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[药物诱导并发症的支气管表现]

[Bronchial manifestation of drug-induced complications].

作者信息

Hugues F C, Le Jeunne C, Haas C

机构信息

Service de Médecine Interne II, Hôpital Laennec, Paris.

出版信息

Ann Med Interne (Paris). 1989;140(7):585-8.

PMID:2575362
Abstract

Bronchial side effects of drugs are varied and numerous. The most frequent are the hypersensitivity type 1 and 3 reactions of asthma. Asthma is primarily caused by anti-infectious agents but also by protein drugs (and many others). At the present time, attention is being focused on excipients and solvents: cremophore, anti-oxidative sulfites (E 220 to E 227), found in over 700 drugs and responsible for severe side effects. Other bronchospasms are due to direct or indirect potentiation of parasympathetic bronchomotor tonus, chiefly with alpha-agonists, and perhaps with beta-agonists but this remains to be proven. Asthmatic reactions caused by interference in mediator synthesis are another current topic of study; some are well known, such as histamine release and interference in arachidonic acid metabolism (non-steroidal antiinflammatory drugs). Other side effects are the result of local irritation, obstruction or bronchial stenosis. A drug-induced cough could be a consequence of local irritation or of the action of converting enzyme inhibitors on bradykinin catabolism.

摘要

药物的支气管副作用多种多样。最常见的是哮喘的1型和3型超敏反应。哮喘主要由抗感染药物引起,但蛋白质药物(以及许多其他药物)也可导致。目前,人们的注意力集中在辅料和溶剂上:聚氧乙烯蓖麻油、抗氧化亚硫酸盐(E220至E227),存在于700多种药物中,可导致严重副作用。其他支气管痉挛是由于副交感神经支气管运动张力的直接或间接增强,主要是α激动剂,β激动剂可能也会导致,但这仍有待证实。干扰介质合成引起的哮喘反应是当前另一个研究课题;有些是众所周知的,如组胺释放和对花生四烯酸代谢的干扰(非甾体抗炎药)。其他副作用是局部刺激、阻塞或支气管狭窄的结果。药物引起的咳嗽可能是局部刺激的结果,也可能是转化酶抑制剂对缓激肽分解代谢作用的结果。

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