Analeptics include medications, contributing to the restoration of respiratory functions, the activity of the cardiovascular system, providing a stimulating effect on the vital centers of the medulla oblongata - respiratory and vasomotor. Analeptics to a lesser extent stimulate other parts of the central nervous system: the cerebral cortex, subcortical centers, spinal cord... The stimulating effect of analeptics (revitalizing effect) is especially pronounced when the respiratory functions and the activity of the cardiovascular system are suppressed, including those resulting from the use of drugs that suppress the central nervous system (anesthetic, hypnotics).
Analeptics include bemegrid, camphor, cordiamine, etymizole, etc. Analeptic is caffeine, which has a psychostimulating effect, as well as lobelia, cytiton and other drugs with reflex mechanism actions, mainly stimulating the respiratory center due to the excitation of the H-cholinergic receptors of the carotid sinus zone.
BEMEGRID- the most powerful analeptic. Bemegrid is used to stimulate respiration and blood circulation, to remove from the state of anesthesia, in case of overdose drugs; recommended for poisoning with barbiturates and other hypnotics. The dosage of bemegrid is strictly individual, depending on the patient's condition. Side effects when using bemegrid: vomiting, convulsions. Bemegrid is contraindicated in case of a tendency to seizures. Release form: ampoules of 10 ml of 0.5 solution. List B.
An example of a bemegrida recipe in Latin:
Rp .: Sol. Bemegridi 0,5% 10 ml
D. t. d. N. 10 in ampull.
S. Administer intravenously 2-5 ml to non-anesthetized patients; 5-10 ml - in case of poisoning with sleeping pills, to remove from anesthesia.
ETIMIZOL- has a pronounced stimulating effect on the respiratory center, is used as a breathing stimulator (with anesthesia, etc.). Etimizole improves short-term memory, increases mental performance. Etimizole stimulates the pituitary-adrenal system, and therefore has an anti-inflammatory, anti-allergic effect. Etymizole is used for polyarthritis, bronchial asthma, etc. In the mechanism of action of etymizole, the accumulation of cAMP in tissues plays a role. Side effects when using etymizole: nausea, dyspeptic symptoms, anxiety, sleep disturbances, dizziness. Etimizole is contraindicated in diseases accompanied by excitation of the central nervous system. Etimizole is prescribed orally and parenterally (intramuscularly, intravenously slowly). The form of release of etymizole: tablets of 0.1 g and ampoules of 3 ml of a 1.5% solution. List B.
An example of a recipe for etymizole in Latin:
Rp .: Sol. Aethimizoli 1,5% 3 ml
D. t. d. N. 10 in ampull.
S. 3-5 ml intramuscularly.
Rp .: Tab. Aethimizoli 0.1 N. 50
D. S. 1 tablet 2-3 times a day.
CORDIAMINE- official 25% diethylamide solution nicotinic acid, stimulates the respiratory and vasomotor centers. Cordiamine is used for heart failure (improves blood circulation), shock, asphyxia, poisoning, infectious diseases (to improve the function of the cardiovascular system and respiration). Cordiamine is prescribed by mouth and intravenously slowly (in case of poisoning, shock), subcutaneously, intramuscularly. Cordiamine release form: 15 ml bottle and 1 ml and 2 ml ampoules. List B.
An example of a recipe for cordiamine in Latin:
Rp .: Cordiamini 15 ml
D. S. 20-25 drops 2-3 times a day.
Rp .: Cordiamini 1 ml
D. t. d. N. 10 in ampull.
S. 1 ml subcutaneously 1-2 times a day.
MIKOREN- has a powerful stimulating effect on the respiratory center in case of respiratory impairment of central and peripheral origin. Mikoren is used for poisoning with drugs that depress the central nervous system (hypnotics, drugs for anesthesia, alcohol, etc.), asphyxia of newborns. Mikoren is administered intravenously 0.3-0.5 ml; in emergency cases (coma, respiratory arrest, poisoning) - 3-4 ml (maximum - 10 ml), and then, if necessary, inject at a rate of 3-9 ml / h into isotonic solution sodium chloride or dextran. Side effects of mycorena: passing paresthesias, agitation, rarely - vomiting, convulsions. Form of release of mycoraine: ampoules of 1.5 ml of a 15% solution (containing 225 mg of mycoraine). Foreign drug.
