothalamus, thalamus, limbic system. Lawv txhim kho cov txheej txheem ntawm internal inhibitory synapses. Lawv feem ntau siv los kho cov kab mob tsis cuam tshuam txog kev puas siab puas ntsws.
Piv txwv li, cov nqaij ntshiv ntawm cov nqaij ntshiv yog qhov tseem ceeb tsis yog hauv kev kho cov kab mob neurological nkaus xwb, tab sis kuj tseem muaj tshuaj loog. Qee cov tshuaj tuaj yeem ua rau cov leeg du, uas ua rau lawv tsim nyog rau kev kho mob ntawm ntau yam kab mob uas muaj nrog spasms, xws li ulcerative manifestations ntawm gastrointestinal ib ntsuj av.
Benzodiazepines
Nov yog pab pawg ntau tshaj plaws thiab nthuav dav ntawm classical anxiolytics. Cov tranquilizers muaj hypnotic, sedative, anxiolytic, cov leeg nqaij so, amnestic thiab anticonvulsant teebmeem. Rau benzodiazepine tranquilizers, cov txheej txheem ntawm kev txiav txim uas cuam tshuam nrog lawv cov txiaj ntsig ntawm limbic system thiab, rau qee qhov, ntawm lub paj hlwb ntawm cov chaw muag tshuaj reticular thiab hypothalamus, qhov nce hauv GABAergic inhibition nyob rau hauv lub hauv paus paj hlwb yog yam ntxwv. Cov tshuaj no muaj cov nyhuv stimulating ntawm benzodiazepine receptorchloride channel ntawm GABA-ergic complex, uas ua rau muaj kev hloov pauv hauv cov receptors thiab nce cov chloride channels. Los ntawm txoj kev, barbiturates, tsis zoo li benzodiazepines, nce lub sijhawm qhib.
Tam sim no ntawm cov tshuaj chloride ions hauv hlwb nce, affinity (affinity) ntawm GABA rau receptors nce. Txij li thaum muaj ntau tshaj ntawm cov nqi tsis zoo (chlorine) tshwm nyob rau sab hauv ntawm lub cell membrane, inhibition ntawm neuronal rhiab heev thiab nws cov hyperpolarization pib.
Yog tias qhov no tshwm sim nyob rau theem ntawm qhov nce ntawm qhov tsim ntawm reticular ntawm lub paj hlwb qia, cov nyhuv sedative tsim, thiab yog tias nws tshwm sim nyob rau theem ntawm limbic system - anxiolytic (tranquilizing). Kev txo qis kev ntxhov siab, tshem tawm kev ntxhov siab, ntshai, ua rau muaj kev cuam tshuam hypnotic (hais txog hmo ntuj tranquilizers). Cov leeg nqaij relaxant nyhuv (muscle-relaxing) txhim kho vim cov nyhuv ntawm benzodiazepines ntawm polysynaptic spinal reflexes thiab inhibition ntawm lawv cov kev cai.
YCons ntawm benzodiazepines
Txawm tias siv hmo ntuj, thaum nruab hnub tej zaum yuav muaj qhov seem ntawm lawv qhov kev ua, uas feem ntau tshwm sim los ntawm lethargy, apathy, nkees, tsaug zog, nce lub sij hawm tshuaj tiv thaiv, txo qis kev ceeb toom, disorientation, impaired coordination.
Resistance (kam rau ua) txhim kho rau cov tshuaj no, yog li kev nce koob tshuaj yuav tsum tau dhau sijhawm.
Raws li cov kab lus dhau los, lawv yog tus cwj pwm los ntawm kev tshem tawm tus mob uas tshwm sim nws tus kheejrecurrent insomnia. Tom qab lub sij hawm ntev ntawm kev nkag, chim siab, tsis xis nyob, kiv taub hau, tshee, tawm hws, dysphoria koom insomnia.
benzodiazepines overdose
Nrog kev noj ntau dhau, pom kev tsis pom kev, cov leeg nqaij atony (kev so), kev ua tsis taus pa, thiab tom qab pw tsaug zog, coma, kev nyuaj siab ntawm cov hlab plawv thiab ua pa ua haujlwm, kev sib tsoo tshwm sim. Nyob rau hauv cov ntaub ntawv ntawm overdose, Flumazenil yog siv, uas yog ib tug benzodiazepine antagonist. Nws thaiv cov benzodiazepine receptors thiab txo lossis tshem tawm cov teebmeem tag nrho.
Serotonin receptor agonists
"Buspirone" belongs rau pawg ntawm serotonin receptor agonists. Cov txheej txheem ntawm kev ua ntawm lub tranquilizer "Buspirone" yog txuam nrog ib tug txo nyob rau hauv lub synthesis thiab tso tawm ntawm serotonin, raws li zoo raws li ib tug txo nyob rau hauv cov kev ua ntawm serotonergic neurons. Cov tshuaj thaiv cov post- thiab presynaptic dopamine D2 receptors, ua kom lub zog ntawm dopamine neurons.
