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????????

   ???????????λ??????Σ?????****??????Ϊ****???弤??????ҩ?????ã???1??ͨ??ģ????Դ?Կ?ʹ?????Է??ĵ????ã???????????****?????????ǿ?????ʹ???á???һ????ʹ????Ч???Գ????Զ?ʹЧ??ǿ?ڼ??????ʹ???????ʹ????2??????ʹ??ͬʱ?????Ե??????ã???????ʹ???˵Ľ???????????3???????ƺ??????࣬???ͺ???????Զ?????̼???????ԣ??Ժ??????????Ƴ̶?Ϊ?????????ԣ?????????ɵ??º???˥?߶?????????4???????ƿ??????࣬??????????á???5?????˷?ƽ??????ʹ????ƽ???????????Ӷ????±??أ???ʹ??????????ܡ?֧????ƽ???????????ӡ???6???ɴٽ???Դ????֯???ͷŶ?????????Ѫ?????š?Ѫѹ?½?????Ѫ?????š?­??ѹ???ߡ???7???????¡???ͫ?????á?

   ??ҩ?ڷ?????θ???????գ????θ?ҩ??ʹ????ʱ??ɳ???4??6??ʱ??Ƥ?¼?????ע???????Ѹ?٣?Ƥ??ע??0???Ӻ󼴿?????60%??Ѫ?????׽????Ϊ26%??36%?????պ?ɷֲ??ڷΡ??Ρ?Ƣ????????֯??????ͨ??̥?̣???????ͨ??Ѫ?????ϣ??????ܲ?????ʹ???á???ҩ??Ҫ???????л??60%??70%?ڸ???????????ȩ???ϣ?10%?Ѽ׻?Ϊȥ?׻?****??20%Ϊ?????͡???Ҫ????????й??????????֭????֭??й????ͨƬ???????˥??Ϊ1.7??3Сʱ??????Ƭ?Ϳ???Ƭ????ЧӦ??ʱ??ϳ??? 2??3Сʱ????Ũ?Ƚϵͣ?????̬ʱѪҩŨ?Ȳ?????С???????˥??Ϊ3.5??5Сʱ??

????Ӧ֤?? 

1????ʹ????????????????ʹҩ??Ч?ļ??Ծ?ʹ?????????????ˡ????˵ľ?????ʹ?????ڰ?֢???˵???????ֹʹ??

2???ļ???????????Ѫѹ???????ļ????????ߣ????򾲺ͼ??????ฺ?ɵ????ã?????־???????

3????Դ??????????ʱ?????ˮ??֢״??

4????????????ǰ??ҩ??ʹ???˰???????????˯״̬??

??Ӧ??ԭ??

1????ҩΪ????ҩƷ???????ϸ񰴹????й??涨???????ϸ???Ӧ֤ʹ?á?/span>

2????ʹԭ??δ??ȷǰ????ʹ?ñ?ҩ???Է??ڸ?֢״??????ϡ?

3????ҩ????ʹ??3??5?ռ??????????ԣ?1?????Ͽ????????ԣ?????????ʹԭ????ȷ?ļ??Ծ?????ʹ?Ҷ???ʹ?û????ڰ????ض???ʹ?????????ڰ?֢?????ض???ʹ??????????????֯??????ֹʹԭ?򣬿ڷ???ҩ????ʱ?????衢???????廯??һ?㲻????ɳ?񫡣

4.??ҩ????Ƭ?Ϳ???Ƭֻ???????ڰ?֢???˵???ʹ??

5????ҩ???????¼????ж????????ж???Ϊ60mg????????Ϊ250 mg??****??????ҩ?ɵ??????ܣ??????ضȰ?ʹ???˳?????????ҩ????ʹ?????ɴӵͼ????𲽵?????????????????

??ʹ?÷?????

1?????˿ڷ???ҩ????1???????״???ҩ?????????Բ???????????Ϊ5??15 mg/?Σ? 15??60 mg/?ա?????Ϊ30 mg/?Σ?100 mg/?ա???2???ضȰ?ʹӦ??ʱ??????ڷ??????????????廯??ҩ???״μ?????Χ?ϴ?3??6??/?ա???3??????Ƭ?Ϳ???ƬӦ???ݰ?ʹ?????س̶ȡ????估??????ʹҩʷ???????????????ϴ??״???ҩ??һ??10 mg??20 mg??ÿ12Сʱ1?Σ???????ʹЧ????????ҩ??????

