Ushevu ejenti anticholinesterase. Kuyini anticholinesterases?

ku izinzwa ukudluliswa pulses inikezwa yi izinto ezikhethekile - balamuli. Omunye neurotransmitter kuyinto acetylcholine. Laba basizi, kuyilapho ngesikhathi synapse, kuthinte ulwelwesi cell okubangela okusithiyayo zabo noma ukushukuma futhi okubangela imiphumela ehlukahlukene. I neurotransmitter ngokweqile wajinge wanamatsela ngu enzyme ethize.

izidakamizwa Anticholinesterase: izici nangezinjongo

Ngu izidakamizwa anticholinesterase yilezo zivimbela cholinesterase enzyme. Lokhu enzyme uhlaba yi hydrolysis we acetylcholine neurotransmitter, okuyinto okuhambisa pulses e singangena nalokho synapse nezinzwa parasympathetic, ganglia, futhi kuzo zonke Imicu yotshani ukuphathwa kwabathintwayo. anticholinesterases ziye zakhelwe ukuthuthukisa isinyathelo isimo acetylcholine izinzwa, nqgo izingxenye ezithile zesimiso sezinzwa. Ukusetshenziswa le mithi kuyalithinta lonke umzimba.

Isenzo anticholinesterases kufana umphumela ukukhuthazwa nezinzwa cholinergic. Le mithi uxhumana kusayithi efanayo phezu yokwamukela ebusweni msebenzi acetylcholine, ngaleyo ndlela kwakhele isenzo ezingaba we isiphetho emsipheni. Cholinomimetics namanxusa anticholinesterase, eqinisweni, iqembu elifanayo izinto kwemithi. Kunezinhlobo eziningana izidakamizwa ukuthi kuhluke yabo isakhiwo zamakhemikhali reversibility yesenzo. blocker Cholinesterase zihlukaniswe awushintsheki futhi engelapheki.

Kusho isenzo esethola

Anticholinesterases - amalungiselelo isinyathelo esethola kukhona isakhiwo amakhemikhali carbamic acid esters futhi aminoalcohols ahlukahlukene. Ukuphendula ingxenye ekuvimbeni cholinesterase, kuba isiphetho esidi, owenza izindlela enzyme ne-molecule esitebeleni kakhulu zokuxhumana kunalokho ezakhiwe nokuxhumana acetylcholine okuyinto. ukubhujiswa okuphelele kwalesi kwakwakhe kwenzeka hydrolysis 3-4 amahora.

Esebenzisa umphumela esethola anticholinesterase kukhona "galantamine", "physostigmine", "Neostigmine" (noma "Neostigmine"), "pyridostigmine," "oksazil", "rivastigmine", "edrophonium."

Ngo phosphorous - into action engelapheki

Ukwakhiwa isinyathelo engelapheki kuleli qembu zezakhi organophosphorus. Lezi izinto zivimbela acetylcholinesterase isikhathi eside. Phosphorus, elisesifundeni Ukwakheka yezinhlayiya yakha kwakwakhe esitalini enzyme, okungase ukusinda emzimbeni izinsuku eziningana noma amasonto. Yokutakula edingekayo lemali acetylcholinesterase kwenzeka ngokusebenzisa kumiswa molecule entsha. Leli qembu compounds kuhlanganisa "phosphacol", "Armin", "trichlorfon", "Malathion", "dichlorvos" ezinobuthi, elisetshenziswa inkambo ezempi imisebenzi - sarin futhi Soman.

izidakamizwa Organophosphate anobuthi kakhulu. Avame esetshenziswa ekuphileni kwansuku zonke njengokungathi zinambuzane; ubuthi kungenzeka ngokusebenzisa yabo engalungile futhi okungezona ukugcinwa izinyathelo zokuphepha.

Imiphumela anticholinesterase izidakamizwa

Ngezinye ukufana ezithile phakathi imiphumela ukukhiqiza anticholinesterases umzimba, izinkomba ngayinye kulo bayizinkulungwane ekhethekile. Ukuze sicabangele umphumela esisebenzayo uma iqondiswa ku ikani umzimba isibonelo, "neostigmine".

