Chefo mahlahana anticholinesterase. anticholinesterases ke eng?

ka methapo ea kutlo phetiso linaoa e fanoa ke dintho khethehileng - mediators. E mong oa neurotransmitter ke acetylcholine. mahlahana tsena, ha ka synapses, e ama lera la seleng ea etsa hore thibelo ea bona kapa ho hlasimolla le ho etsa hore liphello tse sa tšoaneng. The neurotransmitter feteletseng khomaretse ke enzyme e itseng.

lithethefatsi Anticholinesterase: makgetheng le merero

Ke lithethefatsi le anticholinesterase ba elang hore thibela metsoako e potlakisang tsebetso ea lik'hemik'hale cholinesterase. cleaves ena potlakisang tsebetso ea lik'hemik'hale ke hydrolysis tsa neurotransmitter acetylcholine, e leng fetisetsa linaoa ka habonolo tlhokeng synapses methapo parasympathetic, ganglia, 'me ka likhoele tsohle somatic. anticholinesterases ebe li entsoe ho ntlafatsa bohato situational tsa methapo ea kutlo acetylcholine, le tlhotlheletso likarolo tse itseng tsa tsamaiso ea methapo. Tšebeliso ea lithethefatsi tsena e na le phello e phelang kaofela.

Action anticholinesterases e tšoanang le phello ea tlhotlheletso ya methapo cholinergic. lithethefatsi tsena li ka sebelisana le site ya e tšoanang ka receptor mosebetsi holim'a ka acetylcholine, ka tsela eo ho bōpa le bokgoni ba ketso tsa methapo ea kutlo 'me ho qetelloa. Cholinomimetics le mahlahana anticholinesterase ke e le hantle, sehlopha se tšoanang oa ho dintho diokobatsi. Ho na le mefuta e 'maloa ea lithethefatsi hore li fapana ka lik'hemik'hale sebopeho bona le reversibility ea nkang khato. blockers Cholinesterase ba arotsoe ka reversible le etsolloa.

Bolela ketso reversible

Anticholinesterases - litokisetso bohato reversible ke ya sebopeho lik'hemik'hale tsa esters carbamic acid e le aminoalcohols tse sa tšoaneng. Itsoara joang ka karolo thibela cholinesterase, ho ba asiti qetellang ka, e leng theha potlakisang tsebetso ea lik'hemik'hale le molek'hule e ngata ho feta e tsitsitseng le puisano e feta hore e leng e thehiloe ke sebelisana le acetylcholine. Complete timetso ea motsoako o hlahellang ke hydrolysis bakeng sa lihora tse 3-4.

Ka ho ba le reversible le phello anticholinesterase ke "galantamine", "physostigmine", "Neostigmine" (kapa "Neostigmine"), "pyridostigmine," "oksazil", "rivastigmine", "edrophonium."

Ka phosphorous - ntho bohato etsolloa

Formulations etsolloa ketso tsa sehlopha sena ke organophosphorus metsoako. dintho tsena thibela metsoako acetylcholinesterase bakeng sa nako e telele. Phosphorus, e leng ka ho hlophisoa ha limolek'hule le e bopa le komponeng tsitsitseng le potlakisang tsebetso ea lik'hemik'hale, e leng ka pholoha 'meleng bakeng sa matsatsi a' maloa kapa esita le libeke tse. Hlaphoheloa hlokahalang palo acetylcholinesterase le hlaha ka sebopeho sa limolek'hule tsa bocha. Sehlopha sena sa metsoako akarelletsa "phosphacol", "Armin", "trichlorfon", "Malathion", "dichlorvos" dintho nang le chefo e, le sebelisitsoe ka tsela ea tshebetso sesole - sarin le soman.

lithethefatsi Organophosphate ke haholo nang le chefo e. Ba atisa ho sebediswa ka bophelo ba letsatsi le letsatsi e le bolaeang likokoanyana; chefo khoneha ke ho sebelisa ha bona fosahetseng le batho bao e seng bolokoa mehato polokeho.

