Respiratory analeptic drugs list. Respiratory analeptics

Analeptic drugs (from the Greek analeptikos - restorative, strengthening) mean a group medicines, stimulating primarily the vital centers of the medulla oblongata brain - vascular and respiratory. In large doses, these drugs can excite the motor areas of the brain and cause seizures.

In therapeutic doses, analeptics are used when weakening vascular tone, with respiratory depression, with infectious diseases, in the postoperative period, etc.

Currently, the group of analeptics according to the localization of action can be divided into three subgroups:

1) Drugs that directly, directly activate (I revive

breathing center:

Bemegrid;

Etimizole.

2) Means that reflexively stimulate the breathing center:

Cititon;

Lobelin.

3) Means mixed type actions that have both direct and

reflex action:

Cordiamine;

Camphor;

Corazol;

Carbon dioxide.

Bemegridum (in amp. 10 ml of 0.5% solution) is a specific antagonist of barbiturates and has a “revitalizing” effect in case of intoxication caused by drugs of this group. The drug reduces the toxicity of barbiturates, relieves respiratory and circulatory depression. The drug also stimulates the central nervous system, so it is effective not only for barbiturate poisoning.

Bemegride is used for acute poisoning barbiturates, to restore breathing upon recovery from anesthesia (ether, fluorotane, etc.), to remove the patient from a severe hypoxic state. The drug is administered intravenously, slowly until breathing and blood pressure are restored,

Side effects: nausea, vomiting, convulsions.

Among direct-acting analeptics special place occupies the drug etimizol.

Etimizole (Aethimizolum; in the table, 0, 1; in amps, 3 and 5 ml of 1% solution). The drug activates the reticular formation of the brain stem, increases the activity of neurons in the respiratory center, and enhances the adrenocorticotropic function of the pituitary gland. The latter leads to the release of additional portions of glucocorticoids. At the same time, the drug differs from bemegride in its slight inhibitory effect on the cerebral cortex (sedative effect), improves short term memory, promotes mental work. Due to the fact that the drug promotes the release of glucocorticoid hormones, it has a secondary anti-inflammatory effect.

Indications for use. Etimizole is used as an analeptic, a respiratory stimulant in case of poisoning with morphine, non-narcotic analgesics, in recovery period after anesthesia, with lung atelectasis. It is used in psychiatry sedative effect in states of anxiety. Given its anti-inflammatory effect, it is prescribed for the treatment of patients with polyarthritis and bronchial asthma, and also as an antiallergic agent.

Side effects: nausea, dyspepsia.

Reflex-acting stimulants are N-cholinomimetics. These are the drugs cititon and lobeline. They excite H-cholinergic receptors in the sinocarotid zone, from where afferent impulses enter the medulla oblongata, thereby increasing the activity of neurons in the respiratory center. These remedies act for a short time, within a few minutes. Clinically, breathing becomes more frequent and deep, and blood pressure increases. The drugs are administered only intravenously. Used for only one indication - for poisoning carbon monoxide.

In mixed-type agents, the central effect (direct stimulation of the respiratory center) is supplemented by a stimulating effect on the chemoreceptors of the carotid glomerulus (reflex component). These are, as stated above, cordiamine and carbon dioxide. IN medical practice carbogen is used: a mixture of gases - carbon dioxide (5-7%) and oxygen (93-95%). Prescribed in the form of inhalations, which increase breathing volume by 5-8 times.

Carbogen is used for overdose of general anesthetics, carbon monoxide poisoning, and asphyxia of newborns.

The drug cordiamine is used as a respiratory stimulant - a neogalenic drug (prescribed as an official one, but representing a 25% solution of diethylamide nicotinic acid). The effect of the drug is realized by stimulation of the respiratory and vasomotor centers.

Prescribed for heart failure, shock, asphyxia, intoxication.

