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JoVE Core
Pharmacology
中枢神经抑制剂:酒精和尼古丁
中枢神经抑制剂:酒精和尼古丁
JoVE Core
Pharmacology
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JoVE Core Pharmacology
CNS Depressants: Alcohol and Nicotine

12.2: 中枢神经抑制剂:酒精和尼古丁

1,310 Views
01:27 min
December 19, 2024
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Please note that some of the translations on this page are AI generated. Click here for the English version.

Overview

乙醇是一种无色透明的酒精,人类饮用已有数千年历史,但它对人体的影响远非良性。在较低剂量下,它会导致抑制力下降和增加健谈性,从而具有社会吸引力。然而,由于其零级消除动力学,在较高剂量下会导致严重后果,如昏迷和呼吸抑制。长期滥用乙醇会对多个器官系统造成严重破坏,尤其是中枢神经系统和肝脏。突然停止摄入乙醇会引发危及生命的戒断症状,​​称为震颤性谵妄 (DT),如心动过速、出汗、震颤、焦虑、幻觉和抽搐,需要立即进行医疗干预和长期戒瘾治疗。对于治疗酒精依赖,双硫仑等药物会产生厌恶反应以阻止进一步饮酒,而纳曲酮可以减少渴望。阿坎酸与心理疗法相结合,有助于通过 NMDA 介导的谷氨酸能作用减少酒瘾。

尼古丁是一种广泛使用的中枢神经兴奋剂,存在于烟草中,低剂量时可导致欣快感、注意力和认知能力的提高。然而,高剂量时会导致神经节阻滞,引发对健康风险的担忧。因此,尼古丁具有剂量依赖性的双重作用,既是中枢神经兴奋剂,又是抑制剂。尼古丁的成瘾性很高,戒断症状包括易怒、睡眠问题和注意力不集中。为了对抗尼古丁成瘾,尼古丁替代疗法 (NRT)、金雀花碱、伐尼克兰、安非他酮和行为疗法等疗法已被证明是有效的。尼古丁通过吸烟和皮肤接触等各种途径快速吸收,这加剧了其成瘾性。酒精和尼古丁成瘾都需要解毒来控制戒断症状和进行长期治疗。酒精和苯二氮卓类等镇静剂之间的交叉耐受性加剧了同时使用这两种药物的危险。酗酒的不良影响不仅限于成瘾,还包括抑郁、记忆力减退、肝病和胃肠道问题。综合评估、补水和药物治疗(通常使用苯二氮卓类药物)是酒精解毒的初始步骤。

Transcript

酒精和尼古丁等 CNS 抑制剂通过不同的机制通过离子型受体介导它们的作用。

乙醇主要存在于酒精饮料中,作为 GABA 激动剂并抑制谷氨酸的兴奋作用,导致运动控制和镇静受损。

长期使用乙醇会导致耐受性和身体依赖性,从而导致焦虑、震颤和癫痫发作等戒断症状。

酒精依赖通过解毒和药物治疗来治疗,使用苯二氮卓类药物等药物。此外,双硫仑会对饮酒产生不愉快的反应并减轻渴望。

此外,纳曲酮(一种竞争性的长效阿片类药物拮抗剂)和阿坎酸酯(一种 NMDA 调节剂)也有助于减少对酒精的渴望。

尼古丁存在于烟草中,可作为 CNS 兴奋剂和镇静剂。它刺激 CNS 中的烟碱乙酰胆碱受体,导致多巴胺释放。这会产生放松和愉悦的感觉。

尼古丁戒断会导致烦躁、不安和渴望。

为了帮助尼古丁死亡,部分烟碱受体激动剂伐尼克兰可缓解戒断症状。

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