2??????Ƥ??ע?䣺??????Ϊ5??15 mg/?Σ?15??40 mg/?ա?????Ϊ20 mg/?Σ?60 mg/?ա?

3?????˾???ע?䣺??ʹ?ij?????Ϊ5??10 mg/?Σ??????ضȰ?ʹ?״μ?????Χ?ɽϴ?3??6??/?ա?

4??????ӲĤ??ע?䣺????Ϊ5 mg/?Σ??????ض?ӲĤ????ҩ??Ϊ2??3 mg/?Ρ?

5??????????Ĥ??϶ע?䣺????0.1??0.3 mg?????ظ???ҩ??

6?????????????ü???

7????ͯ????ʹ?ñ?ҩ??

?????ü????ɡ?

1?????ã???1???????˺Ͷ?ͯ????2??????ʧ?????ߡ???3??θ?????????䶯δ?ָ??ߡ???4?????ʻ??о??ʷ???ʷ?Ļ??ߡ???5??????ʧ??????ɱ?????ߡ???6???Ρ??????ܲ?ȫ?ߡ?

2??????֤????1???Ա?ҩ??????****??ҩ?????????2???и????????ڸ?Ů??????????Ӥ??????3??ԭ????????ʹ????4???ݿ???δ???ơ???5???ж??Ը?к????6?????Գ????衣??7??ͨ?????㡢???????ơ???8??֧????????????9???????????Էμ???????10????Դ?????ಡʧ????????11??­?ڸ?ѹ??­?????ˡ???12????״?ٹ??ܵ??¡???13????????Ƥ?ʹ??ܲ?ȫ????14??ǰ???ٷʴ????????ѡ???15?????ظι??ܲ?ȫ??

????????Ӧ??

1????Ѫ??ϵͳ????ʹ????Ѫ?????ţ?????ֱ???Ե?Ѫѹ?????ں?ӲĤ???ҩ????Ѫѹ?½???

2??????ϵͳ??ֱ?????ƺ??????ࡢ???ƿ??Է??䡢???غ??????ƿ??º???ֹͣ??ż??֧???ܾ??κͺ?ͷˮ?ס?

3???????????ġ?Ż?¡????ء????????ʡ???ʹ??????ʹ??

4??????ϵͳ????????Ƶ???򼱡????????ѡ?????????

5????????ϵͳ??һ???Ժ???????˯??ע??????ɢ??˼ά??????????Į???????????겻???????֡?η?塢???????ˡ?????ģ?????ӡ????롢?þ???

6???ڷ???ϵͳ????????ҩ???????Եڶ??????˻???Ů?Ավ??????????ơ?

7???ۣ?ͫ????С?????״??

8??Ƥ????ݡ?????????Ƥ??ˮ?ס?

9????Ϸ?Ӧ???Ա?ҩ???????????ߣ?ͻȻͣ?û????****?????׿?ҩ?ɳ??ֽ???ۺ?????????Ϊ???ᡢ???顢??????ͫ??ɢ??Ѫѹ???ߡ????ʼӿ졢???????ߡ?Ż?¡???ʹ????к??????ؽ???ʹ???񾭡??????˷??????ߣ?????Ϊ???֡??????????Ƿ???????ʧ?ߡ?

??ע?????

1????ͯ?????????????????????˥?ڳ???????????????ơ?

2????ҩ??͸??̥??????Ӱ??̥???????????̥??ҩ???????????????????????????ֽ??֢״??

3???????????ʹ?絨??????ʹʱ??Ӧ??⾷ҩ????Ʒ????ʹ?ã??Ƴ??˶̡?

4??ͣ?õ???????ø???Ƽ?2??3?ܺ󣬲ſ?Ӧ?ñ?ҩ??

5??????Ƭ?Ϳ???Ƭ????ʱ??????Ƭ?̷??????ɽؿ?????顣

6????ҩע??Һ???????ȱ?ມ????ມ?????******?ࡢ????Ӣ?ơ?̼?????ơ??????ơ?????ड??ǰ???व?ҩ????ע?䡣

7??ӲĤ???????ע?䱾ҩʱ??Ӧ???ܼ???????ѭ?????ܡ?

