问题 单项选择题

苯二氮类中毒血压下降时可给予()

A.阿托品

B.地西泮

C.有机硫类

D.间羟胺

E.普鲁卡因酰胺

答案

参考答案:D

解析:

阿片类中毒救治措施:发现中毒后首先明确进入途径,以便尽快排出毒物。

(1)如系口服中毒,以1∶2000高锰酸钾溶液洗胃,以硫酸镁溶液或硫酸钠溶液导泻,中毒较久的口服中毒患者,因为幽门痉挛可能有少量药物长时间滞留在胃内,仍应洗胃,禁用阿朴吗啡催吐。如系皮下注射过量吗啡中毒,迅速用止血带扎紧注射部分上方,局部冷敷。

(2)静脉滴注葡萄糖氯化钠注射液,促进排泄,防止脱水,注意保温。

(3)有呼吸抑制时,保持呼吸道畅通和积极有效吸氧,给予阿托品刺激呼吸中枢。应防止吸入性肺炎。

(4)救治期间,禁用中枢兴奋剂(士的宁等),因其可与吗啡类对中枢神经的兴奋作用相加而诱发惊厥。亦不可用阿扑吗啡催吐,以免加重中毒。

(5)重度中毒患者可给予血液透析和血液灌流治疗。慢性中毒治疗在2~3周之内逐渐撤药。

苯二氮类中毒救治措施:

(1)应立即催吐、洗胃、硫酸钠导泻,以排除药物。

(2)血压下降时,选用升压药如去甲肾上腺素、间羟胺等。

(3)输液,保持体液平衡并促进药物从肾脏排出。

(4)呼吸抑制时给氧,必要时做人工呼吸,酌用呼吸中枢兴奋药如尼可刹米等。一般情况下对症支持治疗是足够的,需注意的是血液透析和血液灌流疗法不能清除血液中的本类药品。

吩噻嗪类抗精神病药中毒救治措施:

1.吸氧,保持充分的氧供给,出现呼吸抑制时,行气管插管,必要时呼吸机辅助通气。

2.保温,避免发生低温。

3.清除毒物洗胃,洗胃后给予活性炭吸附,给予硫酸钠20~30g导泻促进毒物排出。

4.支持疗法低血压:补充血容量,持续性低血压时应用去甲肾上腺素等α肾上腺受体激动剂,禁用肾上腺素,慎用多巴胺,因可加重低血压。震颤麻痹综合征:应用苯海索、氢溴酸东莨菪碱。治疗奎尼丁样心脏毒性(Q-T间期延长、QRS波宽大):可用5%碳酸氢钠注射液静脉滴注。癫痫发作:应用地西泮、苯妥英钠(但是院前处理应避免为控制癫痫发作而使用镇静药,因可引起呕吐)。昏迷、呼吸抑制:纳洛酮可使患者昏迷时间明显缩短,心率加快,血压升高,解除呼吸抑制。中枢神经抑制严重患者应用中枢兴奋剂,如哌醋甲酯、苯甲酸钠咖啡因或苯丙胺等。

三环类抗抑郁药中毒救治措施:

1.催吐、洗胃及导泻清醒患者口服吐根糖浆15ml,饮水500ml催吐。大量吞服药物者,以1∶2000高锰酸钾溶液洗胃。催吐、洗胃后,再行药用炭吸附,硫酸钠导泻,促使药用炭和药物从肠道排出。

2.对症治疗发生心律失常时,可静脉滴注普鲁卡因酰胺0.5~1.0mg或利多卡因50~100mg。如出现心力衰竭,可静脉注射毒毛花苷K0.25mg或毛花苷丙0.4mg。同时严格控制补液量和速度。发生低血压时,可扩充血容量,必要时可使用去甲肾上腺素,但是应尽量避免使用拟交感神经药物。癫痫发作时可使用苯妥英钠治疗,避免使用安定类及巴比妥类药物,因为有中枢神经和呼吸抑制作用。

单项选择题
单项选择题

Natural flavorings and fragrances are often costly and limited in supply. For example, the vital ingredient in a rose fragrance is extracted from natural rose oil at a cost of thousands of dollars a pound; an identical synthetic substance can be made for 1% of this cost. Since the early twentieth century, success in reproducing these substances has created a new industry that today produces hundreds of artificial flavors and fragrances.
Some natural fragrances are easily synthesized; these include vanillin, the aromatic ingredient in vanilla, and benzaldehyde, the aromatic ingredient in wild cherries. Other fragrances, however, have dozens, even hundreds of components. Only recently has it been possible to separate and identify these ingredients by the use of gas chromatography and spectroscopy. Once the chemical identity is known, it is often possible to synthesize them. Nevertheless, some complex substances, such as the aroma of fresh coffee, have still not been duplicated satisfactorily.
Many of the chemical compounds making up these synthetics are identical to those found in nature, and are as harmless or harmful as the natural substances. New products must be tested for safety, and when used in food, must be approved by the U.S. Food and Drug Administration.
The availability of synthetic flavors and fragrances has made possible a large variety of products, from inexpensive beverages to perfumed soap to used cars with applied "new car odor."

Which of the following is NOT true according to the last paragraph

A.Synthetic fragrances can be used to make a used car smell like a new one.

B.Synthetic flavors and fragrances have added to the varieties of products.

C.Lemon soap is made out of some delicious lemon.

D.It is likely that a bottle of orange juice is synthesized.