Leeuwin R S
Arch Int Pharmacodyn Ther. 1984 May;269(1):34-41.
Interactions of cholinesterase inhibitors or dexamethasone with the hypnotic effect of benzodiazepines appear to be strongly dependent on the dose of the cholinesterase inhibitor used and to a lesser extent on the dose of the hypnotic. The duration of the loss of righting reflex caused by the benzodiazepines, diazepam or chlorodiazepoxide, is markedly prolonged by 500 micrograms/kg, significantly antagonized both diazepam and chlorodiazepoxide. Relatively higher doses of physostigmine have no significant effect on either diazepam or chlorodiazepoxide. Dexamethasone, in relatively low doses of 250 and 500 micrograms/kg or 500 micrograms/kg respectively, significantly reverses the effect of diazepam and chlorodiazepoxide, while in relatively high doses of 1000 micrograms/kg the hormone significantly potentiates the hypnosis produced by the benzodiazepines. It is suggested that the interactions described may be the result of a modification of possible changes in cholinergic activity caused by the benzodiazepines. Although as yet no unequivocal explanation can be offered for the different effects, the observations described in this paper may explain the highly contradictory findings of other authors in both animal and human studies.
胆碱酯酶抑制剂或地塞米松与苯二氮䓬类催眠作用的相互作用似乎强烈依赖于所用胆碱酯酶抑制剂的剂量，在较小程度上依赖于催眠药的剂量。苯二氮䓬类药物地西泮或氯氮䓬引起的翻正反射消失持续时间，在500微克/千克时显著延长，对氯氮䓬有明显拮抗作用。相对较高剂量的毒扁豆碱对地西泮或氯氮䓬均无显著影响。地塞米松分别以相对低剂量250微克/千克和500微克/千克或500微克/千克时，能显著逆转地西泮和氯氮䓬的作用，而在相对高剂量1000微克/千克时，该激素能显著增强苯二氮䓬类药物产生的催眠作用。有人认为，所描述的相互作用可能是苯二氮䓬类药物引起的胆碱能活性可能变化的改变所致。尽管目前对于不同作用尚无明确解释，但本文所述观察结果可能解释了其他作者在动物和人体研究中高度矛盾的发现。
