Atropine yog cov khoom siv kho mob uas tau txais los ntawm cov nroj tsuag xws li belladonna, dope, henbane. Nws yog tus neeg sawv cev parasympathetic, uas yog, nws muaj peev xwm inhibiting cov haujlwm ntawm cov hlab ntsha ntawm pawg parasympathetic.
Atropine action
Atropine belongs rau pawg ntawm alkaloids. Txhua yam ntawm cov pab pawg no hauv cov koob tshuaj me me muaj cov txiaj ntsig kho mob. Txawm li cas los xij, kev siv ntau tshaj qhov tso cai ua rau muaj tshuaj lom hnyav, uas, yog tias muaj kev kho mob tsis tu ncua, ua rau tuag.
Hauv cov tshuaj, atropine yog siv ntau txoj hauv kev, vim tias qhov spectrum ntawm nws cov teebmeem loj heev:
- relaxes smooth nqaij;
- relieves mob plab hnyuv thiab biliary colic;
- nce plawv dhia;
- txo cov qog ua kua: bronchial, salivary, gastric, hnyuv, hws thiab pancreas;
- siv los kho cov kab mob uas tau tsim hauv plab lossisduodenum.
Tsis tas li, atropine yog siv hauv kev kho mob rau cov menyuam yaus.
Nws yog noj qhov ncauj, txhaj, siv qhov muag dauv.
Hauv tshuaj, xws li tshuaj lom neeg xws li atropine sulfate tau pom daim ntawv thov. Outwardly, nws yog cov hmoov dawb, muaj cov muaju. Tsis muaj ntxhiab tsw thiab yaj sai sai.
Siv atropine hauv OP tshuaj lom
Organophosphorus tebchaw (OPs) tau nquag siv hauv kev ua liaj ua teb thiab lub neej txhua hnub rau kev puas tsuaj ntawm kab, nas, nroj tsuag, thiab lwm yam. Ua rau OPs tuaj yeem ua rau ib leeg thiab loj heev.
Thaum lub sijhawm thawj cov tsos mob ntawm organophosphate lom, nws yog ib qho tsim nyog yuav tsum tau ua cov tshuaj tua kab mob nrog 0.1% atropine tov:
- qib me me ntawm kev lom - 1-2 ml intramuscularly;
- nruab nrab ntawm kev lom - 2-4 ml intravenously lossis intramuscularly;
- mob hnyav - 4-6 ml IV lossis IM thiab rov ua dua ntawm 3-8 feeb kom txog thaum pib cov tsos mob ntawm atropinization (cov menyuam kawm dilated, cov mucous qhuav) pib tshwm.
Nyob rau hauv mob hnyav heev, koob tshuaj atropine tau txais mus txog 30 ml.
Yuav ua rau muaj tshuaj lom
Atropine lom tshwm sim nyob rau hauv ob peb kis. Txhua tus ntawm lawv tuaj yeem zam tau, tab sis kev tsis saib xyuas kev noj qab haus huv dhau los ua qhov tshwm sim ntau dua.
mob atropine lom tautshwm sim nyob rau hauv tus txheej txheem ntawm kev noj tshuaj raws li nws los yog tshwm sim los ntawm kev noj henbane, belladonna, dope, thiab lwm yam. Ib qho overdose ntawm cov tshuaj nrog atropine tuaj yeem txiav txim los ntawm cov menyuam kawm ntawv dilated, uas yog vim qhov nce hauv intraocular siab.
Kev noj txiv hmab txiv ntoo, txiv hmab txiv ntoo thiab lwm qhov chaw ntawm cov nroj tsuag muaj tshuaj lom uas muaj cov co toxins, ib tus neeg yuav muaj kev phom sij rau cov alkaloid no. Cov hau kev tseem ceeb ntawm kev nkag mus rau cov tshuaj lom hauv lub cev muaj xws li:
- ingestion;
- thov ntawm daim tawv nqaij;
- thaum nqus pa;
Qhov tshwm sim tuag los ntawm kev lom yuav tshwm sim yog tias tus menyuam noj 100 mg ntawm atropine sulfate, thiab tus neeg laus - 130 mg.
Cov tsos mob tseem ceeb ntawm kev lom
Kev npam sai heev. Txawm hais tias nws tag nrho nyob ntawm qhov loj ntawm cov koob tshuaj alkaloid, cov tsos mob tseem ceeb pib tshwm sim tom qab 20 feeb. Muaj cov tshuaj tiv thaiv ntawm cov tshuaj sib xyaw ua ke thiab daim siab cov protein, uas ua rau tsim cov metabolites. Kev ua haujlwm ntawm ob lub raum txo qis - ntshav pom nres, thiab cov khoom lag luam metabolic tsis tawm hauv lub cev nrog cov zis lawm.
