Atropine yog qhov paub zoo heev tshwm sim alkaloid (cov khoom ntawm qee cov nroj tsuag). Thiab, txawm hais tias nws tau nquag siv hauv cov tshuaj, nws yog cov tshuaj lom neeg txaus ntshai (cov menyuam yaus muaj kev pheej hmoo). Nws txaus tsuas yog noj belladonna berries, muaj nyob rau hauv peb cheeb tsam.
Ntxiv rau hauv kab lus koj yuav kawm txog kev siv thiab kev cuam tshuam ntawm atropine rau tib neeg lub cev, nrog rau kev txheeb xyuas kev lom thiab yuav ua li cas nrog nws.
phom sij alkaloid
Yog li atropine yog dab tsi? Cov tshuaj no belongs rau pawg ntawm alkaloids. Lub sij hawm alkaloid txhais tau hais tias lub hauv paus heterocyclic muaj cov pab pawg nitrogenous thiab nthuav tawm cov haujlwm lom neeg hauv qee cov nroj tsuag. Yooj yim hais, cov no yog cov khoom sib txuas uas tuaj yeem cuam tshuam rau ib txoj hauv kev lossis lwm qhov ntawm cov kab mob muaj sia. Ib tsob nroj tuaj yeem muaj ob peb alkaloids.
Cov nroj tsuag muaj atropine: henbane, datura, belladonna (Belladonna), scopolia thiab lwm hom nightshade.
Kev piav qhia
Cov tshuaj yog ib yam tshuaj lom, txawm li cas los xij, kev siv tshuaj atropine me me tau nthuav dav hauv kev kho mob.
Cov qauv tshuaj ntawm alkaloid faib nws ua cov hmoov crystalline. Cov tshuaj no yog amorphous, tsis muaj xim thiab tsw. Nws muaj ob isomers. Hyoscyamine yog ib qho levorotary, uas yog nquag tshaj li atropine. Nws yog hyoscyamine uas yog ib feem ntawm cov muaj pes tsawg leeg ntawm cov nroj tsuag, tab sis thaum chemically tso tawm, nws hloov mus rau hauv atropine.
Mechanism of action
Cov alkaloid hauv nqe lus nug tiv thaiv kev ua ntawm cov hlab ntsha impulse los ntawm kev thaiv cov receptors. Nws hloov tawm hais tias nws yog ib tug neeg sib tw ntawm tej yam ntuj tso khoom ntawm lub cev (acetylcholine), nyob rau hauv lub peev xwm los khi rau rhiab xaus thaum lub sij hawm impulse. Muaj ob hom rhiab kawg: H thiab M. Tsuas yog tom kawg yog thaiv los ntawm alkaloid txaus ntshai.
Lub tshuab ua haujlwm ntawm atropine yog tias tsis yog acetylcholine, nws khi rau cov txheej txheem tshwj xeeb ntawm cov paj hlwb.
Cov teebmeem sib txawv tau pom nyob ntawm thaj tsam ntawm qhov raug tshuaj:
- Kev so ntawm cov leeg nqaij du - sau tseg hauv plab hnyuv, bronchi, zais zis. Cov nyhuv no yog vim qhov inhibition ntawm impulses ntawm lub paj hlwb parasympathetic.
- Txo kev ua haujlwm zais cia ntawm cov qog endocrine, suav nrog bronchial, digestive, hws, salivary, lacrimal. Cov nyhuv suppressive ntawm atropine nyob rau hauv cov ntaub ntawv no yog vim lub blockade ntawm lub sympatheticpaj hlwb (tua, hws) thiab parasympathetic (bronchial, digestive).
- Mydriasis lossis cov menyuam yaus dilated. Ua antagonists, cov leeg radial thiab ncig ntawm iris ntawm lub qhov muag sib npaug. Lub orbicular leeg ntawm iris so vim yog kev khi ntawm atropine rau M3 cholinergic receptors, thiab kev ua ntawm cov leeg radial predominates, nws yog nruj, uas ua rau cov menyuam kawm ntawv dilation.
- Paralysis ntawm chaw nyob. Cov nyhuv so ntawm atropine ntawm cov leeg ciliary ntawm lub qhov muag ua rau lub lens flatten, ua rau pom kev deb.