"Neostigmine" itholakala ampoules ngesimo 0.05% isixazululo kanye phansi kwesikhumba injected noma ngemithambo yegazi. Lapho injected igazi kusiza ukudlula pulses e yokudlulisela kwamanyuroni kanye ganglia ka autonomic nesimiso sezinzwa. isimo wesiguli kubonakala ngendlela elandelayo:

• ngenxa isiyingi imisipha iris umfundi is ayisesemikhulu;
• kwenzeka spasm yokuhlala, i-lens eqala umumo ayizindunduma ngenxa ukuphumula Zinn izinyanda focus isethwa kulobo ibanga eduze, ikhono lokuhlukanisa izinto kude is wancipha;
• kwehle kwenhliziyo;
• kwandisa ithoni imisipha abushelelezi izitho zangaphakathi - ipheshana zokuphefumula, isisu namathumbu, kwesibeletho, isinye;
• sithuthukiswe lwamathambo imisipha Kufinyeta ngenxa indinyana ngcono inkanuko at synapse;
• uketshezi anda exocrine nezindlala - umjuluko, salivary, imithambo emaphashini, esiswini.

isicelo

Le miphumela banesibopho ukusetshenziswa leli qembu izidakamizwa e-imithi ezimweni ezahlukene. Izinkomba anticholinesterase ejenti akugcini izifo ezithile, ngoba inethonya ephakathi neuropathy isimiso sezinzwa, okubangela umphumela jikelele kwi umtimba. Ngokuvamile amiswa ephula innervation futhi ithoni kwemisipha zohlaka lwamathambo noma bushelelezi.

Cabanga ukuthi kungenzeka ukwelashwa nge ejenti anticholinesterase kungaba isibonelo "neostigmine". Lo muthi isenzo esethola isicelo myasthenia - isifo sokuhlasela kwamasosha omzimba, lokubonakala nobuthakathaka le imisipha yohlaka. Lesi sifo kubonakala ekuqaleni kwehle ithoni izicubu ezithile ebusweni, bese buthakathaka izicubu emikhawulweni entanyeni, yasenhla nemithombo yasenzansi; ezimweni ezimbi kakhulu, nokuvaleka kwemigudu yokuphefumula ngenxa operation ukungadli diaphragm. "Neostigmine" izenzo lingaze emzimbeni, ekubuyiseleni ukudluliswa inkanuko nokudlulisela kwamanyuroni, ekuthuthukiseni imisipha ithoni kanye motor umsebenzi lula.

Futhi, lolu izidakamizwa kunikezwa esikhathini postoperative lapho ipheshana wokugaya ukudla noma atony kwesinye urinary. Zamehlo it is kuyaqabukela kuboniswe ngoba glaucoma yokunciphisa izingcindezi intraocular. Njengoba isitha isetshenziswa ukweqisa izidakamizwa kwemisipha relaxants nezidakamizwa antidepolyarizuyuschego senzo. Ngezikhathi ezithile "Neostigmine" isetshenziselwa ukugqugquzela imisipha Kufinyeta ngemihelo ababuthakathaka.

Alzheimer isifo

Amalungiselelo isinyathelo esethola ziye zasetshenziswa yezifo isimiso sezinzwa esiyinhloko, kunzima ukuyelapha. Alzheimer umiselwa "galantamine" - i alkaloid eyatholakala kusukela nezilimo eziyizigaxa snowdrops uhlobo Galantus ( "Rivastigmine", aka "Exelon"), kodwa therapeutically ephumelela kunazo baba "donepezil", ukuthi ngokukhetha sivimba acetylcholinesterase synapse ubuchopho futhi cishe akuphazamisi yayo neuropathy isimiso sezinzwa.

Izimo

Kususelwa imithelela cholinesterase izidakamizwa isinyathelo esethola, Izimo lapho zilibangise khona kukhona isithuthwane, isifuba somoya, pectoris angina, isifo i-Parkinson futhi kwempilo we inhliziyo conduction uhlelo.