Analeptics include medications that help restore respiratory function, activity of cardio-vascular system, having a stimulating effect on the vital centers of the medulla oblongata - respiratory and vasomotor. Analeptics stimulate other parts of the central nervous system to a lesser extent: the cerebral cortex, subcortical centers, and the spinal cord. The stimulating effect of analeptics (revitalizing effect) manifests itself especially clearly when respiratory functions and the activity of the cardiovascular system are depressed, including those resulting from the use of central nervous system depressants (anesthetics, hypnotics).

Analeptics include bemegride, camphor, cordiamine, etimizol, etc. Caffeine, which has a psychostimulating effect, is also analeptic, as well as lobelia, cititon and other drugs with a reflex mechanism of action, mainly stimulating the respiratory center due to the stimulation of H-cholinergic receptors in the carotid sinocarotid zone.

BEMEGRID- the most powerful analeptic. Bemegride is used to stimulate breathing and blood circulation, to recover from a state of anesthesia, in case of an overdose of narcotic drugs; recommended for poisoning with barbiturates and other sleeping pills. The dosage of bemegride is strictly individual depending on the patient’s condition. Side effects when using bemegride: vomiting, convulsions. Bemegride is contraindicated if you are prone to seizures. Release form: ampoules of 10 ml of 0.5 solution. List B.

An example of a recipe for bemegride in Latin:

Rp.: Sol. Bemegridi 0.5% 10 ml

D.t. d. N. 10 in ampull.

S. Administer 2-5 ml intravenously to non-anesthetized patients; 5-10 ml - in case of poisoning with sleeping pills, for recovery from anesthesia.

ETIMIZOL- has a pronounced stimulating effect on the respiratory center, is used as a respiratory stimulant (under anesthesia, etc.). Etimizole improves short-term memory, increases mental performance. Etimizole stimulates the pituitary-adrenal system, and therefore has an anti-inflammatory, anti-allergic effect. Etimizol is used for polyarthritis, bronchial asthma, etc. The accumulation of cAMP in tissues plays a role in the mechanism of action of etimizol. Side effects when using etimizol: nausea, dyspepsia, anxiety, sleep disturbances, dizziness. Etimizole is contraindicated in diseases accompanied by central nervous system stimulation. Etimizole is prescribed orally and parenterally (intramuscularly, slowly intravenously). Release form of etimizol: tablets of 0.1 g and ampoules of 3 ml of 1.5% solution. List B.

Example of a recipe for etimizol in Latin:

Rp.: Sol. Aethimizoli 1.5% 3 ml

D.t. d. N. 10 in ampull.

S. 3-5 ml intramuscularly.

Rp.: Tab. Aethimizoli 0.1 N. 50

D.S. 1 tablet 2-3 times a day.

CORDIAMINE- official 25% solution of nicotinic acid diethylamide, stimulates the respiratory and vasomotor centers. Cordiamine is used for heart failure (improves blood circulation), shock, asphyxia, poisoning, infectious diseases (to improve the function of the cardiovascular system and respiration). Cordiamine is prescribed orally and intravenously slowly (for poisoning, shock), subcutaneously, intramuscularly. Cordiamine release form: 15 ml bottle and 1 ml and 2 ml ampoules. List B.

Example of a cordiamin recipe in Latin:

Rp.: Cordiamini 15 ml

D.S. 20-25 drops 2-3 times a day.

Rp.: Cordiamini 1 ml

D.t. d. N. 10 in ampull.

S. 1 ml subcutaneously 1-2 times a day.

MIKOREN- has a powerful stimulating effect on the respiratory center in case of respiratory failure of central and peripheral origin. Mykoren is used for poisoning with drugs that depress the central nervous system (hypnotics, anesthetics, alcohol, etc.), asphyxia of newborns. Mykoren is administered intravenously 0.3-0.5 ml; in emergency cases (coma, respiratory arrest, poisoning) - 3-4 ml (maximum - 10 ml), and then, if necessary, administered at a rate of 3-9 ml/hour per isotonic solution sodium chloride or dextran. Side effects of mycorene: transient paresthesia, agitation, rarely - vomiting, convulsions. Release form of mycorene: ampoules of 1.5 ml of 15% solution (containing 225 mg of mycorene). Foreign drug.

