Nomuchetura anticholinesterase yomuchipatara. Chii anticholinesterases?

pamusoro Tutsinga tunofambisa mashoko utwu kutapukirwa pulses inopiwa chaiyo zvinhu - nevamiririri. Mumwe neurotransmitter ndiyo acetylcholine. vamiririri izvi, nepo panguva synapses, zvazvinoita sero membranes zvichikonzera chinovhiringidza dzavo kana kurudziro uye kukonzera siyana zvinokonzerwa. The zvakawandisa neurotransmitter wakanamatira ne chaicho makemikari.

Anticholinesterase zvinodhaka: zvinhu uye zvinangwa

Pakazosvika anticholinesterase mishonga ndivo avo kuti tunodzivisa enzayemu cholinesterase. Izvi enzayemu unodokwairira kubudikidza hydrolysis ari neurotransmitter acetylcholine, izvo transmits pulses vari kubatwa kwachiri synapses parasympathetic tsinga, ganglia, uye mune zvose somatic fibers. anticholinesterases kunge yakagadzirwa yokuwedzera ezvinhu kuitwa acetylcholine Tutsinga tunofambisa mashoko utwu, uye kweiyi zvimwe zvikamu tsinga. Kushandisa zvinodhaka izvi zvine zvazvinoita pane yose muviri.

Action anticholinesterases zvakafanana migumisiro kweiyi cholinergic tsinga. zvinodhaka izvi anosangana chete nzvimbo pamusoro Kanotokonya pamusoro basa sezvo acetylcholine, nokudaro pakusika chiito zvinogona pamusoro etsinga nokuguma. Cholinomimetics uye anticholinesterase vamiririri Chokwadi, iroro boka pharmacological zvinhu. Kune mhando dzakawanda zvinodhaka zvakasiyana kwemakemikari ravo marongerwo uye reversibility nezvaaiita. Cholinesterase blockers akakamurwa reversible uye kusingarapiki.

Zvinoreva reversible chiito

Anticholinesterases - gadziriro reversible chiito vari kwemakemikari maumbirwo carbamic asidhi esters uye aminoalcohols siyana. Zvaakazoita chinoumba ichivharira cholinesterase, zvinova acidic nekuguma, izvo ndiye ari enzayemu pamwe morekuru zvikuru itsige kutaurirana pane icho chakaumbwa kubata pamwe acetylcholine. zvachose remubatanidzwa ichi kunoitika kuburikidza hydrolysis kwemaawa 3-4.

Achishandisa reversible anticholinesterase chaizvoizvo vari "galantamine", "physostigmine", "Neostigmine" (kana "Neostigmine"), "pyridostigmine," "oksazil", "rivastigmine", "edrophonium."

In phosphorous - a fuma kusingarapiki chiito

Formulations kusingarapiki chiito boka iri ndivo organophosphorus yeimwe. Izvi zvinhu tunodzivisa acetylcholinesterase kwenguva yakareba. Phosphorus, riri Kuronga mamorekuru anoumba yakatsiga remubatanidzwa pamwe enzayemu, izvo zvinogona kurarama mumuviri kwemazuva akawanda kana kuti mavhiki. Recovery zvaida mari acetylcholinesterase kunoitika kuburikidza nokuumbwa mamorekuru itsva. Ichi boka yeimwe rinosanganisira "phosphacol", "Armin", "trichlorfon", "Malathion", "dichlorvos" zvine chepfu, akashandiswa kosi emauto remapazi - sarin uye soman.

mishonga Organophosphate dzine chepfu. Ivo inowanzoshandiswa hwezuva nezuva sezvo zvipembenene; chepfu zvinobvira avo kushandiswa zvisiri uye asiri kuchengetwa vakachengeteka matanho.

