U.O.C. di Medicina e Chirurgia d'Accettazione e d'Urgenza, Az. Osp. S. Elia, Caltanissetta, Italy.
Eur Rev Med Pharmacol Sci. 2010 Jan;14(1):25-30.
Sodium-channel blockers act by slowing sodium influx into myocytes through voltage gated channels. Many substances have sodium-channel blocking properties and many others show this effect when taken in overdose. Sodium-channel blocker poisoning, associated with a high death rate, is characterized by a variety of clinical presentation, depending on the pharmaceutical agent involved. Sodium bicarbonate or lactate, increasing serum pH and extracellular concentration of the ion, displace the drug from its receptor sites and can be used for the treatment of cardiac toxicity in the setting of sodium-channel blocker poisoning. In spite of this theoretical assumption, the role played by hypertonic sodium salts is not well elucidated and conflicting results have been reported. Authors review the pathophysiologic mechanisms of sodium-channel blocker poisoning and the evidences in literature concerning the efficacy of hypertonic sodium salts in the treatment of the related toxicity.
钠通道阻滞剂通过电压门控通道减缓钠离子流入心肌细胞而起作用。许多物质具有钠通道阻滞特性，许多其他物质在过量服用时也会表现出这种作用。钠通道阻滞剂中毒与高死亡率相关，其特征是临床表现多种多样，具体取决于涉及的药物。碳酸氢钠或乳酸盐可提高血清 pH 值和离子的细胞外浓度，将药物从其受体部位置换出来，可用于治疗钠通道阻滞剂中毒引起的心脏毒性。尽管存在这种理论假设，但高渗钠盐的作用尚未得到充分阐明，并且已有报道称存在相互矛盾的结果。作者回顾了钠通道阻滞剂中毒的病理生理机制，以及文献中关于高渗钠盐在治疗相关毒性方面的疗效证据。