CAMPHOR- stimulates the respiratory and vasomotor centers, and also acts directly on the heart, normalizing metabolic processes in the myocardium. It is also possible that there is a reflex effect on the centers of the medulla oblongata due to the irritating effect of camphor. Camphor has a longer lasting effect than previous drugs. Camphor is used for various infectious diseases, poisonings accompanied by depression of breathing and functions of the cardiovascular system, for arterial hypotension, collapse, in complex therapy acute and chronic heart failure. Side effects when using camphor: embolism when the oil solution gets into the lumen of the vessel, skin reaction (rash), agitation, convulsions. Camphor is contraindicated in diseases characterized by central nervous system excitation and convulsions. Camphor release form: powder; ampoules of 1 ml and 2 ml of 20% oil solution; bottles of 30 ml of 10% camphor oil and bottles of 40 ml and 80 ml of camphor alcohol.

Example of a camphor recipe in Latin:

Rp.: Sol. Camphorae oleosae 20% pro injectionibus 2 ml

D.t. d. N. 10 in ampull.

Rp.: Camphorae tritae 0.1 Sacchari 0.2

M.f. pulv.

D.t. d. N. 10 in charta cerata.

S. 1 powder 3 times a day.

Rp.: Camphorae tritae 2.0

T-rae Valerianae 20 ml

M.D.S. 20 drops 3 times a day (in hot water after meal).

Rp.: Spiritus camphorati 80 ml

D.S. For rubbing.

SULPHOCAMPHOCAINE- a complex compound of sulfocamphoric acid and novocaine. Sulfocamphocaine is used for acute cardiac and respiratory failure, the action is close to camphor. This drug(sulfocamphocaine) is not prescribed for hypersensitivity to novocaine and exercise great caution when administering to patients with arterial hypotension(due to possible hypotensive effect novocaine). Sulphocamphocaine is administered intramuscularly, slowly intravenously and subcutaneously. Release form sulfocamphocaine: ampoules of 2 ml of 10% solution.

Example of a recipe for sulfocamphocaine in Latin:

Rp.: Sol. Sulfocamphocaini 10% 2 ml

D.t. d. N. 10 in ampull.

S. 2 ml under the skin 2-3 times a day.

CARBON DIOXIDE- has a direct stimulating effect on the centers medulla oblongata and reflex - through the receptors of the sinocorotid zone. Carbon dioxide is formed in the process of metabolism and is a physiological stimulant of the respiratory center; stimulates the vasomotor center, causing constriction of peripheral vessels and increasing arterial pressure. To stimulate breathing, a mixture of carbon dioxide (5-7%) and oxygen (93-95%), called carbogen, is used. Carbogen is used for overdose of anesthetics, carbon monoxide poisoning, asphyxia of newborns, etc. If after 5-7 minutes from the start of inhalation with carbogen there is no effect, then the administration of carbon dioxide should be stopped, since otherwise more severe respiratory depression may occur. Carbon dioxide is also used in balneology (in medicinal baths) for diseases of the cardiovascular system, dermatology (treatment with “carbon dioxide snow” of warts, neurodermatitis, lupus erythematosus, etc.). Carbonated drinks containing carbon dioxide, used to enhance secretory activity and motility of the gastrointestinal tract.

Breathing stimulants are also lobeline And cititon(see N-hom nomimetics).

For respiratory depression, respiratory stimulants are used to stimulate the respiratory and vasomotor centers of the medulla oblongata. Because they restore vitality important functions(breathing and circulation), they are called analeptics, which means revitalizing agents.