Yog tus neeg raug tsim txom tsis tau txais kev pabcuam thawj zaug, nws tsim muaj kev nqhis dej, kev nqhis dej yuav cuam tshuam, thiab lub suab yuav ploj mus.
Tom qab, cov tsos mob hauv qab no ntawm kev lom atropine tshwm sim:
- tawv thiab flaky;
- ntsej muag thiab lub cev blush, khaus tshwm sim;
- ua pa nrawm, tachycardia tshwm sim;
- hnoos hnyav pib,uas tig mus ua "barking";
- lub cev kub nce;
- cov menyuam kawm ntawv tsis hnov qab lub teeb thiab nyob twj ywm, qhov muag poob;
- dizzy.
Thaum saib xyuas tus neeg mob tus mob, koj yuav tsum tsis txhob tsom mus rau qhov ntsuas pulse nkaus xwb, txij li thaum ncav cuag 160 tus neeg ntaus ib feeb, nws xyaum tsis hloov.
Thaum tus kab mob atropine ua rau mob hnyav, cov tsos mob ntawm tus kab mob zoo ib yam li cov hlab ntsha hauv nruab nrab. Cov txheej txheem no tau muab faib ua ob theem.
1 theem
Cov yam ntxwv ntawm tus cwj pwm ntawm tus neeg mob hauv thawj theem ntawm kev mob hnyav ntawm atropine intoxication yog lub suab nrov, ntuav hauv txaj, nce kev ntxhov siab. Ib tug neeg tsis taw qhia nws tus kheej hauv qhov chaw, tas li sib tsoo nrog cov khoom uas nyob hauv nws txoj kev, sim ntes cov khoom hauv huab cua uas tsis muaj nyob. Tus neeg mob coj tus cwj pwm tsis zoo ntau dua. Muaj kev hloov pauv sai ntawm kev quaj thiab luag.
Tag nrho cov tsos mob no tshwm sim nyob rau tib lub sijhawm nrog mob taub hau hnyav, pom kev pom tshwm sim, thiab cov leeg nqaij nce ntxiv. Cov tsos mob ntawm pathological reflexes yog ua tau. Nyob rau hauv cov ntaub ntawv ntawm qhov hnyav ntawm daim ntawv lom, qaug dab peg thiab convulsions pib.
theem ob
Rau theem tom ntej, kev qaug cawv dhau 6-10 teev tom qab lub sijhawm lom. Lub sijhawm thib ob yog faib rau cov xwm txheej no thaum tus neeg mob tau nkag mus rau hauv cov tshuaj tua kab mob. Tom qab ntawd, tus neeg mob nyob rau hauv lub xeev kev nyuaj siab, tej zaum yuav ncua sij hawmpoob siab. Nyob rau theem ob, tus neeg mob yuav poob rau hauv coma.
pab thawj rau atropine intoxication
Yuav ua li cas pab nrog atropine lom? Nyob ntawm qhov ua rau intoxication.
Nyob rau hauv rooj plaub thaum ua rau lom yog ib qho overdose ntawm cov tshuaj, nws yog tsim nyog los pib ntxuav lub plab. Txhawm rau ua qhov no, tus neeg mob yuav tsum haus li peb litres ntawm cov tshuaj sov, uas tau npaj nrog kev ntxiv cov pa roj carbon monoxide lossis potassium permanganate (potassium permanganate) hauv qhov sib piv ntawm 1: 1000..
Koj tseem tuaj yeem muab tus neeg mob 1-2% kev daws ntawm tannin rau haus thiab ib qho enema nrog tib tannin, tab sis 0.5% concentration.
Tom qab cov kev tswj hwm zoo li no, tus neeg mob yuav tsum tau muab tso rau hauv lub tsev kho mob toxicological lossis mob hnyav ntawm lub tsev kho mob, qhov chaw nws yuav tau txais kev pab tag nrho.
Kev kho mob hauv tsev kho mob ntawm atropine lom
Nyob hauv tsev kho mob, tus neeg mob ua ntej ntawm tag nrho cov yuav tsum tau nkag mus rau ib qho tshuaj tua kab mob, cov tshuaj pharmacological uas yuav cuam tshuam rau atropine. Kev xaiv tshuaj tua kab mob rau atropine lom nyob ntawm tus neeg mob cov tsos mob.