CAMPHOR- stimulates the respiratory and vasomotor centers, and also acts directly on the heart, normalizing metabolic processes in the myocardium. It is also possible that a reflex effect on the centers of the medulla oblongata is due to the irritating effect of camphor. Camphor has a longer lasting effect than previous drugs. Camphor is used for various infectious diseases, poisoning, accompanied by respiratory depression and the functions of the cardiovascular system, with arterial hypotension, collapse, complex therapy acute and chronic heart failure. Side effects when using camphor: embolism when an oil solution enters the vessel lumen, skin reaction (rash), agitation, convulsions. Camphor is contraindicated in diseases characterized by excitation of the central nervous system, convulsions. Camphor release form: powder; ampoules of 1 ml and 2 ml of a 20% oil solution; vials of 30 ml of 10% camphor oil and vials of 40 ml and 80 ml of camphor alcohol.
An example of a camphor recipe in Latin:
Rp .: Sol. Camphorae oleosae 20% pro injectionibus 2 ml
D. t. d. N. 10 in ampull.
Rp .: Camphorae tritae 0.1 Sacchari 0.2
M. f. pulv.
D. t. d. N. 10 in charta cerata.
S. 1 powder 3 times a day.
Rp .: Camphorae tritae 2.0
T-rae Valerianae 20 ml
M. D. S. 20 drops 3 times a day (in hot water after meal).
Rp .: Spiritus camphorati 80 ml
D. S. For grinding.
SULFOCAMPOCAINE- a complex compound of sulfocamphoric acid and novocaine. Sulfocamfocaine is used for acute cardiac and respiratory failure, the action is close to camphor. This drug (sulfocamphocaine) is not prescribed for hypersensitivity to novocaine and is very careful when administered to patients with arterial hypotension(due to the possible hypotensive effect of novocaine). Sulfocamfocaine is administered intramuscularly, intravenously slowly and subcutaneously. Release form sulfocamfocaine: ampoules of 2 ml of 10% solution.
An example of a sulfocamphocaine recipe in Latin:
Rp .: Sol. Sulfocamphocaini 10% 2 ml
D. t. d. N. 10 in ampull.
S. 2 ml under the skin 2-3 times a day.
CARBON DIOXIDE- has a direct stimulating effect on the centers of the medulla oblongata and reflex - through the receptors of the sinocortid zone. Carbon dioxide is formed in the process of metabolism and is a physiological stimulant of the respiratory center; stimulates the vasomotor center, causing peripheral vasoconstriction and increasing blood pressure... To stimulate respiration, a mixture of carbon dioxide (5-7%) and oxygen (93-95%), called carbogen, is used. Carbogen is used for overdose of anesthetics, carbon monoxide poisoning, asphyxiation of newborns, etc. If there is no effect after 5-7 minutes from the beginning of inhalation with carbogen, then the introduction of carbon dioxide should be stopped, since otherwise a sharper respiratory depression may occur. Carbon dioxide is also used in balneology (in medicinal baths) for diseases of the cardiovascular system, dermatology (treatment with "carbon dioxide snow" of warts, neurodermatitis, lupus erythematosus, etc.). Carbonated drinks containing carbon dioxide are used to enhance the secretory activity and motility of the gastrointestinal tract.
Respiratory stimulants are also lobeline and cititon(see H-khom nomimetics).
Most drugs in this group have a stimulating effect on the entire brain stem, and only carbon dioxide selectively stimulates the respiratory center. The presentation of the specific pharmacology of analeptics must be preceded by a few general remarks.
1. The mechanism of respiration stimulation by analeptics with central action (excluding CO 2) is based on the anti-drug effect. Strong enough stimulants nervous system, they increase the lability of brain cells and thereby increase their function, despite the presence of the drug. The depth of inhibition of the trunk centers, including the respiratory and vasomotor centers, decreases. Thus, drugs of this group (except for CO 2) do not have a selective effect on the respiratory center - an increase in pulmonary ventilation is always accompanied by a decrease in the depth and duration of anesthesia, excitation of other brain structures (to convulsions with forced administration).
2. Stimulation of the central nervous system leads to a significant increase in oxygen consumption by its cells and an increase in oxidative processes and metabolism in general, which can aggravate the insufficiency of external respiration, blood circulation and increase brain hypoxia.
3. Without having, with a few exceptions (caffeine, camphor), a direct effect on the heart, drugs of this group are able to improve hemodynamics by increasing the tone of the vasomotor center.