Stimulation of the breathing center leads to an increase in pulmonary ventilation and gas exchange, an increase in oxygen content and a decrease in carbon dioxide in the blood, an increase in oxygen delivery to tissues and the removal of metabolic products, stimulation of redox processes and normalization of the acid-base state. Stimulation of the vasomotor center causes an increase in vascular tone, vascular resistance and blood pressure, improves hemodynamics. Some analeptics (caffeine, camphor, cordiamine) have a direct effect on the heart. The effects manifest themselves mainly against the background of respiratory and circulatory depression.

Most analeptics in large doses can cause convulsions. The difference between respiratory stimulating doses and convulsive doses is relatively small. Convulsions also affect the respiratory muscles, which is accompanied by respiratory and gas exchange disorders, increased stress on the heart and the risk of arrhythmias. A sharp increase in the need of neurons for oxygen with insufficient oxygen delivery leads to hypoxia and the development of degenerative processes in the central nervous system. Analeptics are antagonists of anesthetics, hypnotics, alcohol, narcotic analgesics and provide "awakening" an effect that is manifested by a decrease in the depth and duration of anesthesia and sleep, restoration of reflexes, muscle tone and consciousness. However, this effect is expressed only when large doses are used. Therefore, they should be prescribed in doses sufficient to restore breathing, circulation and some reflexes with mild to moderate depression of these functions. Antagonism between analeptics and CNS depressants double-sided Therefore, in case of an overdose of analeptics and the occurrence of convulsions, anesthesia and sleeping pills are used.

MD analeptics are associated with increased excitability of neurons, improved function of the reflex apparatus, reduction latent period and increased reflex responses. The stimulating effect is most pronounced against the background of life-threatening depression of the central nervous system.

According to the direction of action, analeptics are divided into 3 groups: 1) direct action on the respiratory center (bemegride, etimizol, caffeine, strychnine); 2) mixed action(cordiamin, camphor, carbon dioxide); 3) reflex actions(lobeline, cititon); Possessing general properties, individual drugs differ in main and side effects. The choice of drugs depends on the cause of respiratory depression and the nature of the disorders.

Bemegrid used mainly for poisoning with barbiturates and anesthetics, for rapid recovery from anesthesia, as well as for respiratory and circulatory depression caused by other reasons. it is administered intravenously slowly, 5-10 ml of 0.5% solution every 3-5 minutes. until breathing, circulation and reflexes are restored. If convulsive muscle twitching occurs, administration should be stopped.

Etimizole occupies a special position, since, along with excitation of the centers of the medulla oblongata, it has a depressing effect on the cerebral cortex. Therefore, it does not give an “awakening” effect in case of poisoning with anesthetics and sleeping pills. It combines the properties of an analeptic and a tranquilizer, as it can even enhance the hypnotic effect. It is used primarily for poisoning with narcotic analgesics, and also in psychiatry as a sedative. Etimizole stimulates the hypothalamus and the production of adrenocorticotropic hormone from the pituitary gland, which is accompanied by stimulation of the adrenal cortex and an increase in the content of corticosteroids in the blood, resulting in anti-inflammatory and antiallergic effects. Therefore, etimizol can be used in the treatment bronchial asthma and inflammatory processes.

Caffeine described in detail in the lecture on “psychostimulants”. The analeptic effect occurs with pareitheral application of sufficient doses that stimulate the centers of the medulla oblongata. As an analeptic, caffeine is weaker than bemegride, but unlike it, it has a pronounced cardiotonic effect, and therefore has a more significant effect on blood circulation. It is prescribed mainly for alcohol poisoning and a combination of acute respiratory failure and cardiac failure.

