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ID:45629175
大小:91.00 KB
页数:26页
时间:2019-11-15
《姚晨玲-镇静催眠药中毒》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、Toxicity,Sedative-Hypnotics中山急诊姚晨玲BackgroundSedative-hypnoticsareagroupofdrugsthatcauseCNSdepression.Benzodiazepines(BZD)barbituratesnonbarbituratenonbenzodiazepinesedative-hypnotics(NBNB)themostcommonlyusedagentsBackgroundacutesedative-hypnoticspoisoningwithdrawalsyndromeEtiologyBenzodiazep
2、ines(BZD)Longacting(halflife>30h):chlordiazepoxide(利眠宁)diazepam(地西泮、安定)flurazepam(氟安定)Shortacting(halflife6-30h):alprazolam(阿普唑仑)Ultrashortacting:triazolam(三唑仑)EtiologyBarbituratesUltrashortactingMethohexital(Brevital甲己炔巴比妥)thiopental(Pentothal硫喷妥那)Shortactingpentobarbital(Nembutal戊巴比妥)secob
3、arbital(Seconal司可巴比妥)IntermediateactingAmobarbital(Amytal异戊巴比妥)butalbital(Fioricet,Fiorinal异丁巴比妥)LongactingPhenobarbital(Luminal鲁米那)Nonbarbiturate,nonbenzodiazepinesedative-hypnotics(NBNB)Chloralhydrate(水合氯醛)Ethchlorvynol(乙氯维诺)Glutethimide(导眠能)Methyprylon(甲乙哌酮)Meprobamate(眠尔通)Etiology一、Pharm
4、acokinetics:1、PharmacokineticsoftheBZDMostBZDareextensivelymetabolizedbytheliver.Somearemetabolizedtoproductswhichareactiveandmayhaveamuchlongerhalflifethantheparentdrug.ThemajorrouteofmetabolismisN-demethylation.intheelderlyCimetidinePathogenesisPathogenesis2、PharmacokineticsofBarbituratesB
5、arbiturateswithlowlipidsolubilityareexcretedintheunchangedformbythekidneys.iephenobarbital(苯巴比妥).Barbiturateswithhighlipidsolubilityaremetabolizedtomorepolarcompoundsintheliverbeforebeingexcretedviathekidneys.iethiopental(硫喷妥).3、PharmacokineticsofNBNBMostNBNBareextensivelymetabolizedbytheliv
6、erPathogenesisBZDIntheCNS,benzodiazepinesexerttheirclinicaleffectbyenhancingtheactivityoftheinhibitoryneurotransmitterGABA.(TheclinicaleffectsofGABAreleaseandGABA-gatedchloridechannelsincludesleepinductionandexcitementinhibition)BarbituratesinprolongationofthedurationofopeningofGABA-gatedchl
7、oridechannels,leadingtohyperpolarizationofthemembraneandsuppressionofneurotransmission.。NBNBsimilartotheactionofBarbiturates二、ThemechanismofactionPathogenesisBZDGABAchloridechannelCl-Cl-+++++-----hyperpolarizationClinicalBenzodiazepineblurredvision
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