Izimpawu ukweqisa izidakamizwa futhi ubuthi Ache

Ushevu anticholinesterases unika izimpawu ezihlobene ngokuqondile ukushukuma ngokweqile receptor nezinzwa ezisenza sizwele lapho acetylcholine. Pupillary waphawula, okwehlisa izinga inhliziyo (bradycardia), spasm bronchial kanye - ngenxa yalokho - izimpawu dyspnea hyperperistalsis pheshana emathunjini kuze ihlanze noma ikhishwe yisisu, ukuchama kaningi. Kancane kancane umfutho wegazi ngenxa umphumela unyathela amabhuleki we emsipheni vagal. Wenzeka Kufinyeta kunezinxushunxushu futhi ukudikiza imisipha lwamathambo kanye nolimi ngenxa conduction iziyaluyalu e yokudlulisela kwamanyuroni.

ushevu Fos

Ukungenisa Organophosphorus compounds okubangela isithombe emtholampilo ofanayo ukuze ubuthi ejenti esethola anticholinesterase senzo. Izimpawu zingavela licace ngenxa ubuthi ephakeme izidakamizwa. Ngokuba izimpawu ubuthi ezingeni ukuphathwa kwabathintwayo kunezelwa imiphumela phezu sezinzwa uhlelo ezingeni - ukudideka, disorientation, ukucindezeleka zokuphefumula.

Organophosphorus compounds kubangele amajaqamba abukhali, angaboni kahle, dyspnea, ukujuluka, ukuhlanza ezinzima, ukuyaluza - isiguli siqala sokuba netwetwe, kuba unmanageable. Ngenxa bushelelezi imisipha spasm esezwa ukuhlaba okubuhlungu esiswini. Lapho ukuwohloka zenzeka amajaqamba, umfutho wegazi uwela, ikhoma eba. Ukufa kungenzeka ngenxa ukukhubazeka isikhungo zokuphefumula.

izimpawu ezifanayo kuyagcinwa ezimeni ushevu Amanita muscaria. Lokhu kungenxa okuqukethwe kwabo muscarinic - ubuthi nesenzo cholinomimetic.

Izenzo uma ubuthi

ukunakekelwa Medical uma ubuthi nge ejenti anticholinesterase ungaba kuphela onguchwepheshe. Kulezi zimo, ikhambi sivela "Atropine" umjovo ongama kungenzeka yokunika "Metacin" noma ezinye anticholinergics. Kuyadingeka ukuba silondoloze ukuphefumula ezingeni elifanele. Kungasetshenziswa tracheotomy, ukupholisa mechanical futhi oxygenation.

Lapho ubuthi yasendlini Fos ukuhlonza umthombo ushevu engena emzimbeni. Uma imfuyo singene ngesikhumba, it is engahashazanga 3-5 isixazululo% soda noma usebenzise insipho namanzi. Esimeni lapho izidakamizwa iye udle, afeze lavage esiswini enemas amaningi, nika adsorbents noma laxatives. Uma kwakwakhe organophosphorus iye kwadingeka isikhathi iwe ngokwezinga elikhulu emgudwini wegazi, inikezwa diurez usebenzisa izidakamizwa isisu. Kwezinye izimo, iphendukele izindlela okufika ngegazi hemodialysis futhi hemosorption.

Ngaphezu kwalokho, uma Fos ushevu esimisiwe cholinesterase Reaktivatory, okuyinto lapho yaphathwa amahora Emavikini okuqala ambalwa ngemva ukudakwa Ungayibuyisa enzyme ivinjiwe. Kungenzeka "Izonitrozin", "Trimedoksim", "Dipiroksim". Uma umfutho wegazi usuke okusezingeni eliphezulu, symptomatically ebekiwe izidakamizwa antihypertensive. Kukhethwa ikakhulu lezo musa kuthinte isimiso sezinzwa esiyinhloko. Nge buthakathaka ukuphefumula nokuguqulwa kuyinto ukupholisa mechanical akunika umoya-mpilo.