4. The stimulating effect of central respiratory analeptics is rather long-lasting, in any case it exceeds the duration of the effect of reflex stimulants.
5. The influence of large doses of analeptics on the central nervous system (including the respiratory center) is biphasic: after short-term excitation, inhibition may increase.
Differences in the localization of the main action make it necessary to prefer drugs with a predominant effect on the region of the brain where the respiratory and vasomotor centers are located. The comparative activity of central respiratory stimulants can be illustrated by the data of Cranston (Kranston, 1959), obtained in experiments on 3000 rabbits, whose pulmonary ventilation was previously reduced by anesthesia:
Corazol. Stimulation of respiration during excretion of corazole is due to the direct excitatory effect of the drug on the cells of the respiratory center, restoration of their sensitivity to CO 2 and indirect influence through the higher regulatory parts of the brain. Strengthening breathing is especially clearly manifested against the background of oppression of the respiratory center. In this respect, corazole is sometimes effective where other analeptics do not. The therapeutic latitude of corazole depends on the nature of the agent causing the inhibition of the respiratory center; in case of poisoning with barbiturates, it is maximum. On the contrary, morphine and especially local anesthetics potentiate the convulsive action of corazole. In conditions of poisoning with these agents, corazole should be prescribed with great caution, and to relieve possible seizures, have a syringe with thiopental solution at the ready. There are indications that corazole locally (in the area of neuromuscular synapses) and centrally (by increasing the sending of impulses to the muscles) counteracts the effects of competitive relaxants (Hahn-Hahn, 1960).
When administered intravenously, corazole causes respiratory stimulation, lasting several minutes, with intramuscular injection- up to half an hour. The duration of action of corazole also depends on the dose and the factor that caused the depression of the respiratory center. Approximate scheme the appointment of an analeptic is as follows: 1 ml of a 10% solution of the drug is injected intravenously; if the stimulation of respiration is manifested clearly enough, an additional injection of another 2-3 ml is made into the muscle to maintain the effect; in the absence of a visible effect of corazole (deep barbiturate anesthesia), a 2% solution of it (10-15 ml or more) is slowly injected into the vein until breathing is restored or signs of overdose appear (increased reflex excitability, flinching, tremor). Corazol compares favorably with many other analeptics by the almost complete absence of the second phase of action (oppression). The main danger of an overdose of the drug is seizures of a clonic nature, arising in paroxysms. The convulsive dose of corazole is far from the lethal dose. Nevertheless, the respiratory muscles can be involved in convulsions, which aggravates hypoxia. When precursors of convulsive action appear, the minimum dose of thiopental necessary to relieve increased excitability is immediately introduced into the vein, and the oxygen supply is increased.
The rate of inactivation of corazole with the introduction of a moderate dose is 50% in 2.5 hours. Very large doses are destroyed slowly (up to 10 hours). The liver and kidneys are interested in the process of drug elimination (Khan, 1960). The toxicity of corazole (associated mainly with convulsive properties) is reduced under conditions of anesthesia. Up to 2 g of the drug can be fractionally injected into a vein without much concern (Goodman and Gilman, 1955).
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Analeptics. Classification by mechanism of action. Respiratory stimulants
1.
Wed-va, directly activating c. Breath
(direct stimulation of the respiratory center ++++, stimulation of the respiratory center reflexively -)
Bemegrid
Etimizole
2.
Wed-va,Sbreathing reflexively
(direct stimulation of the respiratory center -, Stimulation of the respiratory center reflexively ++++)
Lobelina hydrochloride
3.
Wed-va mixed type
(direct stimulation of the respiratory center ++, stimulation of the respiratory center reflexively ++)
Cordiamine
Carbon dioxide
Analeptics
Analeptic drugs mean a group medicines, exciting, first of all, the vital centers of the medulla oblongata - vasomotor and respiratory. In large doses, these drugs can excite the motor areas of the brain and cause seizures.
Application V therapeutic doses analeptics are used for weakening vascular tone, for respiratory depression, for infectious diseases, in the postoperative period, etc.
Contraindications... Psychoses, psychomotor agitation, tendency to convulsive reactions, Severe organic lesions of the cardiovascular system, respiratory arrest as a result of progressive depletion of the respiratory center.
Analeptics tone up the respiratory and vasomotor centers of the medulla oblongata.
