麻醉药(Anesthetic Agents)

一、填空题(5*2 分=10 分)1、巴比妥酸无催眠作用，当 5 位碳上的两个氢原子均被取代后，才具有镇静催眠作用。

2、吗啡结构中 B/C 环呈顺式，C/D 环呈反式， C/E 环呈顺式，环 D 为椅型构象，环 C 呈半船式构象，镇痛活性与其分子构型密切相关。

3、根据局部麻醉药的特点，可将其化学结构概括为三部分，既包括亲脂性部分、中间部分和_亲水性部分_。

4、药物中的杂质主要来源有合成过程引入和贮存过程引入5、阿托品的水解产物是莨菪醇和莨菪酸。

6、非甾体抗炎药是抑制环氧化酶的活性，减少体内从花生四烯酸合成前列腺素和血栓素前体的一大类具有不同化学结构的药物，这些药物都具有解热、镇痛和抗炎的作用，其抗炎的作用的机制与甾类抗炎药如可的松不同。

7、左旋肾上腺素在 pH 4 以下的水溶液中能发生消旋化反应而使活性降低。

8、药物从进入人体到产生药效的过程，要经历药剂相、药代动力相、药效相三个重要相。

P5219、解热镇痛药按结构可分为水杨酸类，苯胺类，和吡唑酮类等。

10、去甲肾上腺素为 R 构型，具有左旋性，结构上具有儿茶酚胺的结构受体， N 受体11、拟胆碱药物的受体有 M1 受体， M2 受体， M312、药物分子含有 2 个苯环，一般空间位阻较小的部位发生氧化代谢；若 2 个苯环取代基不同，则一般是电子云密度高的芳环易被氧化。

13、普鲁卡因作用时间较短的主要原因是 _含有酯基，易水解分解。

14、先导化学物的发现和优化方法有很多，归纳起来可认为是从分子的多样性，分子的互补性和分子的相似性三方面考虑。

二、名词解释(5*4 分=20 分)1.*组合化学(combinatorialchemistry) ：是一门将化学合成、组合理论、计算机辅助设计及机械手结合一体，并在短时间内将不同构建模块用巧妙构思，根据组合原理，系统反复连接，从而产生大批的分子多样性群体，形成化合物库，然后，运用组合原理，以巧妙的手段对库成分进行筛选优化，得到可能的有目标性能的化合物结构的科学。