Zvinoitika anticholinesterase zvinodhaka

Pane imwe zvakafanana pakati zvinokonzerwa kuti pave muviri anticholinesterases, zviratidzo nomumwe wavo dzinokosha. Kutarisa rinoshanda mugumisiro kana raitongwa kupinda muviri zvinogona somuenzaniso, "neostigmine".

"Neostigmine" inowanika ampoules muchimiro 0,05% mhinduro uye jekiseni subcutaneously kana nomutsinga. Kana jekiseni muimba ropa payo hwezvekukurukurirana kwemutemo pulses mune neuromuscular hutachiwana uye ganglia pamusoro autonomic tsinga. Murwere ezvinhu kunoratidzwa sezvinotevera:

• nokuda dzeraundi tsandanyama marwadzo ari Iris mudzidzi ari kujekesa;
• kunoitika spasm akkommodasie, kuti izvo anotora munhu convex chimiro nokuda kuzvivaraidza Zinn tsapo kuti pfungwa iri pedyo daro, mano kusiyanisa kure zvinhu zviri zvikuru shoma;
• ungaderedza kwemwoyo;
• anowedzera mataurire anotsvedzerera tsandanyama ose nhengo dzomukati - kufema turakiti, dumbu uye ura, dumbu, dundira;
• kunowedzera skeletal tsandanyama sunga nokuda nani kwemutemo nomunhu ari synapses;
• vakawedzera secretion kuti exocrine mumasero - ziya, mate, Árbol, gastric.

kunyoresa

Migumisiro ava basa kushandisa boka iri zvinodhaka ari mushonga akasiyana zviitiko. Zvairatidza anticholinesterase nevasori hakungoitwi zvirwere chaizvo, sezvo vane zvainoita nechepakati uye peripheral tsinga, kukonzera zvinonyatsorehwa zvainoita yose muviri. Kakawanda vanogadzwa vari kutyora innervation uye mataurire skeletal kana mvere tsandanyama.

Chimbofunga mukana kurapwa pamwe anticholinesterase yomuchipatara kunogona kuva muenzaniso "neostigmine". mishonga Uyu reversible chiito kushandiswa myasthenia - imwe chirwere autoimmune, izvo zvinoratidzwa neutera ari skeletal netsandanyama. The chirwere kunoratidza pacharo pakutanga ungaderedza matauriro tsandanyama dzechiso, ipapo kwakaderera tsandanyama zviri pamutsipa, okumusoro migumo; muna Muzviitiko zvakaipisisa, kufema kukundikana nokuda rwakakwana nokushanda diaphragm. "Neostigmine" symptomatic mabasa ari mumuviri, kudzorera nokupfuuridzirwa nomunhu kuna neuromuscular hutachiwana, avandudze tsandanyama matauriro uye gwenya kuita akwanise.

Uyewo, mushonga uyu wakapiwa postoperative nguva apo zvomudumbu turakiti kana atony nezvezvimwe zvinetso zvedundira dundira. In ophthalmology zvinonzi kashoma akaratidza kuti yemaziso kuderedza intraocular kumanikidzwa. Somunhu antagonist rinoshandiswa mune ovhadhozi kuti tsandanyama relaxants uye zvinodhaka antidepolyarizuyuschego chiito. Apo neapo "Neostigmine" rinoshandiswa havi tsandanyama sunga pamwe simba basa.

cheAlzheimer chirwere

Kugadzirira reversible chiito zvave zvirwere zviri nechepakati tsinga, zvakaoma kurapa. chirwere cheAlzheimer anogadzwa "galantamine" - imwe alkaloid yakawanikwa kubva tubers ose snowdrops mhando Galantus ( "Rivastigmine", aka "Exelon"), asi zvikuru therapeutically inobudirira akava "donepezil", kuti zvokusarudza kutigumbura ari acetylcholinesterase muuropi synapses uye akapotsa asingadi kukanganisa kwaro peripheral tsinga.

Contraindications

Zvichienderana migumisiro cholinesterase mishonga reversible chiito, contraindications kwadzinenge vari pfari, asima, angina pectoris, Parkinson nehosha uye zvinetso zvakasiyana-siyana pamusoro cardiac conduction hurongwa.