Strychnine - an alkaloid from the seeds of the chilibuha, or “vomit nut,” native to tropical areas of Asia and Africa. It stimulates all parts of the central nervous system: enhances functional activity cortex, sensory organs, centers of the medulla oblongata, spinal cord. This is manifested by improved vision, taste, hearing, tactile sensitivity, muscle tone, heart function and metabolism. Thus, strychnine has a general tonic effect. Strychnine MD is associated with a weakening of postsynaptic inhibition, the mediator of which is glycine. The direct effect on the centers of the medulla oblongata is weaker than that of bemegride, but strychnine increases their sensitivity to physiological stimuli, resulting in an increase in the volume of pulmonary ventilation, an increase in blood pressure and increased vasoconstrictor reflexes. Excitation of the vagal center leads to a slowdown in the heart rate. The spinal cord is most sensitive to strychnine. Even in small doses, strychnine increases the reflex excitability of the spinal cord, which is manifested by increased reflex reactions, increased tone of skeletal and smooth muscles. The weakening of postsynaptic inhibition leads to easier interneuronal transmission of impulses, acceleration of central reflex reactions and increased irradiation of excitation to the central nervous system. At the same time, conjugate (reciprocal) inhibition weakens and the tone of the antagonist muscles increases.

Strychnine has a small latitude therapeutic action and is able to accumulate, so an overdose can easily be caused. At poisoning Strychnine sharply increases reflex excitability and develops tetanic convulsions that occur in response to any irritation. After several attacks of convulsions, paralysis of the central nervous system may occur. Treatment: administration of drugs that depress the central nervous system (fluorotane, sodium thiopental, chloral hydrate, sibazone, sodium hydroxybutyrate), muscle relaxants, gastric lavage with potassium permanganate solution, Activated carbon and a saline laxative orally, complete rest.

Strychnine is used as general tonic PM with functional impairment of vision and hearing, with intestinal atony and myasthenia, with sexual impotence of a functional nature, as an analeptic to stimulate breathing and blood circulation. It is contraindicated for hypertension, atherosclerosis, angina pectoris, bronchial asthma, liver and kidney diseases, epilepsy and children under 2 years of age.

Analeptics of mixed action stimulate the respiratory center directly and reflexively through the chemoreceptors of the sinocarotid zone. Cordiamine stimulates breathing and blood circulation. Increased blood pressure and improved blood circulation are associated with a direct effect on the vasoconstrictor center and the heart, especially in heart failure. It is prescribed orally and parenterally for weakened breathing and circulation caused by intoxication, infectious diseases, shock, etc.

Camphor - bicyclic terpene ketone, part of essential oils camphor laurel, camphor basil, etc. Synthetic camphor is also used. Camphor is well absorbed and partially oxidized. Oxidation products combine with glucuronic acid and are excreted by the kidneys. Part of the camphor is released through Airways. Locally irritating and antiseptic effect. Stimulates the centers of the medulla oblongata directly and reflexively. It acts slowly, but lasts longer than other analeptics. Camphor increases blood pressure by constricting blood vessels abdominal organs, while expanding the blood vessels of the brain, lungs and heart. The tone of the venous vessels increases, which leads to an increase in venous return to the heart. Different influence camphor on blood vessels is associated with a stimulating effect on the vasomotor center and a direct dilating effect on the walls of blood vessels. When the heart is depressed by various poisons, camphor has a direct stimulating and detoxifying effect on the myocardium. The cardiotonic effect is due to the sympathomimetic effect and activation of oxidative phosphorylation. In large doses, camphor stimulates the cerebral cortex, especially motor areas, increases reflex excitability of the spinal cord and can cause clonic-tonic convulsions. Camphor enhances the secretion of bronchial glands, thins mucus and improves its secretion, stimulates the secretion of bile and sweat glands. It dissolves poorly in water, but well in oil and alcohol. Therefore, it is used in the form of solutions in oil subcutaneously to improve breathing and blood circulation in case of poisoning and infectious diseases. Prescribed locally in the form of ointments, rubbing in inflammatory processes, for itching, for the prevention of bedsores, etc. Contraindicated in patients prone to seizures.

