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[呼吸的药物控制]

[Pharmacologic control of breathing].

作者信息

Grassi V, Bruni B, Dottorini M, Malerba M, Tantucci C

出版信息

Recenti Prog Med. 1989 Jul-Aug;80(7-8):404-16.

PMID:2573117
Abstract

Recent advances in respiratory neuropharmacology and neurophysiology have allowed the assessment of the effects of different drugs on the control of the ventilation both qualitatively (alterations of ventilatory pattern) and quantitatively (size and duration of the ventilatory and haemogasometric alterations). In the control mechanism of ventilation, the pharmacological intervention can act both on the respiratory input (basal metabolism, peripheral chemo-receptors, pulmonary receptors, bulbar neurons, cortical nervous system) and on the respiratory output (respiratory muscles). Based on personal experience in this field and the recent literature, the Authors briefly discuss the seat and the mechanism of action of the drugs with stimulating effect (respiratory analeptics, almitrines, progesterone, acetazolamide, salicylates, protriptyline, theophylline) and depressing effect (narcotics and narcotic-antagonists, anaesthetics, barbiturates and benzodiazepines) on the ventilation, as well as the role of the neurotransmitters and modulators. The clinical (positive and negative) effects of these drugs, particularly related to the patients with chronic lung disease, are also illustrated.

摘要

呼吸神经药理学和神经生理学的最新进展使得人们能够从定性(通气模式改变)和定量(通气及血气测量改变的大小和持续时间)两方面评估不同药物对通气控制的影响。在通气控制机制中,药物干预可作用于呼吸输入(基础代谢、外周化学感受器、肺感受器、延髓神经元、皮质神经系统)和呼吸输出(呼吸肌)。基于作者在该领域的个人经验及近期文献,简要讨论了对通气有刺激作用(呼吸兴奋药、烯丙哌三嗪、孕酮、乙酰唑胺、水杨酸盐、普罗替林、茶碱)和抑制作用(麻醉药和麻醉药拮抗剂、麻醉剂、巴比妥类药物和苯二氮䓬类药物)的药物的作用部位和作用机制,以及神经递质和调节剂的作用。还阐述了这些药物的临床(正面和负面)影响,特别是与慢性肺病患者相关的影响。

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