Analeptics speed up and deepen breathing, prompting the depressed respiratory center to work. They increase the sensitivity of neurons to carbon dioxide, hydrogen ions, as well as to reflex stimuli from the carotid glomeruli, vascular chemoreceptors and painful endings of the skin.
BEMEGRID ( Bemegridum; in amp. 10 ml of 0.5% solution) is a specific antagonist of barbiturates and has a "revitalizing" effect in case of intoxication caused by drugs of this group. The drug reduces the toxicity of barbiturates, their inhibition of respiration and blood circulation. The drug also stimulates the central nervous system, therefore it is effective not only for poisoning with barbiturates, but also other means that totally inhibit the functions of the central nervous system.
Bemegrid apply at acute poisoning barbiturates, to restore breathing at the exit from anesthesia (ether, fluorothane, etc.), to remove the patient from a severe hypoxic state. The drug is administered intravenously, slowly until breathing, blood pressure, pulse is restored.
Side effects : nausea, vomiting, convulsions.
In a series of direct-acting analeptics, the drug etymizole occupies a special place.
ETIMIZOL(Aethimizolum; in the table. 0, 1; in amp. 3 and 5 ml of 1% solution). The drug activates the reticular formation of the brainstem, increases the activity of neurons in the respiratory center, enhances the adrenocorticotropic function of the pituitary gland. The latter leads to the release of additional portions of glucocorticoids.
At the same time, the drug differs from Bemegrid in a slight depressing effect on the cerebral cortex (sedation), improves short-term memory, and promotes mental performance. Due to the fact that the drug promotes the release of glucocorticoid hormones, it secondarily has an anti-inflammatory and bronchodilatory effect.
Indications for use: etymizole is used as an analeptic, a respiratory stimulator for morphine poisoning, non-narcotic analgesics, in the recovery period after anesthesia, for lung atelectasis. In psychiatry, its sedative effect is used in states of anxiety. Given the anti-inflammatory effect of the drug, it is prescribed for the treatment of patients with polyarthritis and bronchial asthma and also as an antiallergic agent.
Side effects: nausea, dyspepsia.
Reflex-acting stimulants are H-cholinomimetics CITITONE and LOBELIN... They excite the H-cholinergic receptors of the carotid sinus zone, from where afferent impulses enter the medulla oblongata, thereby increasing the activity of the neurons of the respiratory center. These funds act for a short time, within a few minutes. Clinically, there is an increase and deepening of breathing, an increase in blood pressure. The drugs are administered intravenously only. Used for a single indication - in case of poisoning carbon monoxide.
In drugs of a mixed type of action (III subgroup), the central effect (direct excitation of the respiratory center) is complemented by a stimulating effect on the chemoreceptors of the carotid glomerulus (reflex component). This is as stated above , CORDIAMINE and CARBON GAS. In medical practice, it is used Carbogen: a mixture of gases - carbon dioxide (5-7%) and oxygen (93-95%). It is prescribed in the form of inhalations, which increase the volume of respiration by 5-8 times.
Carbogen is used for overdose of general anesthetics, carbon monoxide poisoning, and asphyxiation of newborns.
The drug is used as a breathing stimulator CORDIAMINE- a neogalenic drug (prescribed as an official one, but it is a 25% solution of niacin diethylamide). The action of the drug is realized by the stimulation of the respiratory and vascular centers, which will affect the deepening of breathing and improve blood circulation, and the rise in blood pressure.
It is prescribed for heart failure, for shock, asphyxia, intoxication (intravenous or intramuscular route of administration), for cardiac weakness, fainting conditions(drops in mouth).
Analeptic drugs include nalorphine, bemegrid, cordiamine, corazole, lobelin, proserin, cititon, tensilon, sugamin.
NALORFIN... This analeptic drug is an antagonist of morphine and other opioid analgesics. Synonyms: Lethidron, Nalorphini, Naline. In their own way chemical structure antorphine is close to morphine, differs in that the nitrogen atom has an allyl group instead of a methyl group.
Weakens or removes such actions of morphine, fentanyl, promedol, isopromedol, such as respiratory depression, vomiting, hypotension, cardiac. Weakens the hyperglycemic reaction after administration of morphine. In people who have not received morphine, antorphine in clinical doses does not affect respiration or blood circulation. Quite often, after its administration, especially after high doses, miosis, increased sweating, drowsiness, nausea, or visual hallucinations are observed.
