Methylene blue, Prussian blue, nehydroxocobalamin: mishonga mitatu yekurwisa chepfu yezvinetso zvakasiyana

Mishonga mitatu ine shoko reruvara rakafanana, asi zvimwe zvinenge zvose zvakasiyana. Methylene blue idhayi yebhuruu inoita mabasa eredox. Prussian blue irongerwo yekristaro yebhuruu. Hydroxocobalamin, inotengeswa seCyanokit, chinhu chitsvuku chinotangira kuumbwa kwevitamin B12. Muverengi anoisa mishonga iyi muboka rimwe chete achitarisa mazita ayo angafungidzira kuti inoita mabasa akafanana. Haiiti. Mumwe nomumwe wakagadzirwa uchibva papfungwa yakasiyana yezvinenge zvakanganisika mumuviri, uye mumwe nomumwe haushandi kunze kwepfungwa iyoyo.

Kutsanangura kuti mumwe nomumwe unoitei kuri nyore. Methylene blue inodzoreredza hemoglobin yakaitwa oxidation ikarega kushanda. Hydroxocobalamin inosunga cyanide zvakananga. Prussian blue inobata cesium ine mwaranzi nethallium mukati meura kuitira kuti muviri uzvibudise. Ruvara ndicho chinooneka. Mashandiro chaiwo ndiwo pfungwa iri pasi pacho, uye kuvhiringidzika kunobva pakubatanidza chinooneka nemashandiro acho.

Uku kuenzanisa kwekudzidzisa, kwete mirayiridzo yekurapa. Kufungidzirwa kwemethemoglobinemia, kusangana necyanide, kusangana necarbon monoxide, kana kusvibiswa nezvinhu zvine mwaranzi inyaya yechimbichimbi. Fonera vezvechimbichimbi uye tevera zano revanoona nezvekudzora chepfu munharaunda yako pane kuita zvinoenderana nechinyorwa.

Methylene blue: mutakuri wemaerekitironi unodzoreredza hemoglobin

Hemoglobin yakajairika inotakura oxygen pasimbi iri muchimiro cheferrous, Fe2+. Mumethemoglobinemia, simbi iyoyo inenge yaitwa oxidation ichipinda muchimiro cheferric, Fe3+, chisingagoni kusunga oxygen. Ropa rinogona kuita serakashava sechokoreti. Kuyera oxygen neyakajairika pulse oximeter kunogona kutsausa. Murwere anenge asina hemoglobin yakakwana inoshanda kunyange mapapu achipinza nokubudisa mweya.

Methylene blue inoshanda pano nokuti inopfuudza maerekitironi, sezvinotsanangurwa panyaya yekuti methylene blue inofambisa sei maerekitironi kubva kune anoapa ichienda kune anoagamuchira. Mukati memasero matsvuku eropa, inoitwa reduction ichiva leucomethylene blue kuburikidza nenzira inoda NADPH, uye chimiro ichi chakaitwa reduction chinopa maerekitironi kusimbi yeferric pasina kushandisa maenzayimu, chichiidzorera kuchimiro cheferrous. Dhayi iyi inodzokorora kutenderera uku pane kupera ichishandiswa. Mashandiro iwayo ndiwo anoita kuti kushandiswa kwemethylene blue mumethemoglobinemia kuve chiitiko chinoitwa muchipatara, paine kuyera mazinga uye kuongorora mhinduro, kwete maitiro ekuitira kumba.

Chipepa chemethylene blue chiripo zvino chinoti kushandiswa kwayo kwakabvumidzwa ndekwemethemoglobinemia inowanikwa muupenyu, muvanhu vakuru nevana, paine huwandu hwakajairika hwevakuru nevana hwe1 mg pa kg hunopinzwa mutsinga mukati memaminitsi 5 kusvika 30, uye hunogona kudzokororwa kamwe chete kana mazinga kana zviratidzo zvikaramba zviripo. Mashoko ane udzame pamusoro pemiganhu yehuwandu, zvinodiwa pakudzokorora, uye nguva yekuchinjira kune imwe nzira anotsanangurwa muchipepa chemethylene blue chiripo zvino, uye mibvunzo yekuti inopiwa sei nokutariswa sei inokurukurwa munyaya yekupiwa nekutariswa kwemethylene blue.

