复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)姚晨玲-镇静催眠药中毒 Toxicity, Sedative?Hypnotics

Toxicity, Sedative Hypnotics 中山急诊姚晨玲
Toxicity, SedativeHypnotics 中山急诊 姚晨玲

Background Sedative-hypnotics are a group of drugs that cause CnS depression Benzodiazepines(bzd) the most commonly a barbiturates used agents a nonbarbiturate nonbenzodiazepine sedative hypnotics( nbnb
Background Sedative-hypnotics are a group of drugs that cause CNS depression. ◼ Benzodiazepines (BZD) ◼ barbiturates ◼ nonbarbiturate nonbenzodiazepine sedativehypnotics (NBNB) the most commonly used agents

Background acute sedative-hypnotics poisoning a withdrawal syndrome
Background ◼ acute sedative-hypnotics poisoning ◼ withdrawal syndrome

Etiology Benzodiazepines(BzD) Long acting(half life >30h) chlordiazepoxide(利眠宁) diazepam(地西泮、安定) flurazepam(氟安定) Short acting(half life 6-30h) alprazolam(阿普唑仑) Ultrashort acting triazolam(三唑仑)
Etiology Benzodiazepines (BZD) • Long acting (half life >30h): chlordiazepoxide (利眠宁) diazepam(地西泮、安定) flurazepam (氟安定) • Short acting (half life 6-30h): alprazolam(阿普唑仑) • Ultrashort acting : triazolam(三唑仑)

Etiology Barbiturates Ultrashort acting Methohexital Brevital甲己炔巴比妥) thiopental( Pentothal硫喷妥那) Short acting pentobarbital( Nembutal巴比妥) secobarbital( Seconal司可巴比妥 Intermediate acting Amobarbital( Amytal异戊巴比妥) butalbital( Fioricet, Fiorina|异丁巴比妥) ong acting Phenobarbital( Luminal鲁米那)
Etiology ◼ Barbiturates ◼ Ultrashort acting ◼ Methohexital (Brevital甲己炔巴比妥) ◼ thiopental (Pentothal硫喷妥那) ◼ Short acting ◼ pentobarbital (Nembutal戊巴比妥) ◼ secobarbital (Seconal司可巴比妥) ◼ Intermediate acting ◼ Amobarbital (Amytal异戊巴比妥) ◼ butalbital (Fioricet, Fiorinal异丁巴比妥) ◼ Long acting ◼ Phenobarbital (Luminal鲁米那)

Etiology Nonbarbiturate, nonbenzodiazepine sedative-hypnotics(NBNB) Chloral hydrate(水合氯醛) Ethchlorvynol(乙氯维诺) Glutethimide(导眠能) Methyprylon(甲乙哌酮) Meprobamate(眠尔通)
Nonbarbiturate, nonbenzodiazepine sedative-hypnotics (NBNB) Chloral hydrate (水合氯醛) Ethchlorvynol (乙氯维诺) Glutethimide (导眠能) Methyprylon (甲乙哌酮) Meprobamate (眠尔通) Etiology

Pathogenesis 、 Pharmacokinetics: 1 Pharmacokinetics of the bzd Most bzd are extensively metabolized by the liver Some are metabolized to products which are active and may have a much longer half life than the parent drug The major route of metabolism is N-demethylation in the elderly↓ Cimetidine↓
一、Pharmacokinetics : 1、Pharmacokinetics of the BZD • Most BZD are extensively metabolized by the liver. • Some are metabolized to products which are active and may have a much longer half life than the parent drug. • The major route of metabolism is N-demethylation. in the elderly Cimetidine Pathogenesis

Pathogenesis 2 Pharmacokinetics of barbiturates Barbiturates with low lipid solubility are excreted in the unchanged form by the kidneys. ie phenobarbita|(苯巴比妥) Barbiturates with high lipid solubility are metabolized to more polar compounds in the liver before being excreted via the kidneys. ie thiopental(硫喷妥)
Pathogenesis 2、Pharmacokinetics of Barbiturates ◼ Barbiturates with low lipid solubility are excreted in the unchanged form by the kidneys. ie phenobarbital(苯巴比妥). ◼ Barbiturates with high lipid solubility are metabolized to more polar compounds in the liver before being excreted via the kidneys. ie thiopental (硫喷妥)

