s(+)-氯胺酮

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分享一篇关于s(+)-氯胺酮的文献摘要

摘要译文

s(+)-氯胺酮: 当前在急诊和重症监护医学领域的应用趋势

s(+)-氯胺酮是氯胺酮的纯右旋对映体，用于临床镇痛和麻醉已经超过25年。主要通过非竞争性抑制N-甲基-D-天冬氨酸(NMDA)受体发挥药理作用，但s(+)-氯胺酮也与阿片受体、单胺受体、腺苷受体和其他嘌呤能受体相互作用。对α-氨基-3-羟基-5-甲基-4-异唑丙酸(AMPA)受体、代谢型谷氨酸受体(mGluR)和L型钙通道的作用也已被描述。s(+)-氯胺酮可以刺激交感神经系统，使其成为不稳定病人的理想麻醉麻醉诱导和镇静镇痛药物。此外，其还具有神经保护特性、扩张支气管、抗痛觉过敏或抗癫痫作用，为临床治疗提供了有趣选择。在本文中，我们讨论s(+)-氯胺酮在药理学和临床方面的众多作用，特别是在急诊医学和重症监护中的典型适应症。

原文摘要

S(+)-ketamine: Current trends in emergency and intensive care medicine.

S(+)-ketamine,the pure dextrorotatory enantiomer of ketamine has been available for clinicaluse in analgesia and anesthesia for more than 25 years. The main effects aremediated by non-competitive inhibition of the N-methyl-D-aspartate (NMDA)receptor but S(+)-ketamine also interacts with opioid receptors, monoaminereceptors, adenosine receptors and other purinergic receptors. Effects onα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors,metabotropic glutamate receptors (mGluR) and L‑typecalcium chanels have also been described. S(+)-ketamine stimulates thesympathetic nerve system, making it an ideal drug for analgosedation orinduction of anesthesia in instable patients. In addition, the neuroprotectiveproperties, bronchodilatory, antihyperalgesic or antiepileptic effects provideinteresting therapeutic options. In this article we discuss the numerouseffects of S(+)-ketamine under pharmacological and clinical aspects especiallyfor typical indications in emergency medicine as well as intensive care.

原文链接

Trimmel H, Helbok R, Staudinger T, et al. S(+)-ketamine : Current trends in emergency and intensive care medicine [published correction appears in Wien Klin Wochenschr. 2018 Sep;130(17-18):557]. Wien Klin Wochenschr. 2018;130(9-10):356-366. doi:10.1007/s00508-017-1299-3

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