Professional Documents
Culture Documents
I CNG:
- Trong mt vi trng hp, lo u bn chn mang ngha tt (to ng lc lm vic)
- Cht dn truyn TK: GABA (-AminoButyric Acid), Norephinephrin, Serotonin gy lo u, cng thng
- Thuc an thn, gii lo u l thuc gim kch thch TKTW, gim qu trnh hng phn v no.
- Gm: an thn nh (tr lo u cng thng), an thn mnh (tr lon thn ...) v thuc ng (gy ng nh gic ng sinh
l).
NHM THUC AN THN
BENZODIAZEPIN (BZD)
- Cht u tin tm thy: 1957 Clodiazepoxid (BD: Librium) bi Leo Sterrback
- Sau l Diazepam (BD: Valium)
- Ho lp th:
Hu ht BZD khng cha C*
Vng B, 7 cnh to 1, 2 cu trc dng thuyn (a, b i xng qua gng, a mnh hn)
Dn cht th 3-hydroxy (lorazepam, oxazepam): hn hp racemic
- Ho l
Tnh kim: do c 2 N trong nhn <Clodiazepoxid kim kh mnh> P/ to mui vi HCl, lng
trong mi trng khan (HClO4, CH3COOH khan, ch th lc malachit)
P/ phn hu vng diazepam: HCl/100oC, diazepam orthoaminobenzophenon
Nu khng th N1 cht to thnh c nhm amin bc 1 nh tnh bng p/ diazo ho, to
phm mu azoic <Clodiazepoxid: carmin, Nitrazepam: , Oxazepam: tm>
CH N1 phn hu thnh N-methylaminobenzophenon khng to mu azoic
Ch nh: Tc dng ph: u im:
An thn nh: D ng, Tc dng chn lc v an ton
Oxazepam, Lorazepam <ngn hn> Liu cao: chng mt, l ln, suy h t tc dng trn h hp
Clodiazepoxid, Diazepam, Lorazepam hp, h huyt p (dng tim) t tng tc thuc
c thm dng bt pha tim Mc quen thuc t hn thuc
Liu cao: c hin tng gy ng Chng ch nh: khc
Gy ng: tnh to khi thc dy Ngi b tm thn, trm cm
Nitrazepam, flunitrazepam <ko di> Ngi nhc c, suy h hp
Loprazolam, triazolam <ngn hn> PNCT, cho con b
Chng co git: clonazepam, diazepam, D ng vi BZD
ng kinh: diazepam Gim liu ngi gi, ngi suy
Gin c: tetrazepam nhc
THUC THNG DNG:
DIAZEPAM ALPRAZOLAM
Cng thc
NHM THUC GY NG
BENZODIAZEPIN:
- 1,4-Benzodiazepin: Nitrazepam, Flunitrazepam
- Dn cht Triazolo-1,4-Benzodiazepin: triazolam
- Dn cht Imidazo-1,4-Benzodiazepin: loprazolam
- Dn cht 1,5-Benzodiazepin: clobazam
- Dn cht 2,3-Benzodiazepin
- Dn cht 1,4-Thienodiazepi: clotiazepam
DN CHT IMIDAZOPYRIDIN V CYCLOPYRROLON
- Zolpidem (Stinox), Zolpiclon (Imovane)
PYRAZOLOPYRIMIDIN: Zaleplon (c ch ging zolpidem)
DN CHT UREID VNG M: bromisoval, carbromal, acetylcarbomal
DN CHT ALDEHYD:
Cloral hydrat: an thn cho tr em
t/d gy ng, chng co git (do thuc)
hiu qu sau 1h, ko di 4-8h,
dng lin tc sau 2 tun, hiu qu gim
DN CHT PIPERIDON:
Methyprylon, thalidomid (qui thai), glutethimid (duy nht cn c s dng)
T/d nh barbiturat trung bnh
Glutethimid: t/d tt nht trong cc non-barbiturat, hp thu khng u h tiu ho ca tng ngi
DN CHT QUALON HOC QUINAZOLON
Methaqualon (TERAFLON): gy ng (100-200mg), liu cao: o gic, lon thn
Mecloquanlon: t/d ging methaqualon, gy nghin
KHNG HISTAMIN V KHNG CHOLINERGIC: Nhm khng histamin H1
Cu trc ethanolamin: Diphenhydramin, doxylamin,
Cu trc phenothiazin: promazin, prometazin
Khng b qun l theo thuc k n
NHM BARBITURAT (1860s)
- 1990s, b thay th bi BZD trong iu tr mt ng
- C ch: TKTW trn trc no tu sng c ch hot ng tk, c xng, c tim, c trn
- c tnh: TKTW, Cm ng men gan, Gy quen thuc & nghin
- Ch cn c s dng trong tc ng gy m v chng co git.