Eisenkraft Arik, Falk Avshalom
Israel Ministry of Defense, HaKirya, Tel Aviv, Israel.
Israel Defense Force Medical Corps, Ramat Gan, Israel.
Br J Pharmacol. 2016 Jun;173(11):1719-27. doi: 10.1111/bph.13486. Epub 2016 Apr 22.
In cases of organophosphate poisoning, patients are treated with a combination of antidotes. In addition to these poison-directed antidotes, patients may require extra oxygen and artificial ventilation; other modalities may also be needed due to the wide range of toxic effects. Anisodamine is a belladonna alkaloid, and like other drugs from this family is non subtype-selective muscarinic, and a nicotinic cholinoceptor antagonist, which has been employed in traditional Chinese medicine. As a muscarinic antagonist, it displays similar pharmacological effects to atropine and scopolamine. However, anisodamine is not only less potent than atropine and scopolamine but also less toxic. Current in vitro and animal model studies have demonstrated that anisodamine has protective effects in a variety of diseases. Organophosphate poisoning involves not only the central and peripheral nervous systems, but also the cardiac and respiratory systems, as well as activation of inflammatory processes and oxidative stress. Therefore, the anticholinergic and additional activities of anisodamine appear to be relevant and justify its consideration as an addition to the existing remedies. However, more research is needed, as at present data on the role of anisodamine in the management of organophosphate poisoning are limited. Here, we review the beneficial effects of anisodamine on processes relevant to organophosphate poisoning.
在有机磷中毒的病例中，患者会接受多种解毒剂联合治疗。除了这些针对毒物的解毒剂外，患者可能还需要额外吸氧和人工通气；由于中毒效应范围广泛，可能还需要其他治疗方式。山莨菪碱是一种颠茄生物碱，与该家族的其他药物一样，它是非亚型选择性的毒蕈碱受体拮抗剂和烟碱胆碱受体拮抗剂，已被应用于传统中药。作为一种毒蕈碱拮抗剂，它表现出与阿托品和东莨菪碱相似的药理作用。然而，山莨菪碱不仅效力比阿托品和东莨菪碱弱，毒性也更低。目前的体外和动物模型研究表明，山莨菪碱在多种疾病中具有保护作用。有机磷中毒不仅累及中枢和外周神经系统，还涉及心脏和呼吸系统，以及炎症过程激活和氧化应激。因此，山莨菪碱的抗胆碱能及其他活性似乎与之相关，这也证明将其作为现有治疗方法的补充是合理的。然而，由于目前关于山莨菪碱在有机磷中毒治疗中作用的数据有限，还需要更多研究。在此，我们综述山莨菪碱对与有机磷中毒相关过程的有益作用。
