解離麻酔薬

WordNet

a drug that causes temporary loss of bodily sensations (同)anaesthetic, anesthetic_agent, anaesthetic agent
characterized by insensibility; "the young girls are in a state of possession--blind and deaf and anesthetic"; "an anesthetic state" (同)anaesthetic
tending to produce dissociation

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/18 13:24:33」(JST)

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Dissociatives are a class of hallucinogen, which distort perceptions of sight and sound and produce feelings of detachment - dissociation - from the environment and self. This is done through reducing or blocking signals to the conscious mind from other parts of the brain.^[1] Although many kinds of drugs are capable of such action, dissociatives are unique in that they do so in such a way that they produce hallucinogenic effects, which may include sensory deprivation, dissociation, hallucinations, and dream-like states or trances.^[2] Some, which are nonselective in action and affect the dopamine^[3] and/or opioid^[4] systems, may be capable of inducing euphoria. Many dissociatives have general depressant effects and can produce sedation, respiratory depression^{[citation needed]}, analgesia, anesthesia, and ataxia, as well as cognitive and memory impairment and amnesia.^{[citation needed]}

Classes of dissociatives

NMDA receptor antagonists

Adamantanes

Amantadine
Memantine
Rimantadine

Arylcyclohexylamines

Dieticyclidine
Diphenidine
Esketamine
Eticyclidine
Gacyclidine
Ketamine^[5]
Metaphit
Methoxetamine
Neramexane
Phencyclidine^[6]

Phenylhexylcyclopyrrolidine^[7]
Rolicyclidine
Tenocyclidine
Tiletamine
Methoxydine (4-MeO-PCP)
3-MeO-PCP

Morphinans

Dextromethorphan
Dextrorphan
Methorphan
Morphanol

Others

2-MDP
8A-PDHQ
Aptiganel
Chloroform
Dexoxadrol
Diethyl ether
Dizocilpine
Etoxadrol
Ibogaine (found in Tabernanthe iboga)
Midafotel
NEFA
Nitrous oxide^[8]
Noribogaine
Perzinfotel
Remacemide
Selfotel
Xenon

κ-opioid receptor agonists

2-EMSB
2-MMSB
Alazocine
Bremazocine
Butorphanol
Cyclazocine
Cyprenorphine
Dezocine
Enadoline
Herkinorin
HZ-2
Ibogaine
Ketazocine
Metazocine
Nalbuphine
Nalfurafine
Nalorphine
Noribogaine
Phenazocine
Pentazocine
Salvinorin A (found in Salvia divinorum)
Spiradoline
Tifluadom
U-50488

Effects

The effects of dissociatives can include sensory dissociation, hallucinations, mania, catalepsy, analgesia and amnesia.^[9]^[10]^[11] The characteristic features of dissociative anesthesia were described as catalepsy, amnesia and analgesia.^[9] According to Pender (1972), "the state has been designated as dissociative anesthesia since the patient truly seems disassociated from his environment."^[12] Bonta (2004) described dissociative anaesthesia as "... a peculiar anaesthetic state in which marked sensory loss and analgesia as well as amnesia is not accompanied by actual loss of consciousness."^[13] Both Pender (1970) and Johnstone et al. (1959) reported that patients under anesthesia due to either ketamine or phencyclidine were prone to purposeless movements and had hallucinations (or "dreams"^[14]) during and after anesthesia. Some patients found the hallucinations euphoric while others found them disturbing.

At sub-anesthetic doses, dissociatives alter many of the same cognitive and perceptual processes affected by other hallucinogenic drugs such as mescaline, LSD, and psilocybin; hence they are also considered hallucinogenic, and psychedelic.^[15]^[16]^[17]^[18] Perhaps the most significant subjective differences between dissociatives and the classical hallucinogens (such as LSD and mescaline) are the dissociative effects, including: depersonalization, the feeling of being unreal, disconnected from one's self, or unable to control one's actions; and derealization, the feeling that the outside world is unreal or that one is dreaming.^[19]

