654-2 is just its code name, its real name is anisodamine. As a classic anti-M cholinergic drug, doctors are very familiar with its basic applications, mainly for the relief of smooth muscle spasm, gastroenteric colic, biliary fistula and acute microcirculation disorders and organic phosphorus poisoning. But apart from these, he actually has some of the following effects.
I. A good partner! Reducing azithromycin gastrointestinal reactions
Azithromycin is a macrolide antibiotic that is widely used clinically and has strong antibacterial activity but is often accompanied by gastrointestinal reactions such as nausea, vomiting, abdominal pain, diarrhea, and epigastric discomfort, which severely restricts its clinical application.
The reason for azithromycin-induced gastrointestinal reactions is to increase gastrointestinal motility, possibly through stimulation of acetylcholine release caused by motilin receptors in the gastrointestinal plexus.
1. The use of oral anisodamine and montmorillonite powder can relieve the gastrointestinal reaction of azithromycin in intravenous injection. 654-2 is a M-cholinergic receptor blocker that competitively antagonizes the agonism of the cholinergic neurotransmitter acetylcholine on the M receptor, inhibits smooth muscle movement, and counteracts the gastrointestinal reaction caused by azithromycin.
2. 654-2 can relieve the spasm of vascular smooth muscle and have a sedative effect, which can reduce the injection site pain caused by intravenous use of azithromycin.
3. 654-2 has antispasmodic effect on bronchial smooth muscle, which can improve the microcirculation of the lungs, reduce the edema of the bronchial mucosa, promote the absorption of inflammation in the lungs, and thus play a role in shortening the course of the disease in the treatment of respiratory tract infections.
4, 654-2 can inhibit the synthesis of thromboxane A2, thereby inhibiting platelet aggregation, can prevent and treat the use of azithromycin-induced thrombophlebitis.
In summary, intravenous infusion of azithromycin plus 654-2 in the treatment of bacterial infection of children with lower respiratory tract, can reduce the azithromycin-induced gastrointestinal reactions, shorten the course of disease, it is worth pediatric clinical promotion.
II. Treatment infusion extravasation
In clinical nursing work, infusion extravasation has always been a problem. In recent years, the use of anisodamine injection for external application and magnesium sulfate was attempted. Anisodamine can relieve vasospasm and increase the tolerance of cells to ischemia and hypoxia, thereby reducing the incidence of phlebitis and surrounding tissue necrosis, and combined with magnesium sulfate can further improve the microcirculation and promote edema reabsorption and analgesia.
III. Treatment of neonatal scleredema
Neonatal scleredema is a severe neonatal critical illness with skin, subcutaneous fat hardening and edema caused by cold, infection, and suffocation. It can be complicated by multiple organ failure. Clinical studies have found that on the basis of conventional treatment, smearing an anisodamine injection at a hard swollen place and massage and touching it has a significant effect on the treatment of neonatal scleredema.
The mechanism of action of anisodamine in treatment of neonatal scleredema mainly lies in its vasodilatory effect, which can relieve microvascular spasm, improve microcirculation, prevent the occurrence of chronic intravascular coagulation (DIC), increase the amount of returning blood and stroke volume, and increase metabolism. Increase body temperature.
IV. Treatment of bronchial asthma
The routine treatment of bronchial asthma is mainly based on the condition of giving anti-inflammatory, anti-allergic, asthma, cough and phlegm and improve ventilation function. Anisodamine has the effect of relieving vasospasm and improving microcirculation. It can also block postganglionic transmission of vagus nerve, reduce vagal tone, relax bronchi, relieve bronchospasm, reduce respiratory secretion, and improve respiratory function.
V. Adjuvant treatment of acute pancreatitis
654-2 has a peripheral anti-M-choline receptor effect, can relieve acetylcholine-induced smooth muscle spasm, but also relieve microvascular spasm, improve microcirculation. It has a relaxing effect on gastrointestinal smooth muscle and inhibits its peristalsis and inhibits secretion of gastrointestinal glands. 654-2 can relieve biliary fistula, reduce biliary pressure, reduce bile reflux pancreatic duct, reduce pancreatic exudation; the other 654-2 can improve microcirculation, reduce pancreatic small static and dynamic embolism and obstruction. Therefore, 654-2 can significantly relieve symptoms and shorten the course of the disease when treating acute pancreatitis.
VI. Treatment of multiple organ dysfunction syndrome
The pathogenesis of MODS is currently considered to be associated with severe infections, humoral mediators, and biochemical metabolic disorders. Severe infections result in microcirculatory disturbances and microembolism in MODS and organs.
The humoral medium causes MODS and severe tissue damage to activate the complement system to release various inflammatory mediators, leading to systemic self-destructive inflammation. The biochemical metabolic disorder activates the nervous and endocrine system and releases large amounts of catecholamines and other hormones under shock and infection. Increase body catabolism resistance and energy consumption, reduce cellular oxygen utilization, mitochondrial dysfunction, organ dysfunction.
Anisodamine is an anticholinergic alkaloid that regulates microcirculation, improves renal blood flow, prevents blood cell aggregation, protects cell membranes, stabilizes lysosomal membranes, inhibits immune complex formation, and exerts anti-shock effects. A large number of animal and clinical studies have shown that the proper application of anisodamine can improve microcirculation, reduce the role of inflammatory mediators such as tumor necrosis factor alpha and interleukin-6, and is beneficial to patients with MODS.
VII. Treatment of acute secretory otitis media
Anisodamine can improve microcirculation, stabilize cell membrane and lysosome membrane, reduce inflammatory exudation, and increase the biological activity of surface active substances. It can restore the normal function of the eustachian tube and the pharyngeal tube pharyngeal opening in patients with acute secretory otitis media, drainage tympanic effusion and Eustachian tube function curve back to normal and so beneficial.
The summary here may not be very comprehensive. The application of 654-2 is more extensive. For example, some reports may also be used for refractory hiccup, diabetic foot, and neurological recovery after brain resuscitation. It is mainly based on its role in improving microcirculation to derive treatment for more diseases.