Carbon dioxide is a physiological regulator of respiration and blood circulation. It acts directly and reflexively on the respiratory center. Inhalation of 3% CO 2 increases ventilation of the lungs by 2 times, and inhalation of 7.5% increases ventilation by 5-10 times. Maximum effect develops in 5-6 minutes. Inhalation of large concentrations of CO 2 (over 10%) causes severe acidosis, violent shortness of breath, convulsions and respiratory paralysis. Excitation of the vasomotor center leads to an increase in peripheral vascular tone and an increase in blood pressure. At the same time, the vessels of the lungs, heart, muscles and brain expand. The dilation is due to a direct effect on vascular smooth muscle.

Carbon dioxide apply to stimulate breathing in case of poisoning with anesthesia, carbon monoxide, hydrogen sulfide, asphyxia of newborns, in diseases accompanied by weakened breathing, for the prevention of pulmonary atelectasis after anesthesia, etc. It can be used only in the absence of pronounced hypercapnia, since a further increase in the concentration of CO 2 in the blood can cause paralysis of the respiratory center. If after 5-8 minutes. after the start of CO 2 inhalation, breathing does not improve, it must be stopped. Use a mixture of CO 2 (5-7%) with oxygen (93-95%) - carbogen.

Cititon And lobeline stimulate the respiratory center reflexively due to stimulation of the chemoreceptors of the carotid glomeruli. With intravenous administration, a strong and rapid effect develops, but short-term (2-3 minutes). In some cases, especially with reflex cessation of breathing, they can contribute to a stable restoration of breathing and blood circulation. In case of poisoning with anesthetics and hypnotics, these drugs are not very effective.

7686 0

Analeptic(revitalizing, awakening) drugs are used to restore the function of vital centers of the brain after general anesthesia, as well as in case of poisoning various substances, CNS depressants (barbiturates, analgesics, alcohol, technical solvents, etc.)

IN outpatient practice These drugs are used for fainting or collapsing conditions during a dental appointment. Analeptics stimulate the respiratory and vasomotor centers, increase cardiac output, and increase blood pressure. These effects are realized due to both direct (bemegride, caffeine) and combined (direct and reflex) effects (cordiamin, camphor) on the centers of the medullary oblongata. Potentially dangerous arrhythmogenic, hypertensive and convulsive effects should be taken into account when overdosing drugs in this group.

Bemegride is a relatively selective antagonist of barbiturates (thiopental, hexenal, methohexital, etc.). However, it should be borne in mind that it is effective only with moderate intoxication.

Naloxone is a selective antagonist of narcotic analgesics. Flumazenil is used to treat overdose of benzodiazepine drugs (section 5.1.2).

Bemegrid(Bemegridum). Synonyms: Ahypnon, Etimid, Glutami sol.

pharmachologic effect : is a pharmacological antagonist of barbiturates (hypnotics and general anesthetics). Eliminates the inhibitory effect of general anesthetics (including inhalational ones - ether, fluorotane, etc.) on the respiratory and vasomotor centers.

Indications: used for poisoning with barbiturates and general anesthetics, to terminate anesthesia and accelerate awakening, in hypoxic conditions.

Mode of application: in case of acute barbiturate poisoning, 5-10 ml of a 0.5% solution is administered slowly intravenously to adults.

If there is no effect, the injections are repeated after 2-3 minutes until breathing and reflexes are restored. For children, the dose is reduced by as many times as the child’s body weight is less than the average body weight of an adult. The appearance of convulsive twitching of the limbs is a signal to stop administering the drug.

Side effect : in high doses, convulsions, nausea, vomiting are possible.

Interaction with other drugs: simultaneous administration of caffeine, mezaton, and other means of symptomatic treatment of poisoning is possible.

Release form: 0.5% solution in ampoules of 10 ml.

Storage conditions: at low temperatures, bemegride crystals may fall out of the solution, which dissolve when heated to 50°C. List B.