Pane miganhu mitatu yakakosha. Kutanga, kushomeka kweglucose-6-phosphate dehydrogenase chinhu chinorambidza kushandiswa kwemushonga uyu zviri pamutemo, nokuti kuwanikwa kweNADPH inodiwa kuita reduction yedhayi kunenge kwakakanganisika, zvichiita kuti mushonga usashande uye zvichiwedzera njodzi yekuparara kwemasero matsvuku eropa. Chechipiri, methylene blue inodzivisa monoamine oxidase A pamazinga enanomolar, saka kuipiwa pamwe chete nemaSSRI, maSNRI, maMAOI, uye mamwe maopioid kune yambiro yakaiswa mubhokisi pamusoro peserotonin syndrome, nyaya inokurukurwa pakuchengeteka kwemethylene blue nekudyidzana kwayo nemimwe mishonga. Chechitatu, kusashanda zvakanaka kweitsvo kunochinja kuti muviri unosangana nemushonga wakawanda sei, uye chipepa chinobvumira varwere vane kusashanda kweitsvo kuri pakati nepakati kana kwakanyanya kupiwa mushonga kamwe chete. Hapana pane izvi chingori cherechedzo duku. Chimwe nechimwe chinobva papfungwa imwe chete yekufambiswa kwemaerekitironi: mushonga unoshandisa maerekitironi anopiwa nesero uye unobata maenzayimu emonoamine uchadyidzana nezvose zviri zviviri.

Methylene blue ine zvakare nhoroondo mukurapa kucheturwa necyanide, kutangira muma1930s, asi nhoroondo haisi maitiro aripo zvino. Vatsvakurudzi vekutanga vakafunga nezvemigumisiro inobva paredox kana pamethemoglobin, uye pakazosvika ma1950s mushonga wacho wakanga waonekwa seusinganyatsoshanda kurwisa cyanide kana uchienzaniswa nenzira dzenitrite nethiosulfate. Nhasi hauna mvumo yekushandiswa kurwisa cyanide muUS. Zvidzidzo zvemakonzo nemasero zvakatangwazve pamusoro pecyanide zvinopa zviratidzo kubva kutsvakurudzo isati yasvika pakuedzwa muvanhu, kwete chikonzero chekuushandisa pachiitiko chechimbichimbi checyanide.

Hydroxocobalamin: nzvimbo yepakati ine cobalt inosunga cyanide

Cyanide inovhara cytochrome c oxidase mumitochondria, saka masero haakwanisi kushandisa oxygen kunyange oxygen iri muropa retsinga dzinobva pamwoyo ichioneka seyakakwana. Izvi zvinoteverwa nelactic acidosis, kuchinja kwekuziva zvinoitika, uye kukundikana kwemwoyo nemidziyo yeropa. Pfungwa yekurapa ndeyekubvisa cyanide pachayo, kwete kugadzirisa hemoglobin.

Hydroxocobalamin, inotengeswa seCyanokit, inoita izvozvo zvakananga. Nzvimbo yayo yepakati ine cobalt inosunga ion yecyanide ichitsiva hydroxo ligand yayo, zvichiumba cyanocobalamin, vitamin B12 yakajairika, inobudiswa neitsvo. Uku kubata chinhu kuti chisarambe chichishanda, kwete kutenderera kweredox. Huwandu hwakabvumidzwa kuvanhu vakuru ndi5 g hunopinzwa mutsinga mukati memaminitsi anenge 15, huchiteverwa neimwe 5 g kana mhinduro isina kukwana, kusvika pahuwandu hwepamusoro hwe10 g. Ndicho chikonzero kuenzanisa methylene blue neCyanokit kuchikurumidza kujekeswa kana mubvunzo wacho wanyatsotaurwa: pakuzivikanwa kana kufungidzirwa kwekucheturwa necyanide, hydroxocobalamin ndiwo mushonga wemazuva ano unotanga kushandiswa muUnited States, pamwe chete nechigadzirwa chakasiyana chenitrite yakabatanidzwa nethiosulfate chinoshandiswa muzviitiko zvakasarudzwa. Methylene blue haisi imwe nzira inotsiva izvi.

