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中毒性昏迷和中枢神经系统抑制。

Toxin-Induced Coma and Central Nervous System Depression.

机构信息

Department of Neurology, Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA.

Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA.

出版信息

Neurol Clin. 2020 Nov;38(4):825-841. doi: 10.1016/j.ncl.2020.07.002. Epub 2020 Sep 12.

Abstract

Many medications and toxins may induce central nervous system (CNS) depression. Even when the intention is to induce CNS depression, other nervous system adverse effects may occur, such as with anesthetics. Pain medications produce characteristic CNS toxicities. Sedative hypnotics may induce altered mentation among systemic toxicities. Stimulants may mimic coma when discontinued abruptly. Acute and chronic carbon monoxide poisoning can lead to altered mental status and prolonged cognitive difficulties. Some medications and environmental toxins can mimic brain death. High clinical suspicion and early recognition of these effects is vital to treatment, most of which is supportive.

摘要

许多药物和毒素可引起中枢神经系统(CNS)抑制。即使是在意图诱导 CNS 抑制时,也可能会出现其他神经系统不良反应,如麻醉剂。止痛药物会产生特征性的 CNS 毒性。镇静催眠药可能会在出现全身毒性时导致思维改变。兴奋剂突然停药时可能会引起昏迷样表现。急性和慢性一氧化碳中毒可导致精神状态改变和认知障碍延长。一些药物和环境毒素可模拟脑死亡。高度怀疑并早期识别这些影响对治疗至关重要,其中大部分为支持治疗。

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