壹生资讯-可卡因与心律失常的关系

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可卡因与心律失常的关系

2020-09-25作者：论坛报沐雨资讯

心律失常

英文原文：

COCAINE AND OTHER RECREATIONAL

DRUGS

Cocaine, a recreational drug, blocks IKr, INa, and the reuptake of catecholamines at adrenergic nerve endings.Sinus tachycardia and ST-T changes suggestive of ischemia are frequently seen in patients with cocaine intoxication. It can cause monomorphic VT due to INa blockade and TdP due to IKr blockade.A hyperadrenergic state induced by cocaine can promote calcium overload and resultant triggered atrial and ventricular arrhythmia. Cocaine intoxication has also been shown to induce a type-1 Brugada-like pattern in predisposed individuals.Additionally,recreational drugs such as ecstasy, ice, crystal, Eve, Death, ma-huang, khat, bath salts, LSD, PCP, and cannabis result in hyperadrenergic states with expected sympathomimetic effects.

翻译

可卡因和其他药物

可卡因，一种兴奋性药物，可阻断IKr, INa电流，以及在肾上腺素神经末梢重新摄取儿茶酚胺。在可卡因中毒患者中，常出现窦性心动过速和提示心肌缺血的ST-T变化。由于INa及IKs电流阻滞可能分别会导致单形VT和TdP。可卡因引起的高肾上腺素能水平促进钙超载，进而导致房性和室性心律失常发生。可卡因中毒也被证明可以在预先处理的个体中诱发一种类似于I型brugada形态的心电图。另外，还有一些兴奋性药物，如摇头丸、冰毒、水晶、止痛药、丧尸药、麻黄、卡特草、浴盐、D-麦角酸二乙胺、普斯普剂和大麻产生高肾上腺素能的拟交感神经作用。

英文原文：

CONCLUSION

• Knowledge of the cardiac action potential, electrophysiologic properties of drugs, and mechanisms of arrhythmia is integral to understanding the effects of various drugs on the ECG.

• Categorization of drug effects by Vaughan Williams class helps to understand these principles, even though drugs may have effects that cut across several of the defined classes, and can have effects that the nosology does not take into account.

• Relating drug-induced arrhythmia to arrhythmia mechanism promotes understanding and facilitates the treatment of these remarkably common but dangerous clinical entities.

翻译

结论

•了解心脏动作电位、药物的电生理特性以及心律失常的机制，是了解各种药物对心电图影响的重要基础。

•Vaughan Williams对药物效果的分类有助于理解这些原则，尽管药物可能会影响到一些已定义的分类，并且可能会影响到疾病治疗效果的分类。

•药物引起心律失常与其机制联系起来，有助于理解药物治疗时非常常见但具有危险性的临床情况。

来源：哈特瑞姆心脏之声

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