References

^ Tamminga, C. A.; Tanimoto, K.; Kuo, S.; Chase, T. N.; Contreras, P. C.; Rice, K. C.; Jackson, A. E.; O'Donohue, T. L. (1987). "PCP-induced alterations in cerebral glucose utilization in rat brain: Blockade by metaphit, a PCP-receptor-acylating agent". Synapse 1 (5): 497–504. doi:10.1002/syn.890010514. PMID 2850626.
^ Snyder, Solomon H. (1980). "Phencyclidine". Nature 285 (5764): 355–6. doi:10.1038/285355a0. PMID 7189825.
^ Giannini, AJ; Eighan, MS; Loiselle, RH; Giannini, MC (1984). "Comparison of haloperidol and chlorpromazine in the treatment of phencyclidine psychosis". Journal of clinical pharmacology 24 (4): 202–4. doi:10.1002/j.1552-4604.1984.tb01831.x. PMID 6725621.
^ Giannini, A. James; Nageotte, Catherine; Loiselle, Robert H.; Malone, Donald A.; Price, William A. (1984). "Comparison of Chlorpromazine, Haloperidol and Pimozide in the Treatment of Phencyclidine Psychosis: Da-2 Receptor Specificity". Clinical Toxicology 22 (6): 573–9. doi:10.3109/15563658408992586. PMID 6535849.
^ Giannini, A. James; Underwood, Ned A.; Condon, Maggie (2000). "Acute Ketamine Intoxication Treated by Haloperidol". American Journal of Therapeutics 7 (6): 389–91. doi:10.1097/00045391-200007060-00008. PMID 11304647.
^ Giannini, A. James; Giannini, Matthew C.; Price, William A. (1984). "Antidotal Strategies in Phencyclidine Intoxication". The International Journal of Psychiatry in Medicine 14 (4): 315–21. doi:10.2190/KKAW-PWGF-W7RQ-23GN.
^ Giannini, A. James; Price, William A.; Loiselle, Robert H.; Malone, Donald W. (1985). "Treatment of Phenylcyclohexylpyrrolidine (Php) Psychosis with Haloperidol". Clinical Toxicology 23 (2-3): 185–9. doi:10.3109/15563658508990627. PMID 4057312.
^ Tarter, RE; Ammerman, RT; Ott, PJ (1998). Handbook of Substance Abuse: Neurobaehavioral Pharmacology. NY: Plenum Press. p. 265. ISBN 0-306-45884-5.
^ ^a ^b Pender, John W. (1970). "Dissociative Anesthesia". California Medicine 113 (5): 73. PMC 1501800. PMID 18730444.
^ Johnstone, M.; Evans, V.; Baigel, S. (1959). "SERNYL (C1−395) IN CLINICAL ANAESTHESIA". BJA: British Journal of Anaesthesia 31: 433–9. doi:10.1093/bja/31.10.433.
^ Oduntan, S. A.; Gool, R. Y. (1970). "Clinical trial of ketamine (ci-581): A preliminary report". Canadian Anaesthetists' Society Journal 17: 411–6. doi:10.1007/BF03004705.
^ Pender, John W. (October 1972). "Dissociative Anesthesia". California Medicine 117 (4): 46–7. PMC 1518731. PMID 18730832.
^ Bonta, I (2004). "Schizophrenia, dissociative anaesthesia and near-death experience; three events meeting at the NMDA receptor". Medical Hypotheses 62 (1): 23–8. doi:10.1016/S0306-9877(03)00307-4. PMID 14729000.
^ Virtue, RW; Alanis, JM; Mori, M; Lafargue, RT; Vogel, JH; Metcalf, DR (1967). "An anesthetic agent: 2-orthochlorophenyl, 2-methylamino cyclohexanone HCl (CI-581).". Anesthesiology 28 (5): 823–33. doi:10.1097/00000542-196709000-00008. PMID 6035012.
^ Mason, Oliver J.; Morgan, Celia J.M.; Stefanovic, Ana; Curran, H Valerie (2008). "The Psychotomimetic States Inventory (PSI): Measuring psychotic-type experiences from ketamine and cannabis". Schizophrenia Research 103 (1-3): 138–42. doi:10.1016/j.schres.2008.02.020. PMID 18387788.
^ Lim, DK (2003). "Ketamine associated psychedelic effects and dependence." (PDF). Singapore medical journal 44 (1): 31–4. PMID 12762561.
^ Gouzoulis-Mayfrank, E.; Heekeren, K.; Neukirch, A.; Stoll, M.; Stock, C.; Obradovic, M.; Kovar, K.-A. (2005). "Psychological Effects of (S)-Ketamine and N,N-Dimethyltryptamine (DMT): A Double-Blind, Cross-Over Study in Healthy Volunteers". Pharmacopsychiatry 38 (6): 301–11. doi:10.1055/s-2005-916185. PMID 16342002.
^ Krupitsky, EM; Grinenko, AY (1997). "Ketamine psychedelic therapy (KPT): a review of the results of ten years of research.". Journal of Psychoactive Drugs 29 (2): 165–83. doi:10.1080/02791072.1997.10400185. PMID 9250944.
^ Vollenweider, F; Geyer, MA (2001). "A systems model of altered consciousness: integrating natural and drug-induced psychoses". Brain Research Bulletin 56 (5): 495–507. doi:10.1016/S0361-9230(01)00646-3. PMID 11750795.

UpToDate Contents

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1. 全身麻酔の導入 induction of general anesthesia
2. 高齢患者に対する麻酔 anesthesia for the older adult patient
3. 新生児疼痛の予防および治療 prevention and treatment of neonatal pain
4. 麻酔および麻酔剤選択の概要 overview of anesthesia and anesthetic choices
5. 全身麻酔に引き続く記憶を伴う術中覚醒 awareness with recall following general anesthesia

English Journal

Ephedrine accelerates psychomotor recovery from anesthesia in macaque monkeys.

Hess L, Votava M, Slíva J, Málek J, Kurzová A, Stein K.Source Laboratory of Experimental Anaesthesiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic Department of Pharmacology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic Department of Pharmacology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic Department of Anaesthesiology and Critical Care Medicine, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic Military Health Insurance Company, Prague, Czech Republic.
Journal of medical primatology.J Med Primatol.2012 Aug;41(4):251-255. doi: 10.1111/j.1600-0684.2012.00545.x. Epub 2012 May 18.
Background Ephedrine is used in treatment of hypotension during anesthesia. We investigated its effects on the psychomotor recovery and its potential adverse reactions on cardiorespiratory functions in rhesus monkeys. Methods The monkeys received 50 μg/kg medetomidine, 2.0 mg/kg S-ketamin
PMID 22594699

Ketamine-like effects after recreational use of methoxetamine.

Hofer KE, Grager B, Müller DM, Rauber-Lüthy C, Kupferschmidt H, Rentsch KM, Ceschi A.SourceSwiss Toxicological Information Centre, Associated Institute of the University of Zurich, Zurich, Switzerland.
Annals of emergency medicine.Ann Emerg Med.2012 Jul;60(1):97-9. Epub 2012 Jan 10.
Methoxetamine, the N-ethyl derivative of ketamine, is a novel recreational drug that is not at present subject to restrictive regulations in most countries. To our knowledge, no case of methoxetamine abuse has been published to date in the scientific literature, and the only sources of information a
PMID 22237166