Litla anticholinesterase lithethefatsi

Ho tšoana itseng pakeng tsa liphello tse hlahisa anticholinesterases 'mele, ho bonahala mong le e mong ba bona ba khethehileng. Ho nahana ka ba le phello e e sebetsang ha tsamaisoa ka 'mele oa ka kgona ho etsa mohlala, "neostigmine".

"Neostigmine" e fumaneha ka ampoules ka mokgwa wa ya 0.05% tharollo le tshelwa subcutaneously kapa a entoe. Ha tshelwa ka mali e ntsetso-peleng ea temana ea linaoa ka phetiso neuromuscular le ganglia tsa tsamaiso ea methapo autonomic. boemo ba mokuli e bontšoa ka tsela e latelang:

• e loketseng ho tse chitja mesifa khutsufatso ea iris e thaka e narrowed;
• le hlaha spasm ea accommodation, lense a qala ho ea sebopeho khonvekse ka lebaka la ho ikhatholla Zinn mangata a a tsitsinkela e behiloeng ka ho hōjana haufi, bokhoni ba ho khetholla beha dintho hole e haholo tsa fokotswa;
• fokotseha ho otla ha pelo;
• eketsa molumo oa mesifa le boreleli la litho tse ka hare - matšoafo pampitšana, mala le mala, popelo, senya;
• ntlafatsoa ya marapo pelehi mesifa e loketseng ho ntafaditsweng feta ha litakatso tsa ho synapses;
• eketseha secretion ea litsoelesa exocrine - mofufutso, mathe, bronchial, gastric.

kopo

liphello tsena ba na le boikarabelo bakeng sa tshebediso ya sehlopha sena lithethefatsi ka moriana maemong a fapaneng. Ho bonahala anticholinesterase mahlahana ha le felle ho mafu a itseng, kaha ba na le phello e tsamaiso ea e bohareng le e pheriferale tšohile, a etsa hore ho e le hantle ka kakaretso ka phelang ka kakaretso. Hangata ka ho fetisisa di khethiloeng ka tlōla innervation le molumo oa mesifa ya marapo kapa boreleli.

Nahana ka monyetla oa ho kalafo le mahlahana anticholinesterase e ka ba mohlala oa "neostigmine". meriana ena ke bohato reversible sebelisoa myasthenia - lefu autoimmune, eo e bontšoa ke bofokoli ba mesifa ya marapo. Lefu lena le bontša ka boeona e qalong fokotseha molumo sefahleho mesifa, joale e ntan'o ba fokolisang tsa mesifa e lipheletsong molaleng, e ka holimo ka tlaase le e; maemong a matla, ho hloleha ho hema ka lebaka la ho tshebetso sa tšoanelehe ba diaphragm ena. "Neostigmine 'liketso tse bontshang matshwao ka' mele, ho tsosolosa phetiso ea litakatso tsa ho phetiso ea neuromuscular, ho ntlafatsa mesifa molumo le mosebetsi dilenaneo e go tlhofofadiwa.

Hape, lithethefatsi ena e fanoeng ka postoperative nako ha pampitšana tshilong ya dijo kapa atony tsa senya mosese. Ka ophthalmology e ka seoelo a bontša bakeng sa glaucoma ho fokotsa khatello ea intraocular. Ka antagonist e e sebediswa ka overdose ea relaxants mesifa le lithethefatsi antidepolyarizuyuschego bohato. Ka linako tse ling "Neostigmine" le sebelisitsoe ho susumelletsa pelehi mesifa le mosebetsi o boima fokola.

lefu la Alzheimer

Litokisetso bohato reversible 'nile ha sebelisoa bakeng sa mafu a sa tsamaiso ea methapo e bohareng, ho ke ho le thata ho phekola. lefu la Alzheimer e behiloeng "galantamine" - e alkaloid fumana ho tswa ho tubers ea snowdrops mofuta Galantus ( "Rivastigmine", aka le "Exelon"), empa ho fetisisa therapeutically e atlehang e-ba "donepezil", hore khetha ho na le masakana le acetylcholinesterase ka synapses boko le hoo e ka bang ha ho ame lona pheriferale tsamaiso ea methapo.