- Qhov kev nce hauv lub plawv dhia tshwm sim vim qhov inhibition ntawm parasympathetic kev txiav txim ntawm lub sinoatrial node. Qee lub sij hawm bradycardia (txo lub plawv dhia) tuaj yeem ua ntej qhov nce hauv lub plawv dhia, uas yog tshwm sim los ntawm kev txhawb nqa ntawm cov chaw vagal.
- Cov tshuaj ntau npaum li cas cuam tshuam rau cov hlab ntsha ntawm tib neeg lub cev: lawv nthuav dav, thiab daim tawv nqaij tig liab. Cov koob tshuaj me me ntawm atropine tsis muaj dab tsi los ua kom cov hlab ntsha, tab sis tuaj yeem cuam tshuam nrog lwm cov tshuaj vasodilating.
Cov lus qhia rau kev siv atropine
Tam sim no, muaj peb hom kev tso tawm ntawm cov tshuaj, cov tshuaj nquag uas yog alkaloid belladonna:
- "Atropine" hauv daim ntawv ntawm cov ntsiav tshuaj.
- "Atropine sulfate" - ib feem pua ntawm cov tshuaj atropine rau kev txhaj tshuaj hauv ampoules ntawm 1 ml.
- "Atropine sulfate" - ib feem ntawm qhov muag tee hauv polyethylene dropper fwj ntawm 5 ml.
Cov tshuaj no yog siv dav hauv kev kho mob. Nws raug sau tseg rau lub hom phiaj gastroenterological:
- txo cov nyhuv ntawm spasms ntawm pyloric sphincter ntawm lub plab;
- tiv thaiv plab hnyuv hauv plab thiab duodenal ulcers;
- tso kua tsib tso tseg thiab nthuav cov ducts nyob rau hauv cov kab mob gallstone thiab o ntawm lub gallbladder.
Cov lus qhia rau kev siv atropine hauv lwm ceg ntawm cov tshuaj:
- nrog bronchial hawb pob (tawm bronchospasm);
- txo qis tso tawm hws, lacrimal, qog qaub ncaug;
- rau lub zais zis spasms;
- nrog qhov txo qis hauv lub plawv dhia cuam tshuam nrog lub suab nrov vagal (ceev faj, yuav ua rau lub sijhawm luv luv ntawm bradycardia);
- nrog hws ntau ntxiv;
- rau premedication thiab tshuaj loog nyob rau hauv tshuaj loog, thaum lub sij hawm intubation, kev khiav hauj lwm kom tshem tawm bronchospasm thiab laryngospasm, kom txo tau salivation;
- kom txo lub plab tone ntawm x-rays.
Lwm qhov twg siv atropine? Nws yog ib qho tshuaj tua kab mob yog tias lub cev raug tshuaj lom los ntawm organophosphorus tebchaw / tshuaj lom, nws kuj yog siv rau kev noj tshuaj ntau dhau ntawm cov tshuaj anticholinesterase thiab cholinomimetic. Tsis tas li ntawd, daim ntawv tso tawm ntawm atropine nyob rau hauv ampoules yog siv nyob rau hauv ophthalmology kom dilate cov me nyuam kawm ntawv nyob rau hauv txoj kev tshawb no ntawm fundus.
Kev noj tshuaj thiab kev tswj hwm
Atropine yog siv rau qhov ncauj, tso ntshav thiab intramuscularly, raws li qhov muag te, lossis subcutaneously. Raws li kev pom zoo thiab kev tshuaj xyuas kev kho mob, Atropine ntsiav tshuaj raug tshuaj los ntawm 0.25 txog 1.mg mus txog peb zaug ib hnub twg. Kev hloov ntau npaum li cas yog txiav txim los ntawm ib tus neeg mus rau hauv kev npaj cov tshuaj rau txhua tus neeg mob.
Intramuscular, intravenous thiab subcutaneous - tib koob tshuaj, tsuas yog nce mus txog ob zaug ib hnub.