Pane migumisiro miviri inoshanda inobva pamakemikari acho. Mushonga wacho wakatsvuka zvikuru, saka ganda dzvuku neweti tsvuku zvinotarisirwa, uye kuchinja kweruvara rweweti dzimwe nguva kunogara kwemavhiki. Kutora kwawo chiedza zvakasimba kunokanganisawo kuongorora kwerabhoritari kunoshandisa ruvara uye kuyerwa neco-oximetry kwecarboxyhemoglobin, methemoglobin, neoxyhemoglobin, huku hukuru hwekukanganisa uye kuti kunowedzera kana kuderedza nhamba zvichisiyana nemudziyo wekuongorora. Murapi asingazivi izvi anogona kududzira zvisiri izvo nhamba chaidzo dzinoshandiswa kuongorora kucheturwa. Kit yekare yecyanide yaishandisa amyl nitrite, sodium nitrite, nesodium thiosulfate yaishanda zvakasiyana: nitrite yaigadzira methemoglobin nemaune kuti isunge cyanide, nepo thiosulfate yaibatsira kushandura cyanide kuita thiocyanate. Nzira iyoyo inoderedza kukwanisa kweropa kutakura oxygen uye inogona kuderedza pressure yeropa, zvinova zvisina kunaka kana kufema utsi kuchireva kuti carbon monoxide ingangovapowo. Hydroxocobalamin inodzivisa dambudziko iroro nokusunga cyanide isina kugadzira methemoglobin.

Prussian blue: musungo wekristaro unoramba uri muura

Prussian blue, inotengeswa seRadiogardase, iferric hexacyanoferrate isinganyunguduki. Shoko rekuti cyanide mufomura iyoyo rinotsanangura ma ligand akavharirwa mukristaro yesimbi, kwete cyanide yakasununguka, uye haina basa pakurapa kucheturwa necyanide. Kushandiswa kwayo kwakabvumidzwa ndekwekusvibiswa kwemukati memuviri necesium ine mwaranzi kana nethallium ine mwaranzi kana isina mwaranzi.

Pfungwa yayo ndeyekuchinjanisa maion munzvimbo yemukati meura. Makristaro acho haapindi mumuviri kuburikidza nemadziro eura asina kukuvara. Anogara muura, achibata maion ecesium kana ethallium murongerwo yekristaro, kusanganisira maion anobudiswa munyongo, uye anokanganisa kutenderera kunodzokororwa pakati peura nechiropa kuitira kuti simbi yakawanda ibude mutsvina. Peji reCDC rekurapa nePrussian blue rinotsanangura mashandiro mamwe chete aya nemashoko ari nyore: inobata simbi idzi muura uye inokurumidzisa kubudiswa kwadzo mutsvina. Maitiro ekupiwa kwayo kuvanhu vakuru nevechiri kuyaruka ndi3 g inonwiwa katatu pazuva, paine huwandu huduku hunoenderana nehuremu kuvana vaduku, uye kazhinji ichiramba ichipiwa kwemazuva 30 kana kupfuura uku kusvibiswa kwacho kuchitariswa.