Contraindications

Thehiloe liphellong tsa lithethefatsi cholinesterase reversible bohato, contraindications ho moo o eang teng ke lefu la sethoathoa, le asma e, angina pectoris, lefu Parkinson le maloetse a fapa-fapaneng tsa tsamaiso ea cardiac conduction.

Matšoao a overdose le chefo AChE

Chefo anticholinesterases fana matšoao a ho toba e amanang le ho hlasimolla ka tsela e feteletseng ea receptors nahanela acetylcholine. Pupillary hlokometse slowing tekanyo pelo (bradycardia), bronchial spasm le - ka lebaka leo - dyspnea le matšoao hyperperistalsis pampitšana gastrointestinal ho fihlela ho hlatsa le ho letshollo, khafetsa ho ntša metsi. Butle-butle fokotswa khatello ea mali ka lebaka la ho braking phello ea methapo ea kutlo vagal. Etsahala pelehi lintoeng le twitch ya marapo mesifa 'me leleme la ka lebaka la ho mafu a conduction ka phetiso neuromuscular.

chefo FOS

A e-ja ba Organophosphorus metsoako etsa hore setshwantsho litleleniki tsa tšoana le chefo mahlahana reversible anticholinesterase bohato. Matšoao a ka 'na hlaha e khanyang e loketseng ho toxicity se hodimo sa lithethefatsi. Bakeng sa matšoao a chefo ka phahameng ka ho somatic di a phaella ka ho litla tse bohareng tsamaiso ea methapo boemo ba - pherekano, disorientation, ho hema ho tepella maikutlo.

Organophosphorus metsoako etsa hore cramps bohale, pono thothofatsang, dyspnea, ho fufuleloa, ho hlatsa haholo, pherekano - mokuli qala ho tšoha, ho ba unmanageable. Ka lebaka la ho boreleli mesifa spasm ile ka utloa bohloko bo hlabang ka mpeng ea hae. Ha senyeha etsahala cramps, khatello ea mali oa, coma develops. Lefu ka 'na etsahala ka lebaka la ho holofala ha setsi sa ho hema.

le matšoao a tšoanang tse hlokometse ka maemo a ho chefo Amanita muscaria. Sena ke ka lebaka la ho dikahare tsa bona tsa muscarinic - chefo le bohato cholinomimetic.

Liketso tsa ka ha chefo

tlhokomelo ea meriana tabeng ea chefo le mahlahana anticholinesterase ka ba le feela setsebi. Maemong ana, tharollo e hlahiswa "Atropine" subcutaneous ente e khoneha ho abela "Metacin" kapa anticholinergics tse ling. Ho ke ke ho hlokahala hore a lule a hema ka phahameng ka ho loketseng. Ka sebelisoa tracheotomy, phetha molao ventilation le oxygenation.

Ha chefo ntlo ea FOS hlwaya e leng mohloli oa chefo kena 'mele. Haeba ntho e phunyelletsa ka letlalo, ho e rinsed 3-5 tharollo% soda kapa ka metsi le sesepa. Tabeng ea moo moriana e se e ingested, phetha gastric lavage, enemas multiple, fa adsorbents kapa laxatives. Ha organophosphorus komponeng e le nako ea ho oela ho isa tekanyong e moholo ka maling, e ka abeloa diurez sebelisa lithethefatsi diuretic. Maemong a mang, retelehela ho mekgwa ya ho filtara mali ka hemodialysis le hemosorption.

Ho phaella moo, ka taba ea FOS chefo e behiloeng Reaktivatory cholinesterase, eo ha tsamaisoa ka lihora tse seng kae tsa pele ka mor'a botahoa ka tsosolosa enzyme thibetsoeng. E ka 'na "Izonitrozin", "Trimedoksim", "Dipiroksim". Ha khatello ea mali e phahameng, symptomatically balletsweng lithethefatsi antihypertensive. Ratang o fuoa le ba u se ke ua ama ea tsamaiso ea methapo e bohareng. Le fokolisang tsa ho hema itlelang feela ke phetha molao ventilation le ho fana ka oksijene.