Qhov muag tee yuav tsum tau muab tso rau hauv qhov kev txiav txim hauv qab no: 1-2 tee peb zaug ib hnub. Txhawm rau dilate cov tub ntxhais kawm rau kev tshawb fawb lub hom phiaj - ob tee 1-2 zaug. koob tshuaj atropine ib zaug yuav tsum tsis txhob ntau tshaj 1 mg, ib hnub twg - tsis ntau tshaj 3 mg.
Qhov hnyav ntawm qhov tshwm sim ntawm kev lom atropine nyob ntawm nws qhov xwm txheej - yuam kev lossis lub hom phiaj. Feem ntau, tib neeg raug tshuaj lom tom qab noj txiv hmab txiv ntoo ntawm tsev neeg nightshade.
Qhia txog kev noj tshuaj ntau dhau
45-60 feeb tom qab noj cov tshuaj, cov tshuaj lom ntawm atropine pib tshwm. Raws li qhov ntau npaum, qhov degree ntawm kev lom tuaj yeem yog me me, nruab nrab lossis hnyav. Cov tshuaj cuam tshuam, ua ntej ntawm tag nrho cov, cov qauv ntawm lub hlwb (psychosis, hallucinations, impaired coordination), tsuas yog ces lub ntsws thiab lub plawv raug kev txom nyem.
Atropine overdose cov tsos mob:
- liab ntawm mucous daim nyias nyias;
- dry mouth;
- txoov hws;
- palpitations, arrhythmia;
- ntuav, xeev siab;
- limb tremor;
- pom qhov tsis pom kev;
- tawv nqaij liab;
- pab;
- cem quav;
- yuav nqhis, nqhis dej;
xav
Txhua cov tsos mob saum toj no tshwm sim thaumtsis txhob txwm noj tshuaj ntau dhau.
Lub hom phiaj cog tshuaj lom muaj cov tsos mob hnyav dua:
- kev xav;
- tsis nco qab;
- coma;
- tus tuag tes tuag taw ua pa;
- lub plawv dhia qis, ventricular fibrillation lossis atrial fibrillation.
Registered lethal dosage of atropine ranges of 100-150mg los yog 1-1.5mg ib kilogram ntawm lub cev qhov hnyav.
Yog suav hauv belladonna berries, ces 4-6 daim tuaj yeem ua rau tus menyuam tuag, uas tshwm sim tsis pub dhau tsib teev tom qab siv tshuaj lom.
Tej zaum yuav muaj lwm yam tshwm sim. Yog hais tias ib tug neeg nyob rau hauv lub coma ntev, nco thiab kev txawj ntse yuav atrophy vim irreversible organic hloov nyob rau hauv lub hlwb.
Yuav ua li cas cawm tus neeg raug mob?
Tshuaj lom nrog zaub lom yog kho feem ntau los ntawm plab hnyuv nrog dej, saline laxative daws (magnesium sulfate) lossis potassium permanganate. Nws yog ib qho tsim nyog yuav tsum muab tam sim ntawd rau tus neeg uas tau tshuaj lom cov tshuaj tiv thaiv ntawm atropine. Ntawm lawv: ib qho kev daws ntawm aminostigmine ib feem pua (2 mg), kev daws ntawm galantimin ib nrab ib feem pua (tshuaj "Nivalin" - 2 mg).
Kev taw qhia yuav tsum rov ua dua tom qab 90 feeb. Qhov muaj zog ntawm kev lom, qhov luv luv ntawm cov koob tshuaj ntawm cov tshuaj tua kab mob. Cov mob hnyav tshaj plaws yuav tsum tau txhaj tshuaj txhua 15 feeb.
Ntau ntxiv txog yuav ua li cas cov tshuaj tiv thaiv ua haujlwm
Aminostigmine pab kom rov qab nco qab sai, tshem tawm kev ntxhov siab psychomotor thiabkev xav tsis thoob. Nws yog siv tsis tsuas yog nyob rau hauv cov ntaub ntawv ntawm overdose, nws yog feem ntau siv los tiv thaiv rov tshwm sim ntawm coma.