Zviratidzo ovhadhozi uye chepfu Ache

Kusvibisa anticholinesterases anopa zviratidzo nechokuita zvakananga kunyanya kweiyi receptors nehanya acetylcholine. Pupillary wakacherechedza, tava kuderera mwoyo mwero (bradycardia), Árbol spasm uye - naizvozvo - dyspnea zviratidzo hyperperistalsis nemudumbu kusvikira kurutsa uye manyoka, kuita weti kakawanda. Zvishoma nezvishoma akaderedza BP sezvo migumisiro braking zvinokonzerwa vagal etsinga. Kuitika runobva sunga uye pfura skeletal tsandanyama uye rurimi nokuda conduction zvinetso zviri neuromuscular hutachiwana.

chepfu vesiputous

Ingestion pamusoro Organophosphorus Compounds kukonzera chiremba mufananidzo akafanana chepfu nevasori reversible anticholinesterase chiito. Zviratidzo kuonekwe chaipenya nokuda rokumusoro toxicity nezvinodhaka. For Zviratidzo nomuchetura panguva somatic pamwero vari kuwedzera zvinokonzerwa pamusoro nechepakati tsinga pamwero - kuvhiringidzika, nekuvhiri- ngika, kufema mwoyo.

Organophosphorus yeimwe kukonzera unopinza chinyamunhari chinorwadza, madzerere, dyspnea, vangadikitira, zvikuru kurutsa, kushungurudzika - murwere anotanga kutya, zvinova unmanageable. Nokuda kumeso tsandanyama spasm akanzwa nomusiyano kurwadziwa nomudumbu rake. Kana kudzikira kuitika chinyamunhari chinorwadza, BP Falls, pakoma hwapedyo. Rufu zvingaitika nokuda kuoma kufema centre.

Zviratidzo akafanana vari kuchengetwa vakuvadzwe nomuchetura Amanita muscaria. Izvi imhaka yavo zviri muscarinic - chepfu pamwe cholinomimetic chiito.

Zviito kana nomuchetura

kuchengetwa Medical kana nomuchetura pamwe anticholinesterase yomuchipatara vanogona chete nyanzvi. Muzviitiko izvi, mushonga kutaurwa "Atropine" subcutaneous jekiseni zvinokwanisika kupa "Metacin" kana zvimwe anticholinergics. Zvakakosha kuramba kufema panguva yakakodzera chechetere. Inogona kushandiswa tracheotomy, zvokuimba kufefetedza uye oxygenation.

Kana mhuri chepfu vesiputous kuziva kunobva chepfu kupinda muviri. Kana fuma hwapinda kuburikidza paganda, zvinonzi kumboshamba 3-5% pasoda mhinduro kana nemvura uye sipo. In Kana apo mushonga inenge yatorwa, vanoita gastric lavage, akawanda enemas, ipai adsorbents kana laxatives. Kana organophosphorus mukomboni ane nguva kuwira kuti mukuru zvakadini kupinda muropa, iri basa diurez kushandisa zvinodhaka diuretic. Mune zvimwe zviitiko, vachishandisa nzira inonzwika apo ropa kuburikidza hemodialysis uye hemosorption.

Uyezve, kana nomuchetura vesiputous akagadza Reaktivatory cholinesterase, iyo kana dzakabatwa ari mumaawa mashomanana okutanga pashure kudhaka angadzorera kuvharidzirwa makemikari. Zvingava "Izonitrozin", "Trimedoksim", "Dipiroksim". Kana BP yakakwirira symptomatically ndishandise mishonga antihypertensive. Zvatinofarira kunopiwa kune avo kuti urege kukanganisa musimboti tsinga. Tiine kwakaderera vaingoerekana kufema chinhu zvokuimba kufefetedza uye kupa okisijeni.