Camphor(Camphora). Synonym: Camphor.

pharmachologic effect: has a stimulating effect on the respiratory and vasomotor centers, directly affects the heart muscle, increasing its sensitivity to catecholamines. Increases blood pressure by increasing cardiac output and constricting peripheral vessels, and helps improve microcirculation. Excreted through the respiratory tract after subcutaneous administration, improves the separation of juice from the company. When applied topically, it has an irritant and antiseptic effect.

Indications: used in cases of respiratory depression due to pneumonia and infectious diseases, poisoning with sleeping pills and narcotic drugs. Used locally for rubbing for neuralgia, rheumatism, arthritis.

Mode of application: to stimulate breathing in adults, 1-5 ml of injection solution is injected subcutaneously. It is necessary to avoid contact with blood vessels due to the risk of embolism. The solution is heated to body temperature. Topically, camphor oil for external use (10% solution in sunflower oil) is used for rubbing; camphor alcohol; solution of camphor and salicylic acid; "Camphocin" is a liniment containing camphor, salicylic acid, Castor oil, turpentine oil, methyl salicylate, tincture capsicum. To soothe toothache, use Denta drops, which contain camphor (see Chloral hydrate).

Side effect: with subcutaneous administration, the formation of an infiltrate is possible, which requires warming to accelerate its resorption.

Contraindications: not prescribed for epilepsy, tendency to convulsive reactions, individual intolerance.

Interaction with other drugs: enhances the effect of sympathomimetic amines on the cardiovascular system.

Release form: 20% oil solution in ampoules of 1 and 2 ml. Forms for local application see above.

Storage conditions

Cordiamine(Cordiaminum). Synonyms: Nicethamidum, Niketha mide, Coramin.

pharmachologic effect: is an analeptic, is a 25% solution of nicotinic acid diethylamide. Stimulates the respiratory and vasomotor centers. Direct action does not affect the functioning of the heart and blood vessels. In toxic doses it causes clonic convulsions.

Indications: used when chronic disorders blood circulation, acute collapse and asphyxia, shock states.

Mode of application: adults are administered subcutaneously, slowly intravenously and intramuscularly, 1-2 ml of the drug 1-3 times a day. 15-40 drops are prescribed orally 23 times a day. Higher doses for adults: single parenteral - 2 ml, daily - 6 ml; single enteral - 60 drops, daily - 180 drops.

Side effect: In case of overdose, convulsions occur. Subcutaneous and intramuscular injections Cordiamine is painful. In this regard, 1 ml of 0.5-1% novocaine solution can first be injected into the injection site.

Contraindications: not prescribed for epilepsy, tendency to convulsive reactions.

Release form: ampoules of 1 and 2 ml for injection; 15 ml bottles for oral administration.

Storage conditions: in a place protected from light. List B.

Caffeine sodium benzoate(Coffeinum-natrii benzoas).

pharmachologic effect: the drug is a stimulant of the central nervous system.

Indications: used for depression of the central nervous system, poisoning with narcotic drugs, insufficiency of the cardiovascular system at a dental appointment as a means of emergency therapy.

Mode of application: prescribed once orally at 0.05-0.2 g or subcutaneously at 1-2 ml of 10% or 20% solution.

Side effect: possible increased excitability, hicardia, insomnia, dizziness. With prolonged use, mental dependence is likely.

Contraindications: not used for atherosclerosis, glaucoma, arterial hypertension, increased neuropsychic excitability.

Interaction with other drugs: goes well with analgesics, atropine, bromides, cardiac glycosides, bronchodilators, ergot alkaloids. Incompatible with MAO inhibitors, it is an antagonist of substances that depress the central nervous system.

Release form: powder, tablets of 0.075 g (for children) and 0.1 g; ampoules of 1 and 2 ml of 10 and 20% solution.

Storage conditions: in a place protected from light. List B.

