Abstract:
Reversal agents are defined as any drug used to counteract the pharmacologic effects of another drug. Several pharmacologic antagonists serve as essential drugs in the contemporary practices of sedation providers and anesthesiologists. Reversal or \"antidote\" drugs, such as flumazenil and naloxone, are often used in unintentional overdose situations involving significant benzodiazepine- and/or opioid-induced respiratory depression. Within the context of skeletal muscle relaxation, neostigmine and sugammadex are routinely used to reverse the effects of nondepolarizing neuromuscular blocking agents. In addition, the alpha-adrenergic antagonist phentolamine is used in dentistry as a local anesthetic reversal agent, decreasing its duration of action by inducing vasodilation. This review article discusses the pharmacology, uses, practical implications, adverse effects, and precautions needed for flumazenil, naloxone, neostigmine, sugammadex, and phentolamine within the context of sedation and anesthesia practice for dentistry.
摘要:
逆转剂定义为用于抵消另一种药物的药理作用的任何药物。在镇静提供者和麻醉师的当代实践中,几种药物拮抗剂可作为基本药物。逆转或“解毒剂”药物,如氟马西尼和纳洛酮,通常用于涉及严重的苯二氮卓和/或阿片类药物引起的呼吸抑制的无意过量情况。在骨骼肌松弛的背景下,新斯的明和sugammadex通常用于逆转非去极化神经肌肉阻断剂的作用。此外,α-肾上腺素能拮抗剂酚妥拉明在牙科中用作局部麻醉逆转剂,通过诱导血管舒张减少其作用持续时间。这篇综述文章讨论了药理学,uses,实际意义,不利影响,以及氟马西尼所需的预防措施,纳洛酮,新斯的明,sugammadex,和酚妥拉明在牙科镇静和麻醉实践中的应用。