8????ҩ????????ҩ??**********???????࿹????ҩ??????֯??ҩ??******??????ҩ??????ड??ɴ???******??******?Ⱥ???ʱ???????

9????ҩ?????ж?????Ҫ֢״Ϊ???ԡ????????ơ?ͫ?׼?????С??Ѫѹ?½?????礡????١??????½???Ƥ??ʪ?䡢???????????տ????ݿˡ?ѭ??˥?ߡ?ͫ??ɢ?????????Ա?ҩ???????õ??????ԣ????????ϴ?

 

******

(Oxycodone) 

????????

******??****???弤?????????ڻ????ж???ʹ???ڷ???ҩ????ʹЧ??Ϊע???ҩ??50%????ͨƬ??ҩЧ4??6Сʱ??????Ƭ?ڸ?ҩ10Сʱ???Կ?ά?ָ?ѪҩŨ?ȡ??ڸ????лΪȥ???ǿ?ͪ????ԭ??ҩ??һ????????ų??????????ֹʹҩ??⾷ҩ????????ֹʹ??⾷??

????Ӧ֤??  

?????ж???ʹ??ֹʹ??⾷?????????ֹʹҩ??⾷ҩ????ʹ?á?

??ʹ?÷?????

******??ͨƬ???ڷ?5??15 mg/?Σ?3??/?ջ??Ҫʱ???ã?????ƬÿƬ5 mg????????ͼ??????ڷ?5mg******????Ƭ1Сʱ????Ч?????ݻ????????????ҩ??????2??/?ա?????Ƭ???ɽ?????á?

?????ü????ɡ?

???????ܲ?ȫ??­?????ˡ??????ڸ?Ů??????????Ӥ?????ã????ظ????????ϰ??????á?

????????Ӧ??

ͬ****???ƣ?????ѣ?Ρ?Ż?¡????ġ????صȣ?????Ӧ???᣻????ʹ?ÿ???????????????ƣ?????????ʹ?ÿɲ???ҩ????????

??ע?????

1????ͨ??̥?????ϻ???֭??й??????̥?????????????????????ڼ??????ڽ??á?

2????????????????**********???Ͽɼ??????????????á?

3???????뿹????ҩ???顣


?????һ?****

(Ethylmorphine) 

???????? 

?һ?****??****??ѧ?ṹ??I?ϵ??ǻ??ⱻ?һ?ȡ??????ƷΪ****??ҩ???????????ɴ??????ƣ?һ?㲻????ʹ??ֹ??ҩ?????ճĤ???????̼????ã?ʹճĤ??Ѫ?????????????????ѪҺ?????????P????????գ??ٽ?????ʧ??

????Ӧ֤??

?????ƹ?Ĥ?ס???Ĥ?ס??????ס?????????ǡ?????ή?????ٽ???Ĥ???˺?ָ?͸???ȡ?

??ʹ?÷?????

?Ƽ???????Һ??0.5%??10%??6.18%Ϊ??????Һ?????۸ࣺ1%??3%??ע??Һ??2%??

?÷?????????0.5%??20%??Һ????1%??3%?۸?Ϳ?ۣ?2??3??/?գ???Ĥ??ע????1%??3%ע??Һ0.2??5 ml??2??/?????ע??1%??3%ע??Һ0.5 ml?????????????񾭲??䡣??????͸???ҩ??1%??3%??Һ??????Ϊ??Ч?缫??

?????ü????ɡ?

??Ĥ??Ѫ?߽??ã???????????á?

????????Ӧ??

?ֲ??̼?????ʹ????Ѫ????????????Ӧͬ****??

??ע?????

??????????ʹ?????ҩʹ?á?

 

???׻?****

???ٰ??? Thebaine?? 

????????

?ٰ?????****???????ijɷ?֮һ???仯ѧ?ṹ??****?Ϳɴ??????ơ??ٰ?????һ???ж????????????????****?????ʣ????????٣?ζ??ɬ???ɵ??¼??⽩ֱ??????****????ϳɹ????еĵ?һ???м???????****?ṹ?е??컷?ṹ????ĩ״??΢????ˮ???ܽ??Ϊ2.2mg/ml?????????Ҵ???