全身麻醉药名词解释医学
全身麻醉药简称全麻药，是一类能抑制中枢神经系统功能的药物，使意识、感觉和反射暂时消失，骨骼肌松弛，主要用于外科手术前麻醉。

全身麻醉药根据给药途径可分为吸入麻醉药和静脉麻醉药。

全身麻醉的麻醉范围广，一般适用于大型手术，但其不良反应及危险性较大。

全身麻醉药被吸收后，作用于中枢神经系统，使机体功能受到广泛抑制，引起意识、感觉和反射消失及骨骼肌松弛。

全身麻醉药用于大型手术或不能用局部麻醉药的患者。

除门诊短小手术等实施单纯静脉麻醉外，全身麻醉均需在气管插管，辅助或控制呼吸下实施。

复合麻醉时，要注意药物的协同作用，根据药物间相互作用的特点，病情和手术要求，合理选择麻醉药物。

准确判断麻醉深度根据所用药物性质、作用时间、剂量，综合循环系统血压、脉搏的变化和病人对手术的反应综合判定麻醉深度。

在满足全麻的基本要求前提下，优化复合用药，原则上应尽量减少用药种类。

保持气道通畅和氧供，维持正常的氧合和通气。

全身麻醉药的副作用包括肌肉不自主运动、嗝逆、咳嗽、支气管痉挛、喉痉挛、低血压、心律紊乱、呼吸抑制及术后恶心、呕吐等。

恶性高热偶见报道，往往和使用卤、烃类麻醉药有关，发病多在使用琥珀胆碱后。

麻醉剂英文Anesthetic Agents: Understanding the BasicsIntroduction:Anesthesia plays a crucial role in modern medicine, enabling surgeons to perform complex procedures while ensuring patient comfort and safety. Anesthetic agents, commonly known as "麻醉剂" in Chinese, are substances used to induce loss of sensation or consciousness. This article aims to provide a comprehensive overview of anesthetic agents, their classification, and their roles in medical practice.Types of Anesthetic Agents:Anesthetic agents can be broadly classified into two categories: general anesthetics and local anesthetics.General Anesthetics:General anesthetics are medications that induce a reversible state of unconsciousness and loss of sensation throughout the entire body. They are administered intravenously or via inhalation. Common intravenous general anesthetics include propofol and etomidate, which act by enhancing the activity of inhibitory neurotransmitters in the brain.Inhalation anesthetics, such as sevoflurane and isoflurane, are delivered via a breathing mask and provide rapid induction and maintenance of anesthesia.Local Anesthetics:Unlike general anesthetics, local anesthetics act by blocking the transmission of nerve impulses in a specific area, numbing the region and allowing for painless surgical procedures. Local anesthetics can be administered topically, through infiltration, or via nerve blocks. Lidocaine and bupivacaine are commonly used local anesthetics due to their efficacy and safety profile.Mechanism of Action:The mechanism of action of anesthetic agents varies depending on the type. General anesthetics work by altering the functioning of neurotransmitters in the central nervous system, leading to inhibition of neuronal activity and loss of consciousness. Local anesthetics, on the other hand, block sodium channels in nerve fibers, preventing the conduction of pain signals.Clinical Applications:Anesthetic agents are used in various medical procedures, rangingfrom minor surgeries to major interventions. General anesthetics are indispensable in surgeries requiring complete unconsciousness, such as cardiac surgeries, abdominal surgeries, and neurosurgical procedures. Local anesthetics find utility in dental procedures, skin surgeries, and pain management during labor.Safety Considerations:While anesthetic agents are generally safe when administered by trained professionals, they are not without risks. Possible complications include allergic reactions, respiratory depression, cardiovascular instability, and postoperative nausea and vomiting. These risks are mitigated by careful patient selection, comprehensive preoperative assessment, and vigilant monitoring during anesthesia administration.Conclusion:In conclusion, anesthetic agents are essential tools in modern medicine, allowing for painless surgical interventions and ensuring patient comfort. Understanding the classification, mechanism of action, and clinical applications of these agents is crucial for healthcare professionals involved in anesthesia management. By balancing the benefits and risks, anesthetic agents contribute significantly to improving patient outcomes and enhancing the quality of healthcare delivery.Anesthetic AgentsIntroduction:Anesthesia is a critical component of modern medicine, allowing surgeons to perform procedures without causing pain or discomfort to patients. Anesthetic agents play a vital role in this process, providing temporary loss of sensation and consciousness. In this article, we will explore the various types of anesthetic agents commonly used in medical practice.Types of Anesthetic Agents:1. Local Anesthetics:Local anesthetics are primarily used to provide localized pain relief. They work by blocking the nerve signals in a specific area, numbing the region and preventing pain sensation. Commonly used local anesthetics include lidocaine, bupivacaine, and procaine. These agents are typically administered via injection or topical application.2. General Anesthetics:General anesthetics induce a reversible loss of consciousness, allowing surgeons to perform complex procedures without causing anydiscomfort to patients. These agents are usually administered through inhalation or intravenous injection. Some commonly used general anesthetics include sevoflurane, propofol, and desflurane.3. Regional Anesthetics:Regional anesthetics are used to numb larger areas of the body, such as an entire limb or a specific region. These agents block nerve signals along a specific nerve pathway, resulting in loss of sensation in the targeted area. Examples of regional anesthetics include epidural and spinal anesthesia, which are frequently used during childbirth or orthopedic surgeries.4. Intravenous Anesthetics:Intravenous (IV) anesthetics are administered directly into the bloodstream to induce sedation and relaxation. These agents work rapidly, allowing for quick onset and offset of anesthesia. Commonly used IV anesthetics include midazolam, propofol, and ketamine.5. Topical Anesthetics:Topical anesthetics are applied directly to the skin or mucous membranes to provide localized pain relief. These agents are commonly used during minor surgical procedures, dental work, or to alleviatediscomfort from skin conditions. Lidocaine and benzocaine are popular topical anesthetics utilized in medical practice.Safety and Considerations:While anesthetic agents are essential in modern medicine, it is crucial to consider their potential risks and side effects. Allergic reactions, respiratory depression, and interactions with other medications are some of the risks associated with anesthesia. Therefore, it is crucial for healthcare professionals to carefully evaluate a patient's medical history and tailor the selection and dosage of anesthetic agents accordingly.Conclusion:Anesthetic agents are invaluable tools in the field of medicine, ensuring patient comfort and safety during surgical procedures. From local anesthetics to general anesthetics, each type serves a specific purpose, allowing healthcare professionals to perform intricate surgeries and interventions without causing pain or distress. By understanding the different types of anesthetic agents and their applications, medical professionals can provide effective pain management and optimal patient care.。