Cov txiaj ntsig ntawm kev siv "Buspirone" txhim kho maj mam. Nws tsis muaj hypnotic, leeg-so, sedative, anticonvulsant nyhuv. Yeej tsis muaj peev xwm ua rau muaj kev quav yeeb tshuaj.
Tshuaj ntawm ntau hom kev ua
Cov txheej txheem ntawm kev ua haujlwm ntawm cov tshuaj tranquilizer "Benactizine" yog vim qhov tseeb tias nws yog M, N-anticholinergic. Nws muaj cov nyhuv sedative, uas yog supposedly tshwm sim los ntawm blockade ntawm M-cholinergic receptors nyob rau hauv lub reticular ib feem ntawm lub hlwb.hlwb.
Nws muaj cov tshuaj loog hauv zos nruab nrab, cov nyhuv antispasmodic. Inhibits cov teebmeem ntawm excitatory vagus paj hlwb (txo cov qog nqaij hlav, txo cov suab nrov ntawm cov leeg nqaij), hnoos reflex. Vim muaj kev cuam tshuam ntawm cov teebmeem ntawm cov hlab ntsha excitatory vagus, "Benactizin" feem ntau yog siv los kho cov kab mob uas tshwm sim nrog cov leeg nqaij du, xws li cov kab mob ulcerative, cholecystitis, colitis, thiab lwm yam..
tshuaj tsaug zog tranquilizers
Tranquilizers-hypnotics: lub ntsiab mechanism ntawm kev ua ntawm lub cev yog txuam nrog hypnotic nyhuv. Lawv feem ntau siv los kho cov teeb meem pw tsaug zog. Feem ntau tranquilizers ntawm lwm pab pawg yog siv los ua tshuaj tsaug zog ("Relanium", "Phenazpem"); antidepressants ("Remeron", "Amitriptyline"); neuroleptics ("Aminazine", "Chlorprothixen", "Sonapax"). Qee pawg ntawm cov tshuaj tiv thaiv kev ntxhov siab tau raug tshuaj thaum hmo ntuj ("Lerivon", "Remeron", "Fevarin"), vim tias cov nyhuv ntawm kev qaug zog los ntawm lawv tsim muaj zog heev.
Hypnotics muab faib ua:
- Ybenzodiazepines;
- barbiturates;
- melatonin, ethanolamines;
- non-benzodiazepine hypnotics.
Imidazopyridines
Tam sim no muaj ib tiam tshiab ntawm tranquilizers, uas tau muab faib ua ib pawg tshiab ntawm imidazopyridines (nonbenzodiazepines). Cov no suav nrog Zolpidem("Saib"). Nws yog qhov txawv los ntawm qhov tsawg kawg nkaus toxicity, tsis muaj kev quav tshuaj, nws tsis cuam tshuam rau kev ua pa thaum pw tsaug zog thiab tsis cuam tshuam rau nruab hnub wakefulness. "Zolpidem" shortens lub sij hawm mus pw tsaug zog thiab normalizes pw tsaug zog theem. Nws muaj qhov pom kev zoo ntawm lub sijhawm. Yog tus qauv rau kev kho mob insomnia.
Mechanism of action of tranquilizers: pharmacology
"Medazepam". Nws ua rau tag nrho cov teebmeem ntawm benzodiazepines, txawm li cas los xij, cov teebmeem sedative-hypnotic thiab myorealixant tsis zoo. Medazepam yog suav hais tias yog ib qho kev tranquilizer nruab hnub.
"Xanax" ("Alprazolam"). Zoo tsis muaj sedative nyhuv. Luv luv relieves ntshai, ntxhov siab vim, nyob tsis tswm, kev nyuaj siab. Absorbed sai sai. Qhov siab tshaj plaws ntawm cov tshuaj hauv cov ntshav tshwm sim 1-2 teev tom qab noj. Muaj peev xwm khaws cia hauv lub cev hauv cov neeg uas muaj lub raum tsis zoo thiab lub siab ua haujlwm.
"Phenazepam". Ib tug zoo-paub tranquilizer uas yog synthesized nyob rau hauv lub USSR. Nws zoo nkaus li muaj tag nrho cov teebmeem ntawm benzodiazepines. Nws raug sau ua tshuaj tsaug zog, nrog rau kev tshem tawm ntawm cawv (kev tshem tawm syndrome).
"Diazepam" ("Seduxen", "Sibazon", "Relanium"). Nws muaj ib tug pronounced anticonvulsant thiab cov leeg-so cov nyhuv. Nws yog feem ntau siv los txo qhov convulsions, qaug dab peg. Tsawg siv raws litshuaj tsaug zog.
"Oxazepam" ("Nozepam", "Tazepam"). Nws zoo sib xws hauv kev ua rau Diazepam, tab sis nws tsis tshua muaj zog. Anticonvulsant thiab cov leeg nqaij relaxant cuam tshuam tsis muaj zog.
"Chlordiazepoxide" ("Librium", "Elenium", "Chlosepide"). Nws belongs rau thawj classical benzodiazepines. Nws muaj tag nrho cov txiaj ntsig zoo thiab tsis zoo uas yog yam ntxwv ntawm benzodiazepines.
