纳洛酮的药理特性及其在麻醉镇痛中的应用
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摘要
纳洛酮是一种阿片受体颉颃剂,可快速逆转阿片受体激动剂引起的镇静和麻醉,被国外兽医广泛应用于阿片受体激动剂诱导动物镇静和麻醉后的苏醒,或与其他药物联合应用于临床疾病的治疗。从纳洛酮的药理作用及在动物麻醉方面的应用进行阐述,旨在为该药物在国内兽医临床的合理应用提供参考。
Naloxone was an opioid receptor anti-agonist,could reverse quickly anesthesia and sedation produced by opioid receptor agonist.It was used universally to analepsia animals that were induced by opioid receptor agonist.Naloxone could be also combined with other drugs applying to treat diseases.The pharmacological action of naloxone and application in anesthesia analgesia was elaborated,which will provide a reference for domestic veterinary clinic application.
Naloxone was an opioid receptor anti-agonist,could reverse quickly anesthesia and sedation produced by opioid receptor agonist.It was used universally to analepsia animals that were induced by opioid receptor agonist.Naloxone could be also combined with other drugs applying to treat diseases.The pharmacological action of naloxone and application in anesthesia analgesia was elaborated,which will provide a reference for domestic veterinary clinic application.
引文
[1]王东玉.纳洛酮治疗重型颅脑损伤效果观察[J].中国实用神经疾病杂志,2013,16(2):59-60.
[2]方陈,陈永,齐保龙.纳洛酮治疗慢性阻塞性肺疾病并肺性脑病46例临床观察[J].淮海医药,2013,31(2):127-128.
[3]张志新,闫利红,王长华,等.纳洛酮在中重度新生儿缺氧缺血性脑病治疗中的应用[J].中国妇幼保健,2013,28(7):1120-1121.
[4]邹勇.纳洛酮治疗慢性呼吸衰竭并发肺性脑病的临床疗效[J].中国保健营养,2013(2):872-873.
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[7]LASSEN C L,ZINK W,WIESE C,et al.Naloxoninduziertes LungendemFallbericht mit Literaturübersicht und kritischer Bewertung[J].Der Anaes-thesist,2012,61(2):129-136.
[8]ANNE-MAREE K,DEBRA K,DIETZE P.Intranasal Naloxone for Treat-ment of Opioid Overdose[J].Handbook of Environmental Engineering,2009,6:729-739.
[9]CRISTINA N,TERESA C,LUISA M,et al.Regulation of extracellular sig-nal-regulated kinases(ERKs)by naloxone-induced morphine withdrawal inthe brain stress system[J].Naunyn-Schmiedeberg's Archives of Pharma-cology,2008,378(4):407-420.
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[14]KAKINOHANA M,MARSALA M,CARTER C,et al.Neuraxial morphinemay trigger transient motor dysfunction after a noninjurious interval of spi-nal cord ischemia:a clinical and experimental study[J].Anesthesiology,2003,98:862-870.
[15]吕爱红,王丽娟.纳洛酮对急性脑梗死的脑保护作用[J].中国实用神经疾病杂志,2011,14(11):43-44.
[16]VERTES Z,MELEGH G,VERTES M,et al.Effect of naloxone and D-Met-Pro-enkephalina-mide treatment on the synthesis in the developingrat brain[J].Life Sci,1982,31:119-126.
[17]SUNDAR J S,KAMARAJU L S,DINGFELDER J,et al.beta-Endorphinenhances the Replication of neurotropic human immunodeficiency virus infetal Perivascular microglia[J].J Neuroimmunol,1995,61:97-104.
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[19]冯国智,钱虹,陈旭高,等.纳洛酮在急诊危重病人院前抢救中的应用价值[J].广西医学,2013,35(2):179-180.
[20]GUNJAN G,JOSHI B S,THAKUR S,et al.Role of intravenous naloxonein severe pruritus of acute cholestasis[J].Indian Journal of Gastroenterol-ogy,2009,28(5):180-182.
[21]JIANG J W,LIU B,WILSON B C,et al.Systemic infusion of naloxone re-duces degeneration of rat substantia nigral dopaminergic neurons inducedby intranigral injection of lipopolysaccharide[J].J Pharmacol Exp Ther,2000,295:125-132.
[22]PETER R,RUDOLF B,BEATRICE F,et al.Effect of Naloxone-3-Glucu-ronide and N-Methyl-naloxone on the Motility of the Isolated Rat Colon Af-ter Morphine[J].Digestive Diseases and Sciences,2007,52(2):502-507.