?ٰ????????ͬ???칹????****?????ʵ???Ȼ???֮һ????????????****??ǰ?????ʡ?????ʵ??????ٰ????????ͺͦ???****?????ϣ????䱾?????˺????????ý????????¾??????ã????Բ????????ٴ????ƣ?ͨ??ת??Ϊһϵ?л???????ɴ??????ͪ????****ͪ??????ͪ????????****ͪ???ɲ??ȡ?????ͪ??????ͪ??********??******??Ӧ?á??????????ڡ????????ʷ??????涨??II?????ҩƷ????Ӣ?????ٰ???????1971???ƶ??ġ?ҩ?????÷???A?????ҩƷ???ٰ??????һ??????????ͪҲ???ڹ???ҩƷ????????ҽ?????ΪΥ??ҩƷ???????Եٰ???Ϊԭ??????????ҩƷ????????ȫ???????λ??

????Ӧ֤??

?ٰ???????ϲ??????ٴ????ƣ?ͨ????Ϊ****?ϳɵ??м???????ڸ????????о???????ת??Ϊһϵ?л???????ɴ??????ͪ????****ͪ??????ͪ????????****ͪ???ɲ??ȡ?????ͪ??????ͪ??********??******??Ӧ?á?

 

????********

(Buprenorphine Hydrochloride) 

????????

????********(???********)Ϊ?ٰ???(Thebaine)?İ?ϳ???????ɵ¹?Reckitt & Colmon??˾???????ƣ?1984???״????ձ????Ĵ????????У?1994???ڹ?????׼??????

********Ϊ???֦????弤???????㷺Ӧ??????????ʹ??1978??????******?????Ѷ?????ȡ??????Ч?????ҹ???1991???1998??ֱ???׼********ע????????º?Ƭ??????????ʹ??2000????׼???º?Ƭ????****?????Ѷ????ơ?********????????ϵͳ?̺ͦ?****?????׺?????ǿ????****?????໥???õĶ???ѧ???̱Ƚϻ??????????ǽ????ٶ?????һ?????????ϾͲ????׽???????ֽϳ?ʱ???ҩЧ???á?********ҩЧ???С??ⶥЧӦ?????ã?ҩ??????ﵽһ??ѪҩŨ?Ⱥ?ЧӦ??????????????Ӷ????ӣ?????????һ??ˮƽ?????нϸߵİ?ȫ?ԡ?********?ڷ??׹????????ԣ???˿ڷ?Ч???********ע???ҩ??30??60???ӳ??????ã????¸?ҩ15??40??????Ч?? 2Сʱ????ֵ????ʹЧӦ????5??8Сʱ?????????ö?ԼΪ55%??Ѫ?????׽????Ϊ96%??t1/2Ϊ2??3Сʱ????Ҫ??ԭ?δӷ????й,???־?????N-?????????????й????ͨ??̥?????ϡ?

********?????г???ʹʱЧ????ͬ??ҩ??ʽ?????????ö??Ծ????ͼ???ע????ã????º?????֮????????ʹ??0.3 mgע????൱??50??100 mg???䶡??0.2??0.4 mg???º?Ƭ?൱??10mg????****??ͨƬ?????Ч??ʹǿ??Ϊ****??25??40????????****?????????Ѷ????ƣ???????Ч????****???֢״???ҹ?????ʳƷҩƷ?ල?????֣?SFDA???涨********????****?????????Ѷ????ƣ??Ҳ??????º?Ƭ???͡?

????Ӧ֤??

1?????ڸ???????????ʹ????????ʹ??????????ʹ???Ľ?ʹ????????ʹ?????????????֫??ʹ???С??ض???ʹ????ʹ???ơ?

2??????****???????Ѷ?????(?????????º?Ƭ)??

??Ӧ??ԭ??

1????ҽ???ļ?ػ?ָ???½?????ʹ???ơ?

2???????Ѷ????Ƶ?һ????Ҫԭ???Ǹ??????ƶ???ҩ?????????س̶Ⱥ;?????????????и??廯??ҩ?????Ʊ???????ʽ??ҩ?????????ƻ?????ҽ???ļ???½??С?

??ʹ?÷?????

