Sevoflurane, ib qho tshuaj loog tsis muaj zog, ua rau thiab tswj cov tshuaj loog los ntawm cov txheej txheem nyuaj. Qhov no ntshiab inhalational tshuaj loog feem ntau cuam tshuam rau hauv nruab nrab paj hlwb los ntawm kev ua inhibitory thiab ua rau excitatory neurotransmitters tsis tshua muaj zog. Los ntawm kev khi rau GABA-A receptors,Ntshiab Sevoflurane txhim kho cov teebmeem ntawm gamma-aminobutyric acid (GABA), thawj inhibitory neurotransmitter hauv lub hlwb. Neurons ua hyperpolarized vim qhov kev ua no, txo lawv lub peev xwm los tua hluav taws thiab xa cov cim. Tsis tas li ntawd, sevoflurane inhibits excitatory neurotransmission-associated N-methyl-D-aspartate (NMDA) receptors. Lub xeev tsis nco qab, tsis nco qab, thiab cov leeg nqaij so yog qhov tshwm sim ntawm kev sib xyaw ua ke ntawm cov kev ua no. Niaj hnub nimno tshuaj loog nyiam sevoflurane vim nws qhov pib sai thiab offset, tsis tshua muaj roj faib coefficient, kev tswj xyuas meej ntawm qhov tob ntawm tshuaj loog, thiab rov qab sai.
Peb muab sevoflurane hmoov, thov xa mus rau lub vev xaib hauv qab no kom paub meej cov lus qhia thiab cov ntaub ntawv khoom.
Khoom siv:https://www.bloomtechz.com/synthetic-chemical/api-researching-only/pure-sevoflurane-28523-86-6.html
Pharmacological Properties ntawm Sevoflurane
Chemical Structure thiab Physical Properties
Sevoflurane yog fluorinated methyl isopropyl ether, thiab nws cov tshuaj npe yog fluoromethyl 2,2, 2-trifluoro-1- (trifluoromethyl) ethyl ether. Nws cov txiaj ntsig pharmacokinetic profile yog qhov tshwm sim ntawm nws cov qauv tshuaj lom neeg tshwj xeeb. Nyob rau hauv chav tsev kub, cov ntshiab sevoflurane compound yog ib tug ntshiab, tsis muaj xim, thiab tsis-flammable kua nrog ib tug txawv tsw qab zib. Nws qhov qis qis ntawm 58.6 degree ua rau nws yooj yim rau vaporize, ua rau nws yooj yim rau siv hauv tshuab nqus pa.
Pharmacokinetics ntawm Sevoflurane
Kev ua tau zoo ntawmNtshiab SevofluraneRaws li ib tug tshuaj loog yog heev cuam tshuam los ntawm nws cov pharmacokinetics. Nws cov pa roj carbon dioxide qis qis ntawm 0.65 ua rau nws yooj yim rau induce anesthesia thiab tawm ntawm nws sai. Kev nyab xeeb ntawm tus neeg mob thiab rov qab zoo dua yog qhov txiaj ntsig ntawm cov cuab yeej no lub peev xwm los ua kom meej meej titrate anesthetic tob. Tsuas yog li 5% ntawm sevoflurane yog biotransformed nyob rau hauv daim siab, yog li nws undergoes me ntsis metabolism hauv lub cev. Qhov tseeb hais tias feem ntau ntawm cov tshuaj yog exhaled unchanged ua rau nws sai tshem tawm ntawm lub cev.
Sib piv kev ua tau zoo nrog lwm yam tshuaj loog
Sevoflurane muaj ib tug xov tooj ntawm zoo dua lwm yam inhalational tshuaj loog. Nws yog tshwj xeeb tshaj yog haum rau daim npog qhov ncauj induction, tshwj xeeb tshaj yog nyob rau hauv cov me nyuam cov neeg mob, vim nws tsis tshua muaj pungency thiab tsawg kawg nkaus ntawm cov hlab cua. Sevoflurane, nyob rau hauv sib piv rau cov laus cov tshuaj xws li halothane, muaj ib tug zoo cardiovascular profile thiab ib tug tsawg dua kev pheej hmoo ntawm hepatotoxicity. Nws muaj qhov pib sai dua thiab kev ua txhaum ntawm kev ua haujlwm tshaj li isoflurane, thiab nws tsis tshua muaj soluble hauv cov ntshav dua li desflurane, uas ua rau lub sijhawm tshwm sim sai dua. Sevoflurane yog ib qho tshuaj loog uas muaj ntau yam thiab siv tau zoo hauv kev kho mob niaj hnub vim tias cov khoom no.