Izvi zvinotsanangura zvakananga kutsvaga kwekuenzanisa prussian blue nemethylene blue. Methylene blue inoshanda muropa semutakuri anopfuudza maerekitironi. Prussian blue inoshanda muura semusungo usingapindi mumuviri. Mumwe unodzoreredza puroteni ine simbi. Mumwe unopfupisa nguva inogara simbi mumuviri. Kutsinhanisa mishonga iyi kunosiya zvinetso zvose zviri zviviri zvisina kurapwa: methemoglobin yaizoramba iri muchimiro chakaitwa oxidation, uye cesium yaizoramba ichitenderera ichidzoka.

Carbon monoxide: paisingafaniri kushandiswa methylene blue

Carbon monoxide inosunga hemoglobin zvakasimba zvikuru kupfuura oxygen uye inoshandura girafu rekuparadzana kweoxygen nehemoglobin, ichishandawo panzvimbo dzemwoyo nemitochondria. Kurapa kwakajairika kubvisa munhu paanosangana nayo uye kumupa oxygen ye100 percent kusvikira zviratidzo zvapera, kazhinji kwemaawa akati wandei, huku oxygen inopiwa pasi pepressure yakakwirira ichifungwa muzviitiko zvakakomba zvakasarudzwa zvakadai sekukanganisika kwakanyanya kwetsinga, kurasikirwa nekuziva zvinoitika, kukanganisika kwemwoyo, kana acidosis yakanyanya. Zvinyorwa zvemubatanidzwa wenyika nezvechimbichimbi zvakabatanidzwa mumuunganidzwa weCDC wezvinyorwa zvekurapa kwechimbichimbi zvinoisa oxygen nerubatsiro runotsigira mashandiro emuviri pakati penzira iyi.

Naizvozvo, kutsvaga methylene blue pakurapa kucheturwa necarbon monoxide kunobva pakukanganisa kunonzwika sekune musoro: kana dhayi yebhuruu ichigadzirisa chimwe chinetso chehemoglobin, zvichida inogadzirisa chimwewo. Haidaro. Mushonga uyu hauna mvumo yekushandiswa pakurapa kucheturwa necarbon monoxide, uye nzira dziripo zvino dzekurapa carbon monoxide hadziusanganisi. Pfungwa iyi ndeyekare, yakataurwa mubasa rekuedza pamhuka mukutanga kwema1930s uye ikarambwa nekuongorora kwekuyedza mukati megore rimwe chete, uye chidzidzo chimwe chemazuva ano chemakonzo chinombotaurwa chakaedza kudzivirirwa kwetsinga kunononoka mushure mekusangana nayo, kwete kudzoreredza carboxyhemoglobin nekukurumidza. Simbi yakaitwa oxidation nesimbi yakasungwa necarbon monoxide zvimiro zvakasiyana zvepuroteni imwe chete, uye mutakuri wemaerekitironi wakagadzirirwa chimiro chekutanga hauna basa rakasimbiswa pachimiro chechipiri. Vaverengi vanotevera muganhu uyu vachauwana uchibatsira pamwe chete nemufananidzo wakafara wetsvakurudzo yemethylene blue, unosiyanisa kushandiswa kwakabvumidzwa muvanhu nezviratidzo zvinobva mumasero nemhuka.

Kuongorora zvinhu parutivi neparutivi usati wazvienzanisa

Enzanisa tafura iyoyo nezvikanganiso zvitatu zvinowanzoitwa. Mazita akafanana haarevi kuti mishonga yakanangana nezvinhu zvakafanana. Ruvara rwakasimba harurevi mashandiro emishonga akafanana; kutsvuka kwehydroxocobalamin nebhuruu remimwe miviri hazvitauri chinhu pamusoro pekuti inogona kutsivana here. Uye mugumisiro wekuedza pane imwe mhando yekucheturwa haushandi pane imwe mhando yekucheturwa inongonzwika seiri pedyo nayo. Tanga wapinza pfungwa dzemashandiro, wozotarisa mazita, uye ita zvisarudzo zvechimbichimbi pamwe nevarapi vezvechimbichimbi.