主條目:藥物影響膽能素
Anticholinergics(抗膽鹼性藥物 may refer to antinicotinics or Antimuscarinics; however, when we use the word we often mean Antimuscarinics.
分類[]
natural tertiary amine alkaloid ester of tropic acid: nonselective muscarinic antagonist with little interactions with other receptors (NN or histamine receptors)[]
- l(-)-hyoscylamine→atropine((±)-hyoscylamine)(dl-hyoscylamine):中樞興奮
- hyoscine(scopolamine)少量時中樞抑制,大量時也是中樞興奮
synthetic antimuscarinics: muscarinic antagonist moderately selective for one or another subgroups of muscarinic receptor with interactions with other receptors (NN or histamine receptors)[]
spasmolytics(解痙藥)-解腸胃痙痛劑[]
- atropine: from Tyler
- scopolamine: from Tyler
- bucopan
- clidinium
- dicyclomine
- diphemanil
- glycopyrrolate
- homatropine methylbromide
- isopropamide
- mepenzolate
- methantheline
- oxyphencyclimine
- papaverine
- propantheline
- tridihexethyl
spasmolytics(解痙藥)-drugs for bladder spasm after urologic surgery[]
oxybutynin
incontinence in institutionalized elderly patients[]
- TCA:imipramine
- propiverine
骨架[]
- ethylenediamine
- ethanolamine
用途[]
- antiparkinson
- sedative-hypnotics
- sedation
- hypnotion
- anxiolytics
- 麻醉手術前投與以減少分泌 PS scopolamine尚可有術後失憶的效果(同術前投與的sedative-hypnotics)
- 暈車藥、止吐藥
- 解腸胃痙痛劑、止瀉劑(少用)
- 解毒劑:cholineasterase inhibitor中毒的解毒劑
參考資料[]
Anticholinergic burden[]
- 有的藥有抗膽鹼作用,多重用藥要注意這類藥的累積效應
- 有的SSRI
- 有的抗組織胺
- 有的急迫性尿失禁用藥,用beta3 agonist-Mirabegron(商品名:Betmiga)替代
- 過動性膀胱(Overactive bladder,簡稱OAB),又稱為膀胱過動症(Overactive bladder syndrome),急迫性尿失禁;欲望性尿失禁(Urge incontinence)