Mechanism of Action ntawm Qib Molecular
Kev sib tham nrog GABA Receptors
Thawj mechanism ntawm kev txiav txim ntawmNtshiab Sevofluranentawm qib molecular yog kev txhim kho ntawm GABA-A receptor kev ua haujlwm. Thaum ua haujlwm, cov receptors no yog ligand-gated ion channels uas tso cai rau chloride ions nkag mus rau cov neurons thiab ua rau hyperpolarization. Sevoflurane ua tau zoo amplifies inhibitory neurotransmission los ntawm nce rhiab heev ntawm GABA-A receptors rau lawv endogenous ligand, GABA. Hauv kev sib piv rau GABA qhov chaw sib txuas, qhov kev sib cuam tshuam no tshwm sim ntawm qhov tshwj xeeb receptor complex binding qhov chaw. Sevoflurane qhov nce chloride conductance ua rau muaj kev cuam tshuam ntawm cov neuronal ntau, uas ua rau cov tshuaj loog ntsig txog kev nco qab thiab amnesia.
Cov teebmeem ntawm Lwm Cov Neurotransmitter Systems
Sevoflurane cov tshuaj loog ua rau muaj kev cuam tshuam hnyav rau ntawm kev hloov pauv ntawm GABA-A receptors, tab sis nws kuj muaj kev cuam tshuam rau lwm cov kab mob neurotransmitter. NMDA receptors, uas yog qhov tseem ceeb rau excitatory neurotransmission thiab synaptic plasticity, tshwj xeeb yog inhibited los ntawm sevoflurane. Los ntawm kev txo qis neuronal excitability, qhov inhibition ntxiv ua rau lub xeev tshuaj loog. Tsis tas li ntawd, sevoflurane muaj qhov cuam tshuam rau ntau cov ion channels, suav nrog cov poov tshuaj raws, uas tej zaum yuav yog ib qho tseem ceeb ntawm nws cov teebmeem ntawm neuroprotection thiab plawv ua haujlwm. Tsis tas li ntawd, cov tshuaj hloov pauv glycine receptors, txhim kho inhibitory spinal qaum neurotransmission thiab pab txhawb rau nws cov teebmeem analgesic thiab imobilizing.
Cellular thiab Synaptic teebmeem
Sevoflurane muaj qhov cuam tshuam dav dua li cas cov hlwb thiab synapses ua haujlwm dua li kev sib cuam tshuam ntawm qib receptor. Nws hloov cov protein conformations thiab fluidity ntawm daim nyias nyias, muaj feem cuam tshuam rau ntau cov txheej txheem ntawm tes. Sevoflurane suppresses neuronal kev ua ub no ntxiv los ntawm inhibiting voltage-gated calcium channels ntawm synapses, uas txo cov neurotransmitter tso tawm. Tus neeg sawv cev kuj muaj feem cuam tshuam rau txoj hauv kev hauv lub cev, xws li cov uas koom nrog apoptosis thiab neuroprotection. Sevoflurane's complex pharmacological profile suav nrog tsis tsuas yog nws cov khoom siv tshuaj loog tab sis kuj tseem muaj peev xwm tiv thaiv kev tiv thaiv kab mob thiab neurotoxic, ob qho tib si yog cov kev tshawb fawb tsis tu ncua hauv kev tshuaj loog. Cov teebmeem cellular ntau pab txhawb rau qhov profile complex.
Kev siv tshuaj kho mob thiab kev txiav txim siab
Vim nws qhov zoo tshaj plaws pharmacological profile,Ntshiab Sevofluraneyog siv dav hauv ntau hom neeg mob. Vim nws cov ntxhiab tsw me me thiab ceev induction, nws yog tshwj xeeb tshaj yog haum rau daim npog qhov ncauj induction nyob rau hauv me nyuam tshuaj loog. Sevoflurane nquag siv los ntxias thiab tswj cov tshuaj loog thaum muaj ntau yam kev phais rau cov neeg laus. Hauv cov chaw kho mob sab nraud lossis chaw kho mob hauv chaw kho mob, nws qhov pib sai thiab offset pab txhawb tus neeg mob sai dua. Sevoflurane qhov kev tswj xyuas meej ntawm kev tshuaj loog qhov tob txo qhov kev pheej hmoo ntawm cov hnub nyoog hloov pauv hauv pharmacokinetics thiab pharmacodynamics hauv cov neeg mob laus. Tsis tas li ntawd, nws siv nyob rau hauv obstetric sedation yog upheld los ntawm nws negligible nyhuv ntawm uterine hlab ntsha thiab ceev leeway los ntawm lub fetal chav kawm.
