气管内给药

气管内给药,有几种药物是有效果的,如纳络酮、安定、利多卡因、肾上腺素和阿托品。Redding等提出气管内给药,可作为心跳停止病人的一条给药途径。在狗,用低氧导致心跳停止,然后气管内给予肾上腺素(1mg稀释于10ml),其恢复循环的效果与静脉或心内注射同样量肾上腺素的效果一样。 有时药物经呼吸道给予时,可经肺泡毛细血管膜而被吸收,但这种方法仅适用于极小颗粒或飞沫(直径在6～0.1μm或更小)。较大的颗粒飞沫则在气管、支气管树的粘膜就被吸收了。因为所有气管、     

气管内给药的研究进展

在紧急情况下,有时建立静脉通道很困难。经气管内给药(ET)被认为是可行的用药途径。美国心脏协会及英国复苏委员会都推荐经气管内用肾上腺素和阿托品。气管内给药的生理学基础雾化吸入β受体兴奋药、抗生素及抗心律失常药后的全身反应已被证实。Claude Bernard 首先证明稀释后的药物可经肺直接吸收而发生药理效应,     

密闭式气管内给药器在NRDS患儿气管内给药中的应用研究

[目的]探讨自制密闭式气管内给药器在新生儿急性呼吸窘迫综合征(NRDS)患儿气管内给药中的应用效果。[方法]将2016年3月—2018年12月入住徐州市儿童医院新生儿重症监护室的80例NRDS早产儿随机分为对照组和试验组,每组40例。对照组采用常规方式气管内给药,试验组在对照组基础上,采用自制的密闭式气管内给药器给药。比较两组患儿给药期间的心率最低值、血氧饱和度最低值、面色改变以及药物反流发生情况。[结果]试验组心率最低值为(125. 57±10. 21)/min、血氧饱和度最低值为(88. 23±3. 56)%,对照组心率最低值为(108. 31±18. 43)/min、血氧饱和度最低值为(85. 46±2. 95)%,两组比较,差异有统计学意义(P0. 05);试验组面色发绀发生率为7. 5%、药物反流发生率为5. 0%,对照组面色发绀发生率为35. 0%、药物反流发生率为30. 0%,两组比较,差异有统计学意义(P0. 05)。[结论]采用自制密闭式气管内给药器给药,可以降低NRDS患儿应用固尔苏过程中心率、血氧饱和度的下降程度以及面色发绀和药物反流发生率。     

气管给药法

如果你不能迅速确定急症患者的静脉输液线时,可能必须采用气管给药法给予某个药物。本文确切指导你迅速而正确应用本法的护理措施。气管可作为抢救生命的一条途径。当你由此给予第一线急救药物如肾上腺素、阿托品或利多卡因时,这些药物到达肺迅速经肺泡进入循环。这种途径给药较心内注射有特殊的优越性,它不存在阻力和危险的并发症如:划破冠状动脉、急性心压塞或气胸。为此,心内注射只在无法实施静脉注射或气管内给药时应用。气管给药后药物作用的起始取决于患者的血液动力学状态。因为药物在肺泡中持续地吸收〈称为贮存效应〉,所以作用持续时间通常比静脉给药长得多。为防止发生不良反应,你必须调整好重复剂量和持续的输     

不同方法气管内给药的效果研究

2003年6月-2005年6月，我科护理人员对60例气管切开病人，分别采取不同的气管内给药法进行对照观察。现总结如下。     

不同方法气管内给药的效果研究

2003年6月—2005年6月,我科护理人员对60例气管切开病人,分别采取不同的气管内给药法进行对照观察。现总结如下。1资料与方法1.1临床资料2003年6月—2005年6月共收治60例气管切开病人,其中神经外科39例,神经内科9例,呼吸中毒专科12例。1.2材料选用浙江大学医学仪器有限公司生产     

一种气管内给药的简易方法

当心跳停止时,想经一条静脉通道注射药物使其复跳,常很困难。许多文献已经证明:将某种药物直接注入气管内确有疗效。因为大多数病人在静脉通道建立之前已作气管内插管,那么气管插管就是最快速地给予抢救生命药物的通道。我们最近使用这种方法,并逐渐更趋完善。此种方法并不影响病人的通气功     

气管内给药对大鼠气管黏膜和肺组织影响的研究

目的 研究气管内给药对大鼠气管黏膜及肺组织可能造成的损伤及修复情况.方法 以大鼠为研究对象,经气管穿刺注射生理盐水、利多卡因和丁胺卡那霉素,通过扫描电镜观察气道上皮的超微结构变化,并观察大鼠细支气管黏膜和肺泡上皮细胞的病理改变.结果 局部使用上述3种药物2h后,气管黏膜纤毛细胞排列紊乱、水肿.24h后生理盐水和利多卡因组大鼠气管黏膜损害程度及损害面积明显减轻,48～72 h后基本恢复正常,而丁胺卡那霉素组则到72 h后才开始逐渐恢复.三组大鼠注射药物48h后细支气管出现上皮细胞水肿、排列紊乱,细支气管及肺泡组织周围炎细胞浸润明显,72 h后逐渐恢复.结论 气管内局部使用生理盐水、利多卡因和丁胺卡那霉素,均可造成大鼠气管黏膜和肺泡组织的急性损伤,以丁胺卡那霉素最为明显,但损伤均具有可逆性.     