The mechanism of action of nalorphine: it speeds up the removal of morphine from the body by 100 times, inhibits the formation of the pituitary antidiuretic factor, which is stimulated by morphine.
It is used as an antidote to morphine, opioid analgesics, when there is a sharp respiratory depression with these drugs, as well as other signs of poisoning, overdose. It is also indicated for asphyxia of newborns, if during childbirth the woman in labor received a large number of analgesics.
In case of respiratory depression, signs of an overdose with barbiturates, ether, cyclopropane and chronic morphinism, antorphine is ineffective. Its use can cause an attack of abstinence (anxiety, melancholy, vomiting, severe weakness, sometimes excitement that occurs when the morphine addict abstains from morphine).
Single adult dose of 5-10 mg. If there is no effect, repeat the same dose after 8-10 minutes. To obtain an effect, you can enter up to 50 mg of antorphin. The effectiveness of a drug is determined primarily by its effect on respiration. Within seconds after the introduction of nalorphine, breathing evens out and becomes deep enough.
In newborns, nalorphine is injected into the umbilical vein at 5 mg. If there is no effect, repeat injections of the drug. For prophylactic purposes, women in labor who have received large doses of analgesics are injected 10-20 mg intramuscularly 10-12 minutes before the onset of labor.
BEMEGRID(MEGIMID). This analeptic drug is a barbiturate antagonist and a respiratory pathogen. White powder with a melting point of 124-125 °. Dissolves in 200 volumes of water. Stimulates the central nervous system, significantly reduces the depression of the nervous system caused by barbiturates (hexenal, thiopental sodium, luminal). To a lesser extent, it reduces the depression of the central nervous system caused by ether and some other drugs.
Significantly weakens the depth of barbituric anesthesia and accelerates awakening. It is shown when it is desirable to stop barbituric anesthesia, to accelerate awakening after it, as well as after combined anesthesia with the use of barbiturates, other narcotic substances, in case of poisoning with barbiturates. The appearance of cramps in the limbs (to be distinguished from movements associated with awakening) is a signal to stop the introduction of bemegrid.
The effectiveness of the drug depends on the depth of anesthesia, the degree of poisoning with barbiturates. Depending on the initial state of the patient, in which the drug was administered, it causes the appearance or intensification of eye reflexes, deepening of breathing, movement of the head and limbs, restoration of consciousness. Bemegrid does not cause serious side effects. Changes in pulse and respiration, which are sometimes observed after its introduction, are associated with the beginning awakening of patients.
CORAZOL... Respiratory analeptic, stimulant of the cardiovascular, central nervous system. Synonyms: Apgiazol, Cardiazol, Centrazol, Pentamethazolum. Crystalline white powder. Melting point 60 °. For clinical use, this analeptic drug is available in tablets, powder, ampoules. Most often, a solution of corazole is used and it is administered intramuscularly, intravenously.
By pharmacological action corasol is close to camphor and caffeine. However, due to its good solubility and absorbability, its effect occurs faster, less lasting.
It is used when there is a drop in cardiac activity, weakening of breathing associated with depression of the respiratory center during prolonged awakening after anesthesia, in case of poisoning with drugs or analgesics.
With prolonged awakening and drug overdose, corazol is injected intravenously, 200-300 mg, slowly, 1 ml per minute, it can be dripped with a glucose solution or with blood. For long-term action, you can enter the same dose of the analeptic drug intramuscularly. To stimulate cardiac activity, corazol is injected intravenously with 1-2 ml of a 10% solution.
CORDIAMINE... Respiratory analeptic, stimulant of the central nervous, cardiovascular systems. Synonyms: Anacardon, Cardiamidum, Coramin, Cowitol. Specific gravity 1.023; mix well with water, alcohol. For clinical use, it is available in 1-2 ml ampoules. In terms of its pharmacological action, it is very close to corazole. Indications for use, dosages are the same as corazole.
LOBELIN... The drug is analeptic, respiratory stimulant. V clinical medicine a 1% solution of lobelin hydrochloride in 1 ml ampoules is used. Although the drug is a respiratory analeptic, it does not accelerate awakening or stimulate cardiovascular system... The action is short-lived. It is used for depression, reflex cessation of breathing. Intravenous administration of 10 mg is most effective. It should be injected slowly, 1 ml per minute, since with a rapid introduction, cardiovascular changes are possible.