1????ʹ???ƣ?????ע?????????ע?䣬0.15??0.3 mg/?Σ????º???0.2??0.8 mg/?Ρ?ÿ??6??8Сʱ??ҩһ?λ????ҩ??

2???Ѷ????ƣ???****??ҩ?????????Ƶ?һ????Ҫԭ???ǡ????廯??ҩ??????????ҩ???????ߵ?ҩ??(******)ʹ??ʱ?䡢Ƶ?ʡ??????????ࡢ?????????Լ????ߡ????ء???????????ۺ??????жϵĻ????ϣ??Բ?ͬ?????ƶ???ͬ???Ѷ????Ʒ?????????һ????Ѷ???????ҩԭ?????ȴ?С??????ʼ???粻?ܿ??ƽ??֢״??????4??6Сʱ???ʵ?׷?Ӽ????????ܹ???(????)???ٴ????鱨??********????******?????Ѷ?????Ӧ?ü???Ϊ4??16mg/?գ????ҹ????ٴ??????????????****???????Ѷ????Ƹ?ҩ??????????8mg/?ա?Ӧ?÷????????????1??2 mg/?ա??ж?????2.5??4 mg/?ա??ض?????4.5??8 mg/?գ?????3?θ?ҩ???Դ˼?????ҩ????4?쿪ʼ???????????ķ?ʽһ??Ӹ?ҩ3??/?ո?Ϊ2??/?գ?ÿ?μ??????䣻??6?????ҩ2??/?գ?????????ԭҩ????2/3??1/2????8??????10?ո?Ϊ??ҩ1??/?գ???11??12??ͣҩ??

??????ȫͣҩ????ڼ????ڼ???ֱȽ????ؽ??֢״?Ļ??ߣ?????????Ӧ????ҩ?䶾ҩ????????Ҫ?Ķ?֢???ƣ?һ?㲻?ټ???????????????

?????ü????ɡ?

­?????ˡ?­??ѹ???ߡ????????ܲ?ȫ???߼?6?????¶?ͯ???????ڡ??????ڸ?Ů???ã????껼?????ã????ڽ????????????????Ƽ????ƵĻ??????á?

????????Ӧ??

??ҩ?IJ?????Ӧ?ص???????????????ʹҩ??ͬ????****?Ƚϣ????????????ý??ᡣ?????IJ?????Ӧ??ͷ?Ρ???˯?????ġ?Ż?¡??????ȣ???˯???????Ը???????****??ҩ??????????????????ƣ??????ʵ???10%???⾫?????÷????ʽϵͣ???Ҫ????Ϊһ???Ծ?????Һͷ??ꡣ

?????ټ???????Ӧ??????кͻþ?????ʾ??ҩ?????õĿ??ܣ???????????????????ϵͳҩ?︴??ʱ??

??ע?????

1????Ʒ????һ????ǿ??ЧӦ??DZ??ҩ???????ԣ?Ӧ?ϸ????ع??ҶԾ???ҩƷ?????涨??????Ӧ??ҩ?Ԥ????ҽ??Ŀ?ĵ????û?Ƿ???ʧ??

2????Ʒ?ɽ???ע?????????????ͷ??????????????ҩ?ڼ䲻?˼?ʻ?????Ͳ???????????ҩ?ڼ?????**********????????ơ?

3?????껼?ߡ???ͯ?????︾Ů???????ظΡ??????ܲ?ȫ?????????ܲ?ȫ?????????ܲ?ȫ????״?ٹ??ܵ??¡???????Ƥ?ʹ??ܵ??¡????????ƻ???ԡ??ж??Ծ??񲡡?ǰ???ٷʴ????·??խ?????Ծƾ??ж???????????ߵ????á?

4??????ʹ??ͻȻͣҩ????????????жȽ?Ϸ?Ӧ????˳???ʹ?û???Ӧ?ݼ?ͣҩ??

??Ʒ?ص?Ϊ??Ч??????????ʱ??ϳ???

 

?????һ?****

(?????ɶ? Pholcodine) 

????????

Ϊ???ҩ?????????ɶ?????ѧ????Ϊ17-?׻?-3-??2-??4-????????????????-4??5??-????-7??8-??????****?-6??-??һˮ???????ʽ??C23H30N2O4??H2O??????????416.52 ????Ʒ???????????ҩ????????ɳ?????ƣ?????????????????ã?Ҳ???򾲺???ʹ???ã???ҩ???????Խ?????ɴ???????