Qhov ncauj thiab parenteral (intramuscular, intravenous, ophthalmic, inhalation) txoj hauv kev ntawm atropine rau hauv lub cev uas ua rau arrhythmia, coma, hallucinations, mob siab heev los yog qaug dab peg yog neutralized los ntawm physostigmine. Yog tias tsis muaj lwm yam mob ntawm lub hauv nruab nrab lub paj hlwb thiab kev sib xyaw ntawm cov tshuaj tsis ua haujlwm, ces tag nrho cov tsos mob saum toj no dhau los ntawm ntau yam.feeb.
Cov tshuaj tiv thaiv rau atropine lom yog muab tshuaj subcutaneously thiab cov tshuaj yog 1 ml.
txhawm rau txhim kho tus neeg mob tus mob thiab txo kev qaug cawv, nws yog qhov tsim nyog los ntxuav lub cev ntawm cov co toxins uas tsis tau tawm los ntawm lub raum cuam tshuam. Rau qhov no, tus neeg mob tau muab dej nrog cov tshuaj diuretic (piv txwv li, furosemide). Yog tias tus mob intoxication mob hnyav, nws yog ib qho tsim nyog yuav tsum tau siv cov tshuaj diuresis hauv qab no:
- glucose 5%;
- sodium bicarbonate 4%;
- sodium chloride.
Yuav siv ib hnub kom tshem tawm cov tshuaj lom hauv lub cev kom tiav.
Tshwj xeeb yog mob hnyav, thaum tus neeg mob muaj kev tshee, convulsions lossis psychomotor agitation, neuroleptics yuav raug tshuaj los ntawm kws kho mob.
Txhawm rau txo lub cev kub, txhaj tshuaj analgin yog siv, dej khov siv rau ntawm puab tais thiab lub taub hau, thiab ua kom ntub dej tas li ntawm daim tawv nqaij.
Txhawm rau tshem tawm qhov ua tsis taus pa tob, nws yog qhov tsim nyog los ua kom lub ntsws ua pa tawm.
Tom qab atropine raug tshem tawm tag nrho ntawm lub cev, cov kws kho mob yuav tsum tau tsom mus rau kev kho mob. Nws muaj ntau yam kev ua ub no. Cov tshuaj yuav ua tau zoo npaum li cas thiab sai npaum li cas yuav nyob ntawm qhov ceev ntawm kev tswj xyuas cov tshuaj tua kab mob.
Tiv thaiv kev lom atropine
Tiv thaiv kev lom atropine yog muab faib ua ob thaj chaw, nyob ntawm "tus neeg nqa khoom" ntawm cov tshuaj lom (nroj tsuag, tshuaj).
Kev ntsuas txhawm rau tiv thaiv kev lom nrog cov tshuaj uas muaj belladonna extract, ua ntej ntawm tag nrho cov, ua tib zoo ua raws li cov lus qhia los ntawm cov lus piav qhia. Tsis muaj teeb meem koj yuav tsum tau noj ntau dhau, thiab ntau dua, tsis txhob sim ua koj tus kheej cov tshuaj los ntawm cov nroj tsuag lom hauv tsev.
Thaum lub sijhawm ua si sab nraum zoov, koj yuav tsum hla dhau, thiab ntau ntxiv, tsis txhob noj cov txiv ntoo ntawm cov nroj tsuag tsis paub. Cov me nyuam me ntawm txoj kev yuav tsum tau saib xyuas kom zoo kom tsis txhob noj cov txiv hmab txiv ntoo lom. Rau cov menyuam yaus, kev tiv thaiv yog qhia cov nroj tsuag txaus ntshai thiab piav qhia vim li cas lawv yuav tsum tsis txhob noj.
Txhais tau
Intoxication ua rau muaj mob loj rau lub cev. Nws cov degree nyob ntawm qhov ntim ntawm alkaloid uas tau nkag mus rau hauv cov hlab ntsha, tus yam ntxwv ntawm tus neeg mob thiab txoj kev nkag mus ntawm cov tshuaj lom.
Qhov tshwm sim feem ntau suav nrog:
- glaucoma, retinal detachment thiab lwm yam tsis pom kev;
- cuam tshuam ntawm lub hauv paus paj hlwb;
- teeb meem nrog plab hnyuv;
- mob coma ntev, ua rau muaj qhov tshwm sim tsis zoo hauv lub hlwb thiab tej zaum yuav tuag.