Proserine... Analeptic drug that inhibits the enzyme cholinesterase. This analeptic is used as a muscle relaxant antagonist. Synonyms: Eustigmin, Myostegmin, Neostegmini, Prostigmin. Available in tablets, powder, eye drops, 1 ml ampoules for intravenous, intramuscular or subcutaneous administration.
Weakens, and sometimes completely interrupts the effect of non-depolarizing muscle relaxants or depolarizing relaxants.
The antagonistic effect of this analeptic drug on muscle relaxants is mainly based on the fact that proserin inhibits the production of cholinesterase. As a result, acetylcholine rapidly accumulates, which displaces muscle relaxants from the receptors of the end plate and makes possible the transition of excitation from the nerve ending to the muscle and, consequently, muscle contraction. Less pronounced is the so-called direct, direct effect of proserin on muscle fiber, which improves the muscle response to stimulation.
The use of proserin as an antidote to muscle relaxants is shown when muscle weakness is observed after the end of the action of non-depolarizing muscle relaxants, a weakening of the respiratory amplitude after non-depolarizing muscle relaxants, a change in the action of depolarizing relaxants (cause non-depolarizing block, weakening of muscle tone or respiration).
Proserin should not be used to stop the effect of relaxants when breathing is completely absent, since the concentration of relaxants is high and excessively large doses of proserin are required, which themselves can cause neuromuscular block. In addition, in the presence of a high concentration of relaxants in the blood, after the effect of proserin ends, complete relaxation of the muscles (recurarization) can again occur.
Method of application: first, 0.5 mg of atropine is administered intravenously. If, after the introduction of atropine, the pulse became more frequent or remained unchanged, then 2 minutes after atropine, 2 mg of proserin is injected intravenously. When the effect after the first dose is insufficient, a similar dose is re-administered after 3 minutes. In total, you can enter 5 mg of proserin in 20 minutes. Usually, 2 minutes after the administration of the analeptic drug, the restoration of muscle activity is noted, the force of movement of the limbs appears or sharply increases, the respiratory amplitude increases. Neoserine enhances the effect of depolarizing relaxants such as ditilin. However, when ditilin causes excessive relaxation and does not apparent reasons for this (hyperventilation, severe exhaustion and dehydration of the patient), one can assume the presence of a "double block" and use proserin to weaken it. In practice, if 30 minutes after the last injection of ditilin (if it was injected several times) there is still relaxation of the muscles, spontaneous breathing is weakened and muscle activity is restored gradually, as is the case with the use of non-depolarizing relaxants, it can be assumed that ditilin acts like non-depolarizing relaxants.
The introduction of relatively large doses of proserin, which are used to arrest the action of muscle relaxants, can cause increased salivation, provoke laryngospasm or bronchospasm, bradycardia up to cardiac arrest. Therefore, proserin should not be used in patients with asthma, diseases. For the prevention of bradycardia, it is necessary to inject atropine before using proserin and be sure to make sure that the drug has not caused the so-called vagotonic effect (pulse reduction). It is also the most reliable preventive measure, preventing bradycardia and arrhythmia, is to maintain the necessary pulmonary ventilation (if necessary - artificial respiration) during the entire time when proserin is active.
After the introduction of proserin for 45-60 minutes, the patient should be monitored, since after the end of the effect of proserin, with a sufficient concentration of relaxants in the blood, recurarization may occur.
TENSILON(edrophonium). It is an analeptic drug, an antagonist of non-depolarizing relaxants. In contrast to proserin, it mainly has a direct direct effect on the muscle, increasing the amplitude of the end plate potential and contributing to muscle contraction.
An important feature of tensilon is its short duration of action. So, in 5-8 minutes after the introduction of Tenzilon, its effect completely ends. Such a short duration of action makes it possible to use it to find out whether there is a "double block" after the use of ditilin: if, against the background of the action of ditilin, the administration of tensilone enhances relaxation, therefore, there is a depolarizing effect, which is usual for a relaxant, and proserin and tensilon should not be used. Diagnostic administration of tensilon will not be dangerous, as its action will quickly end. If tensilon reduced the relaxation caused by ditilin, then you can safely enter proserin, since it is clear that there is a non-depolarizing blockade.
Tensilone is administered intravenously, a single dose of 5-10 mg. 0.5 mg of atropine is also administered intravenously beforehand.