[23]LUCIO P,MASSIMO M,LUCA V,et al.Preliminary study on the effect ofparenteral naloxone,alone and in association with calcium gluconate,onbone healing in an ovine“drill hole”model system[J].BMC Musculo-skeletal Disorders,2007,8(1):43.
[24]MORESCO A,LARSEN R S,SLEEMAN J M,et al.Use of naloxone to re-verse carfentanil citrate induced hypoxemia and cardiopulmonary depres-sion in Rocky Mountain wapiti(Cervus elaphus nelsoni)[J].J Zoo WildMed,2001,32:81-89.
[25]刘俊杰,赵俊.现代麻醉学[M].2版.北京:人民卫生出版社,1997:314.
[26]陈新谦,金有豫,汤光,等.新编药物学[M].15版.北京:人民卫生出版社,2003:222-794.
[27]MASAHIKO T,KIMITOSHI S,MASAKI H,et al.Naloxone reversal of opi-oid anesthesia revisited:clinical evaluation and plasma concentration analysis of continuous naloxone infusion after anesthesia with high-dose fentanyl[J].J Anesth,2004,18:1-8.
[28]SHUPAK R C,HARP J R.Comparison between high-dose sufentanil oxy-gen and high-dose fentanyl-oxygen for neuroanalgesia[J].Br J Anaesth,1985,57:375-381.
[29]赵丽云,叶铁虎,张银中,等.小剂量纳洛酮在术后吗啡静脉自控镇痛中的应用[J].中国医学科学院学报,2005,27(2):228-231.
[30]卢德章.小型猪特异性麻醉颉颃剂的研制及其催醒机理的研究[D].哈尔滨:东北农业大学,2011:6,44-48.
[31]尹柏双,李小波,王洪斌,等.纳洛酮对小型猪特异性麻醉剂麻醉大鼠大脑皮质C-jun mRNA表达的影响[J].中国兽医杂志,2012,48(7):20-23.
[32]尹柏双,李小波,石星星,等.纳洛酮对大鼠大脑皮质C-fos mRNA表达的影响[J].中国兽医学报,2013,33(2):250-253.
[2]方陈,陈永,齐保龙.纳洛酮治疗慢性阻塞性肺疾病并肺性脑病46例临床观察[J].淮海医药,2013,31(2):127-128.
[3]张志新,闫利红,王长华,等.纳洛酮在中重度新生儿缺氧缺血性脑病治疗中的应用[J].中国妇幼保健,2013,28(7):1120-1121.
[4]邹勇.纳洛酮治疗慢性呼吸衰竭并发肺性脑病的临床疗效[J].中国保健营养,2013(2):872-873.
[5]JAVED A,RICHARD R,KISHORE S.PCA-induced respiratory depressionsimulating stroke following endoluminal repair of abdominal aortic aneu-rysm:a case report[J].Journal of Medical Case Reports,2007,1(1):45.
[6]VAN DORP E,YASSEN,SARTON E,et al.Naloxone reversal of buprenor-phine induced respiratory epression[J].Anesthesiology,2006,105(1):51-57.
[7]LASSEN C L,ZINK W,WIESE C,et al.Naloxoninduziertes LungendemFallbericht mit Literaturübersicht und kritischer Bewertung[J].Der Anaes-thesist,2012,61(2):129-136.
[8]ANNE-MAREE K,DEBRA K,DIETZE P.Intranasal Naloxone for Treat-ment of Opioid Overdose[J].Handbook of Environmental Engineering,2009,6:729-739.
[9]CRISTINA N,TERESA C,LUISA M,et al.Regulation of extracellular sig-nal-regulated kinases(ERKs)by naloxone-induced morphine withdrawal inthe brain stress system[J].Naunyn-Schmiedeberg's Archives of Pharma-cology,2008,378(4):407-420.
[10]KREEK M J.Opioid receptors:some perspectives from early studies oftheir role in normal physiology,stress responsivity,and in specific addic-tive diseases[J].Neurochem Res,1996,21:1469-1488.
[11]KAPAS S,PURBRICK A,HINSON J P.Action of opioid peptides on therat adrenal cortex:stimulation of steroid secretion through a specific muopioid receptor[J].J Endocrinol,1995,144:503-510.
[12]SINZ E H,KOFKE W A,GARMAN R H.Phenytoin,midazolam,and nal-oxone protect against fentanyl-induced brain damage in rats[J].AnesthAnalg,2000,91:1443-1449.