Pathogenesis 3 Pharmacokinetics of nBNB Most nbnb are extensively metabolized by the liver
3、Pharmacokinetics of NBNB ◼ Most NBNB are extensively metabolized by the liver Pathogenesis

Pathogenesis The mechanism of action ◆BZD In the CNS, benzodiazepines exert their clinical effect by enhancing the activity of the inhibitory neurotransmitter GABa (The clinical effects of GABa release and GABA-gated chloride channels include sleep induction and excitement inhibition) ◆ Barbiturates in prolongation of the duration of opening of GABA-gated chloride channels, leading to hyperpolarization of the membrane and suppression of neurotransmission. ◆NBNB similar to the action of barbiturates
BZD In the CNS, benzodiazepines exert their clinical effect by enhancing the activity of the inhibitory neurotransmitter GABA. (The clinical effects of GABA release and GABA-gated chloride channels include sleep induction and excitement inhibition) Barbiturates in prolongation of the duration of opening of GABA-gated chloride channels, leading to hyperpolarization of the membrane and suppression of neurotransmission. 。 NBNB similar to the action of Barbiturates 二、 The mechanism of action Pathogenesis
按次数下载不扣除下载券;
注册用户24小时内重复下载只扣除一次;
顺序:VIP每日次数-->可用次数-->下载券;
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)姚晨玲-急性一氧化碳中毒 Toxicity, Carbon Monoxide.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)周京敏-感染性心内膜炎 Infective Endocarditis.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)周京敏-心包疾病.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)吕玲-有机磷农药中毒 ORGANOPHORUS PESTICIDES POISONING.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)吕玲-多发性肌炎及皮肌炎.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)刘厚钰-消化总论 Digestive System.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)何礼贤-呼吸系统总论 Disease of Respiratory System Introduction.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)于明香 - 甲亢 Hyperthyroidism.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)严萍萍-心脏瓣膜病 valvular heart disease.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)严萍萍-主动脉瓣狭窄 aortic stenosis.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)丁小强-肾小球疾病 Glomerular Diseases.ppt
- 临床医学专业:《内科学》_内科学(七年制)大纲2006(上).doc
- 临床医学专业:《内科学》_内分泌和代谢系统.doc
- 临床医学专业:《内科学》_泌尿系统疾病.doc
- 临床医学专业:《内科学》_吕玲-有机磷农药中毒教案.doc
- 复旦大学:《内科学》课程教学资源(PPT课件讲稿)吕玲-有机磷农药中毒.ppt
- 临床医学专业:《内科学》_吕玲-多发性肌炎及皮肌炎教案.doc
- 复旦大学:《内科学》课程教学资源(PPT课件讲稿)吕玲-多发性肌炎及皮肌炎.ppt
- 复旦大学:《内科学》课程教学资源(PPT课件讲稿)陆福明-尿毒症.ppt
- 复旦大学:《内科学》课程教学资源(PPT课件讲稿)刘厚钰-消化总论.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)姜林娣-类风关 RHEUMATOID ARTHRITIS(RA).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)张斯为-肺心病 Chronic Pulmonary heart disease.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)张新-支气管肺癌.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)张顺财 - 黄疸鉴别 Differencial Diagnosis of Jaundice.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)徐三荣-急性胰腺炎 ACUTE PANCREATITIS.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)徐建民-出血性疾病 DISORDERS OF HEMOSTASIS.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)徐建民-特发性血小板减少性紫癜 DISORDERS OF HEMOSTASIS.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)於强 - Systemic Lupus Erythematosus(SLE).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)於强-血管炎病的诊断与治疗 Vasculitides.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)施海明-心肌疾病.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)李勇-高血压诊断和治疗(从JNC-7和2003 ESC/EHC指南到临床实践).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)李益明-甲状腺功能减退 Hypothyroidism.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)沈锡中-炎症性肠病(Inflammatory bowel disease,IBD).ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)王吉耀 - 肝硬化 Hepatic Cirrhosis.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)王吉耀-内科学绪论 INTRODUCTION TO INTERNAL MEDICINE.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)白春学-呼吸衰竭 Respiratory Failure.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)胡仁明-糖尿病 Diabetes Mellitus.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)胡必杰-肺炎 Respiratory Diseases Pneumonia.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)范维琥-心力衰竭 Heart failure.ppt
- 复旦大学附属中山医院:《内科学》课程教学资源(PPT讲稿)蔡映云-慢支肺气肿 COPD.ppt