Txhawm rau ua tiav qhov xav tau qhov tob ntawm cov tshuaj loog thaum txo qis cov kev mob tshwm sim, kev tswj hwm ntawm sevoflurane yuav tsum tau ceev faj titration. Feem ntau, kev tshoov siab ntau ntawm {{0}}}% sevoflurane hauv cov pa lossis sib xyaw ntawm cov pa thiab nitrous oxide yog siv los ua kom muaj tshuaj loog. Nyob ntawm tus yam ntxwv ntawm tus neeg mob thiab qhov yuav tsum tau ua ntawm kev phais, kev saib xyuas koob tshuaj feem ntau yog li ntawm 0.5 mus rau 3%. Sevoflurane concentration tuaj yeem tswj tau los ntawm kev siv tshuaj loog niaj hnub, uas nquag coj los ntawm qhov kawg-tidal concentration xyuas. Lub hnub nyoog-dependent sevoflurane yam tsawg kawg nkaus alveolar concentration (MAC) yog ib qho kev qhia rau ntau npaum. MAC txo qis thaum muaj hnub nyoog thiab yog kwv yees li 2% hauv cov neeg laus. Ua raws li kev siv tshuaj loog hauv eco-phooj ywg, cov txheej txheem qis qis thiab kaw qhov hluav taws xob tuaj yeem siv los txo cov sevoflurane siv thiab cov pa phem hauv ib puag ncig.
ThaumNtshiab Sevofluranefeem ntau suav hais tias muaj kev nyab xeeb, kev paub txog nws cov kev mob tshwm sim yog qhov tseem ceeb rau kev muab kev saib xyuas zoo tshaj plaws rau cov neeg mob. Dos-dependent cardiovascular kev nyuaj siab, tus cwj pwm los ntawm hypotension thiab txo lub plawv tso zis, yog ib qho tshwm sim tsis zoo. Bronchodilation thiab koob tshuaj raws li kev ua pa nyuaj siab yog ua pa. Sevoflurane tuaj yeem qee zaus ua rau mob hyperthermia hauv cov neeg uas muaj kev pheej hmoo, yuav tsum tau kho tam sim. Kev txhawj xeeb txog cov compound A, uas yog tsim thaum sevoflurane thiab CO2 absorbents cuam tshuam, tau ua rau muaj kev sib cav txog nws qhov tseem ceeb hauv kev kho mob. Prophylactic antiemetics tuaj yeem txo qis tom qab xeev siab thiab ntuav, uas yog qhov tshwm sim. Sevoflurane lub peev xwm neurotoxicity tau txuas nrog rau lub sijhawm ntev, tshwj xeeb hauv kev tsim lub hlwb, ua rau muaj kev tshawb fawb tsis tu ncua thiab ceev faj txog kev siv tshuaj loog rau menyuam yaus ntev. Sevoflurane tag nrho cov ntaub ntawv kev nyab xeeb, thaum siv kom tsim nyog, pab txhawb rau nws cov xwm txheej raws li kev siv tshuaj loog uas nyiam hauv kev siv tshuaj loog tam sim no txawm tias cov kev xav no.
Cov ntaub ntawv
Patel, SS, & Goa, KL (1996). Sevoflurane. Kev tshuaj xyuas ntawm nws cov tshuaj pharmacodynamic thiab pharmacokinetic thiab nws cov kev kho mob siv hauv kev siv tshuaj loog. Tshuaj, 51(4), 658-700.
2. Behne, M., Wilke, HJ, & Harder, S. (1999). Clinical pharmacokinetics ntawm sevoflurane. Clinical Pharmacokinetics, 36(1), 13-26.
3. Campagna, JA, Miller, KW, & Forman, SA (2003). Mechanisms ntawm kev ua ntawm inhaled anesthetics. New England Journal of Medicine, 348(21), 2110-2124.
4. Eger, EI (2004). Cov yam ntxwv ntawm cov tshuaj loog siv rau induction thiab kev saib xyuas ntawm kev siv tshuaj loog. American Journal of Health-System Pharmacy, 61(suppl_4), S3-S10.
5. Lerman, J., Sikich, N., Kleinman, S., & Yentis, S. (1994). Pharmacology ntawm sevoflurane nyob rau hauv cov me nyuam mos thiab cov me nyuam. Phau ntawv Journal of the American Society of Anesthesiologists, 80(4), 814-824.
6. Wallin, RF, Regan, BM, Napoli, MD, & Stern, IJ (1975). Sevoflurane: ib tug tshiab inhalational anesthetic tus neeg sawv cev. Cov tshuaj loog & tshuaj loog, 54(6), 758-766.