Lwm tus atropine antagonist yog alkaloid pilocarpine. Raws li nws, cov tshuaj (qhov muag tee) yog tsim thiab siv nyob rau hauv ophthalmology raws li ib tug txhais tau tias kom txo intraocular siab. Los ntawm dilating tus menyuam kawm ntawv, atropine tuaj yeem ua rau glaucoma. Nyob rau hauv lub qhov muag, nce siab tuaj yeem ua rau retinal detachment. Nyob rau hauv cov ntaub ntawv ntawm lom los ntawm cov nroj tsuag los yog npaj muaj atropine, pilocarpine yuav tsum tau muab tam sim ntawd raws li cov nram qab no tswvyim:
- rau ib teev 1 poob rau hauv txhua qhov muag txhua 15 feeb;
- hauv ob teev tom ntej no, koj yuav tsum tau 1 poob ntawm cov khoom txhua 30 feeb;
- rau 6 teev tom ntej no koj yuav tsum tau 1 poob ib teev;
- ces ib poob ib hnub txhua xya teev (kom txog thaum lub siab intraocular siab txo qis).
Price of medicine
"Atropine" nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj thiab ampoules yog ib qho tshuaj pheej yig nyob rau hauv ib lub tsev muag tshuaj, tab sis nws yog muab nruj me ntsis raws li cov tshuaj. Hauv lub tsev muag tshuaj, cov kws muag tshuaj yuav xav tau daim ntawv xaj los ntawm tus kws kho mob uas muaj pes tsawg. Daim ntawv tso tawm hauv ampoules raug nqi 70-90 rubles (tus nqi ntawm ib lub ampoule ntawm ib feem pua tshuaj), nyob ntawm thaj tsam. Tus nqi ntawm "Atropine" nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj fluctuates nyob ib ncig ntawm 20 rubles.
Reviews
Raws li cov neeg uas tau sim ua qhov kev txiav txim ntawm atropine ntawm lawv tus kheej, nws tuaj yeem siv los so kom tag lub qhov muag.
Txawm li cas los xij, nws yuav tsum tau nco qab tias tom qabnws txoj kev siv cuam tshuam kev ua haujlwm ntawm lub zeem muag (rau qhov siab kawg ntawm ob hnub). Atropine tau tshaj tawm los ntawm qee cov neeg ua rau mob qhov muag vim muaj zog intraocular siab. Tam sim no, muaj ntau cov analogues uas muaj txiaj ntsig zoo thiab muaj txiaj ntsig zoo. Ntau tus neeg yuav khoom hais tias atropine yog cov tshuaj uas tsis muaj hnub nyoog. Lwm tus pom zoo nrog qhov kev xav no, tab sis yog nyob rau hauv kev pom zoo ntawm cov tshuaj, txij li thaum nws ua nws cov hauj lwm kom zoo thiab, nyob rau hauv kev sib piv nrog rau cov tshiab innovation, yog ntau txhim khu kev qha. Thiab tus nqi ntawm atropine yog me me. Raws li kev tshuaj xyuas tsis ntev los no, atropine tuaj yeem ua rau muaj kev tsis haum tshuaj. Qee cov menyuam yaus mob: daim tawv nqaij thiab qhov muag liab. Nyob rau hauv tas li ntawd, yuav tsum tau mus kho mob tam sim ntawd.
Atropine, raws li tau hais ua ntej, yog alkaloid ntawm cov nroj tsuag ntawm tsev neeg nightshade.
Cov tshuaj anticholinergic no tau siv dav hauv tshuaj. Nws yog siv hauv toxicology, gastroenterology, pulmonology, ophthalmology, anesthesiology, cardiology.
Kev noj tshuaj ntau dhau ntawm atropine tuaj yeem tshwm sim nrog belladonna lossis ntau cov tshuaj. Qhov degree ntawm kev lom nyob ntawm tus nqi ntawm cov khoom noj. 100 mg ntawm atropine yog tuag taus. Aminostigmine thiab galantamine yog cov tshuaj tiv thaiv tshwj xeeb uas yuav tsum tau noj tam sim ntawd (rov muab tso rau hauv cov hlab ntsha). Coma, tsis nco qab thiab kev txawj ntse yog tag nrho cov txiaj ntsig ntawm atropine lom.