CITITONE... Respiratory drug analeptic, is a solution of the alkaloid cytisine. Transparent liquid. A 0.15% solution in 1 ml ampoules is used.
The indication for the use of cytiton is reflex respiratory depression, weakening of respiratory, cardiovascular activity in case of drug overdose. In these cases, 1 ml is usually administered intravenously.
Tsititon slightly increases blood pressure, therefore, the introduction of this analeptic drug is indicated when cardiovascular activity falls, it is contraindicated in hypertension, atherosclerosis.
The article was prepared and edited by: surgeonBemegrid (Agipton, Etymid)
Group affiliation
Mechanism of action
Pharmacological effects
· Analeptic.
· Awakener.
Recipe
Rp .: Sol. Bemegridi 0,5% - 10 ml
D.t.d. No. 5 in amp.
S. 10 ml intravenously slowly 1 time per day.
Indications
· Light poisoning with barbiturates, narcotic hypnotics, anesthetics.
Contraindications
· Psychomotor agitation.
Side effects
· Nausea.
· Convulsions.
· Muscle twitching.
Caffeine-sodium benzoate
Group affiliation
· Analeptic, a direct stimulator of the neurons of the respiratory center.
Mechanism of action
· Increases the excitability of the respiratory and vasomotor centers of the medulla oblongata.
· Shows antagonism with inhibitory mediators of the central nervous system (GABA).
Pharmacological effects:
· Cardiotonic.
· Psychostimulating.
· Analeptic.
· Awakener.
Recipes
Rp .: Sol. Coffeini natrio-benzoatis 10% - 1 ml
D.t.d. No. 10 in amp.
S. 1 ml subcutaneously 2 times a day.
Rp .: Tab. Coffeini natrio-benzoatis 0.1 No. 10
D.S. 1 tablet 2 times a day in the morning.
Indications
· Infectious diseases, accompanied by inhibition of the function of the central nervous system, cardiovascular and respiratory systems.
· Poisoning with drugs and other poisons that depress the central nervous system.
· Migraine.
· Decrease in mental and physical performance.
· Elimination of drowsiness.
· Enuresis in children.
· Hypotension.
Contraindications
· Increased excitability.
· Insomnia.
· Arterial hypertension.
· Atherosclerosis.
· Organic diseases of the cardiovascular system.
· Senile age.
Glaucoma
· Convulsions.
Side effects
· Excitement.
· Insomnia.
Arrhythmia.
· Increased blood pressure.
Sulfocamphocaine (Sulfocamphoric Acid + Procaine)
Group affiliation
· Analeptic of the mixed type of action (direct and reflex).
Mechanism of action
· Increases the excitability of the respiratory and vasomotor centers of the medulla oblongata.
· Reflexively stimulates the chemoreceptors of the carotid glomeruli.
Pharmacological effects
· Improves pulmonary blood flow, ventilation and myocardial function.
Recipe
Rp .: Sol. Sulfocamphocaini 10% - 2 ml
D.t.d. No. 10 in amp.
S. 2 ml subcutaneously 2 times a day.
Indications
· Depression of the respiratory and vasomotor centers.
Contraindications
· Idiosyncrasy to procaine (novocaine).
· Pregnancy.
· Convulsions.
Side effects
· Decrease in blood pressure.
· Allergic reactions.
Etimizole
Group affiliation
· Analeptic of direct type of action.
· Donator of alveolar surfactants.
Mechanism of action
· An adenosine antagonist, with the accumulation of cAMP, which inhibits the release of lysosomal enzymes - the cells are not destroyed and retain their function.
Pharmacological effects
· Analeptic.
· Sedative (on the bark).
Recipe
Rp .: Tab. Aethimizoli 0.1 No. 10
D.S. 1 tablet 3 times a day.
Rp .: Sol. Aethimizoli 1% - 3 ml
D.t.d. No. 5 in amp.
S. 3 ml intramuscularly.
Indications
· Rupture of cerebral aneurysm.
· Atelectasis of the lungs.
· Asphyxia of newborns.
Contraindications
· Psychomotor agitation.
DRUGS AFFECTING THE EXECUTIVE BODIES
Anti-atherosclerotic drugs
1. Means that reduce the absorption of cholesterol and bile acids from the intestine ("sequestrants" of bile acids): - cholestyramine (questran, colestipol); - guar gum (guarem).