Sulfocamphocaine(Sulfocamphocainum).

pharmachologic effect: is an analeptic, a complex compound of sulfocamphoric acid and novocaine. Its action is similar to camphor. It differs from camphor in its solubility in water and does not cause the formation of infiltrates when administered subcutaneously. It is quickly absorbed from the injection site with subcutaneous and intramuscular injection.

Indications: collapse, prevention of cardiac and pulmonary failure, respiratory depression in severe infections and intoxications.

Mode of application: administered to adults 2 ml subcutaneously, intramuscularly or intravenously (stream or drip) 2-3 times a day, no more than 12 ml/day.

Contraindications: not applicable to persons with allergic reactions history of novocaine.

Interaction with other drugs: weakens the antimicrobial effect of sulfonamides.

Release form: ampoules of 2 ml of 10% solution.

Storage conditions: in a place protected from light.

Dentist's Guide to medicines
Edited by Honored Scientist of the Russian Federation, Academician of the Russian Academy of Medical Sciences, Professor Yu. D. Ignatov

Corazol, activating the respiratory and vasomotor centers, stimulates breathing and increases blood pressure. In large doses, it activates the motor areas of the brain and can cause clonic convulsions.

Bemegrid stimulates breathing, has little effect on vascular tone. It is an antagonist of barbiturates, but is effective only in cases of moderate intoxication; it can be used in cases of overdose of CNS depressants, as well as to terminate anesthesia. Large doses may cause nausea and convulsions.

Etimizole- By chemical structure similar to xanthines (caffeine). It is slightly toxic, does not cause seizures, depending on the dose and condition of the patient, it can excite and depress the central nervous system, stimulates the medulla oblongata and excites the respiratory center. Activation of the hypothalamus by etimizol leads to increased secretion of ACTH and increased levels of glucocorticoids; Therefore, etimizol has anti-inflammatory and antiallergic activity. The drug in small doses improves short-term memory and mental performance, increases tissue resistance to hypoxia. Etimizole can be used in combination with other resuscitation measures for mild asphyxia of newborns.

The use of analeptics for asphyxia is not always justified; it is more important to eliminate hypercapnia and acidosis and thereby relieve depression of the respiratory center. In addition, stimulating the central nervous system, analeptics increase the tone of skeletal muscles and enhance the utilization of oxygen, which is already insufficient during asphyxia. The antiallergic and anti-inflammatory properties of etimizol are used to treat bronchial asthma (it also has a moderate bronchodilator effect) and rheumatic diseases.

Niketamide (cordiamine) - 25% solution of nicotinic acid diethylamide, moderately excites the respiratory and vasomotor centers, has a direct and partially reflexive (from the chemoreceptors of the sinocarotid zone) effect on the medulla oblongata. In large doses it causes clonic convulsions. Used for circulatory disorders and weakened breathing, for states of shock, during surgical interventions and in the postoperative period.

Camphor- has a moderate analeptic effect, inferior to other drugs in this group. Oil solution camphor is injected under the skin, which leads to irritation of sensitive receptors subcutaneous tissue and promotes reflex excitation of the centers of the medulla oblongata. After absorption, direct activation of the respiratory and vasomotor centers occurs. The drug stimulates redox processes, normalizes carbohydrate metabolism, increases metabolic processes in the myocardium, its contractility and sensitivity to adrenergic influences, promotes the removal of endotoxins from the heart muscle, increases coronary blood flow and blood supply to the brain, has an antiaggregation effect, increases microcirculation, improves ventilation, pulmonary blood flow; Partially released through the respiratory tract, camphor helps to liquefy and release sputum. Possessing surface activity, adsorbed on the membranes of tissue cells and capillaries, it weakens the destructive effect of inflammatory mediators and protein breakdown products. Camphor is used for acute and chronic heart failure, respiratory depression, collapsed state, and pneumonia. An oil solution of camphor is injected only subcutaneously, preventing it from entering the lumen of blood vessels, as an embolism may develop. Infiltrates may form at the injection site. Currently, a water-soluble analogue is used