[13]ZABRAMSKI J M,SPETZLER R F,SELMAN W R,et al.Naloxone thera-py during focal cerebral ischemia evaluation in a primate model[J].Stroke,1984,15(4):621-627.
[14]KAKINOHANA M,MARSALA M,CARTER C,et al.Neuraxial morphinemay trigger transient motor dysfunction after a noninjurious interval of spi-nal cord ischemia:a clinical and experimental study[J].Anesthesiology,2003,98:862-870.
[15]吕爱红,王丽娟.纳洛酮对急性脑梗死的脑保护作用[J].中国实用神经疾病杂志,2011,14(11):43-44.
[16]VERTES Z,MELEGH G,VERTES M,et al.Effect of naloxone and D-Met-Pro-enkephalina-mide treatment on the synthesis in the developingrat brain[J].Life Sci,1982,31:119-126.
[17]SUNDAR J S,KAMARAJU L S,DINGFELDER J,et al.beta-Endorphinenhances the Replication of neurotropic human immunodeficiency virus infetal Perivascular microglia[J].J Neuroimmunol,1995,61:97-104.
[18]SHIGERU I,YOICHI K,HIROAKI A,et al.α2 Nicotinic acetylcholine re-ceptors in the central amygdaloid nucleus alter naloxone-induced with-drawal following a single exposure to morphine[J].Psychopharmacology,2011,214(4):923-931.
[19]冯国智,钱虹,陈旭高,等.纳洛酮在急诊危重病人院前抢救中的应用价值[J].广西医学,2013,35(2):179-180.
[20]GUNJAN G,JOSHI B S,THAKUR S,et al.Role of intravenous naloxonein severe pruritus of acute cholestasis[J].Indian Journal of Gastroenterol-ogy,2009,28(5):180-182.
[21]JIANG J W,LIU B,WILSON B C,et al.Systemic infusion of naloxone re-duces degeneration of rat substantia nigral dopaminergic neurons inducedby intranigral injection of lipopolysaccharide[J].J Pharmacol Exp Ther,2000,295:125-132.
[22]PETER R,RUDOLF B,BEATRICE F,et al.Effect of Naloxone-3-Glucu-ronide and N-Methyl-naloxone on the Motility of the Isolated Rat Colon Af-ter Morphine[J].Digestive Diseases and Sciences,2007,52(2):502-507.
[23]LUCIO P,MASSIMO M,LUCA V,et al.Preliminary study on the effect ofparenteral naloxone,alone and in association with calcium gluconate,onbone healing in an ovine“drill hole”model system[J].BMC Musculo-skeletal Disorders,2007,8(1):43.
[24]MORESCO A,LARSEN R S,SLEEMAN J M,et al.Use of naloxone to re-verse carfentanil citrate induced hypoxemia and cardiopulmonary depres-sion in Rocky Mountain wapiti(Cervus elaphus nelsoni)[J].J Zoo WildMed,2001,32:81-89.
[25]刘俊杰,赵俊.现代麻醉学[M].2版.北京:人民卫生出版社,1997:314.
[26]陈新谦,金有豫,汤光,等.新编药物学[M].15版.北京:人民卫生出版社,2003:222-794.
[27]MASAHIKO T,KIMITOSHI S,MASAKI H,et al.Naloxone reversal of opi-oid anesthesia revisited:clinical evaluation and plasma concentration analysis of continuous naloxone infusion after anesthesia with high-dose fentanyl[J].J Anesth,2004,18:1-8.
[28]SHUPAK R C,HARP J R.Comparison between high-dose sufentanil oxy-gen and high-dose fentanyl-oxygen for neuroanalgesia[J].Br J Anaesth,1985,57:375-381.
[29]赵丽云,叶铁虎,张银中,等.小剂量纳洛酮在术后吗啡静脉自控镇痛中的应用[J].中国医学科学院学报,2005,27(2):228-231.
[30]卢德章.小型猪特异性麻醉颉颃剂的研制及其催醒机理的研究[D].哈尔滨:东北农业大学,2011:6,44-48.
[31]尹柏双,李小波,王洪斌,等.纳洛酮对小型猪特异性麻醉剂麻醉大鼠大脑皮质C-jun mRNA表达的影响[J].中国兽医杂志,2012,48(7):20-23.
[32]尹柏双,李小波,石星星,等.纳洛酮对大鼠大脑皮质C-fos mRNA表达的影响[J].中国兽医学报,2013,33(2):250-253.