肾上腺素气管内给药在急诊复苏中的应用

2006年1月～2008年1月,我们在不能及时建立静脉通道时,采用气管插管内应用肾上腺素抢救危重患者35例,取得满意效果.现报告如下.     

Emergency endotracheal drug administration using aerosol

Drug administration via the endotracheal route has previously involved direct installation in bolus form. However this necessitates an interruption in ventilation and, for the administration of therapeutic agents to the lungs, may result in failure of delivery to the appropriate sites. Aerosols have advantages over other routes of administration since the drug is delivered directly to its required site of action. Treatment with nebulised beta-2 agonists is the initial treatment of choice in acute severe asthma and a small number of such patients require immediate intubation and ventilation. We describe a technique for aerosol delivery using a nebuliser which can be used in intubated patients during manual intermittent positive pressure ventilation using a bag-valve resuscitator.     

Innovations in drug delivery

With recent innovations in pharmaceutical technology, important new methods of drug delivery have joined established ones. Prolonged-release oral preparations can provide precisely controlled drug delivery, which permits less frequent dosage of drugs with a short elimination half-life and thus improves compliance. These preparations also can narrow fluctuations in plasma levels, which maximizes efficacy and minimizes toxicity. Sustained-release intraocular and transcutaneous preparations offer similar advantages. Infusion pumps provide predictable systemic delivery of drugs that cannot be given orally or transcutaneously. Further innovations can undoubtedly be expected. When the therapeutic alternatives include a prolonged-release preparation, its potential advantages should be weighed against its potential disadvantages. Although some of these preparations cost more, this disadvantage may be outweighed by potential advantages.     

Endobronchial drug administration: does deep endobronchial delivery have advantages in comparison with simple injection through the endotracheal tube?

Endobronchial administration of drugs is a valuable alternative to intravenous delivery when venous access cannot be established quickly enough. Some authors propose that deep endobronchial administration through a catheter or similar auxiliary device should give better absorption than simple injection through the endotracheal tube.

To test this proposal in the present study two groups of each 6 patients during general anesthesia were administered 3 ml aqueous lidocaine solution at a dose of 2 mg/kg, either deep endobronchially through a catheter or simply through the endotracheal tube. The unusually low volume of administration of 3 ml was chosen because it was thought that the advantages of deep endobronchial administration would then be particularly apparent as 3 ml would lead to a more localized deposit with deep endobronchial administration thus being clearly different from simple injection.

No difference in the Pao₂ between the two groups could be statistically established. However, the mean lidocaine plasma concentration in the group with the deep endobronchially administered drug was in tendency lower than in the control group (P < 0.05 at 5 min after delivery). Presumably because of the low volume of administration the mean lidocaine plasma concentrations in both groups always remained under the therapeutic level of at least 1.5 μg/ml.

Thus, at least for small volumes and stable circulation the results after deep endobronchial administration through a catheter were somewhat worse than after simple injection through the endotracheal tube.     

Noninvasive drug delivery

Advances in biopharmaceutical technology have spawned new drug delivery devices and mechanisms. Noninvasive methods, including iontophoresis and transmucosal drug delivery, have improved treatment of certain patient population. Their use is discussed in the following paper.     

Spinal drug delivery

Clinicians currently base decisions regarding the use of intrathecal drug therapy for chronic pain on reports from uncontrolled and retrospective studies that fail to rely on standardized outcome measures. In this article, we summarize what is known about currently administered intrathecal therapies, including opioids, gamma-aminobutyric acid agonists, alpha-2 adrenoreceptor agonists, local anesthetics (sodium channel antagonists), calcium channel antagonists, miscellaneous agents, and drug combination therapy. In addition, we offer a brief look at novel approaches that may revolutionize intrathecal drug delivery.     

Nasal drug delivery

The Nasal Drug Delivery Conference was held at the Institute of Directors in London, England. The meeting was organised by the Management Forum Ltd and chaired by P Seeney (PA Consulting, UK) and Professor F Merkus (Leiden University, The Netherlands; Innoscience Technology, Belgium). The conference covered a wide range of topics including aspects of nasal physiology, formulation, new nasal products, nasal vaccines, nose to brain transport and pain management via nasal sprays.     

Prodrugs in nasal drug delivery

Prodrugs have been used to overcome poor solubility, insufficient stability, incomplete absorption across biological membranes and premature metabolism to active species. This review examines the importance of various physicochemical factors affecting nasal absorption of drugs. Novel trends in nasal prodrug development in the areas of targeted delivery to the CNS and selective targeting of the nutrient transporter system of the nasal mucosa have received considerable attention.