????Ӧ֤??

??????ҸɿȺ??ж???ʹ??

??ʹ?÷?????

?ڷ???ˮ????Ƭ????????5??15 mg/?Σ?3??4??/?ա???ͯ(2??????)??5 mg?? 4??/?գ???ʯ???Σ?10??30 mg/?Σ?3??4??/?ա?

?????ü????ɡ?

̵???߽??á?

????????Ӧ??

?ж??ġ???˯?ȣ?????????????겻?????˶?ʧ????

??ע?????

?г???ԡ???ͯ?ж?????ԼΪ200mg?????????Ͷ?ͯ?Դ?ҩ?ײ????????ԡ?

 

????******

(Methadone Hydrochloridum) 

????????

????******(???******)Ϊ??****???弤??????ҩЧ??****???ƣ???????ʹ???ã????ɲ??????????ơ???ͫ???򾲵????á???****?Ƚϣ?????????ʱ??ϳ??????ײ????????ԡ?ҩ???????Ե͵??ص㣬?Ƕ?ս?ڼ?¹??ϳɵ????****??????????ʹҩ??20????60??????ڷ??ִ?ҩ????????******?????Ѷ??????ά?????Ƶ?ҩЧ???á?

******?ڷ????????ã???ҩ??30??????Ч??4СʱѪҩŨ?ȴ?߷壬???ó???ʱ??24??36Сʱ??t1/2Ϊ15??18Сʱ??Ѫ?????׽????Ϊ85%??90%????Ҫ?ڸ????л???????༰??֭??й????????ҩ????֯??????á?

????Ӧ֤??

1?????ڴ??ˡ????󡢰?֢??????ض???ʹ????ʹ???ơ?

2??????****?????????Ѷ????ơ?

3??????****???????????ά?????ơ?

??Ӧ??ԭ??

1??******???˾???ע?䷽ʽ??ҩ?????????Ѷ?????ʱ??ֹע?䷽ʽ??ҩ????????ʹ????ʱ???ɲ??ÿڷ???????ע???Ƥ??ע???ҩ??

2?????ڽ??????ܵ????ã???****??(??******)?????߽????Ѷ????ƺ????ά??????ʱ??Ӧ???ݸû??߶?****?????????س̶Ƚ???******???廯??ҩ????ʼ??ҩ????С???ⷢ?????????ơ???ͣ?ö?Ʒ(******)??4??6СʱӦ??******??һ??أ????θ?ҩ??15 mg??ʼ?????˳???30mg/?Σ??粻?ܻ?????֢״????????ؽ?Ϸ?Ӧ???????6??8Сʱ???Ӿ??????׷??******??????׷??????Ϊ5??10mg/?Ρ???ͣҩ??72Сʱ?ڲ????????ؽ?Ϸ?ӦΪԭ????м???????????ҩ???ʿɸ??ݻ????????????һ???4??6??ɼ???5??10 mg/?գ??Ժ??3??5 mg/?գ?2??3????ɵݼ???

3??????******?Ѷ??ݼ?????ʱ?????????ʲ??˹??죬???????ֽ?Ϸ?Ӧ???Ӽ?????ʼ????ȫͣҩ??ʱ??Ӧ???˶??죬һ??Ϊ2??3?ܣ??ڼ????????У???????Ƚ?Ϸ?Ӧ????????????ʱ??Ӧ??һЩ??ҩ?䶾ҩ???֢???ƣ????dz??????ؽ?Ϸ?Ӧ??һ?㲻??Ҫ????????******??????

4?????ά???????????㹻?ʵ??ļ???Ϊ?????????Ӧע????ݻ???ҩ???????̶ȵ?????ҩ??????????????廯??ҩ??

??ʹ?÷?????

1. ??????ʹ???ڷ???????5??10 mg/?Σ?2??3??/?գ????Ҫʱ?????Ƥ??ע??5??10 mg/?Ρ????Ǽ?ע??Ѫ????ֵ?ߣ????ó??ֽϿ죬??˿ɲ??????Ǽ?ע?䡣????10mg/?Σ?20 mg/?ա?

2. ????****???????Ѷ????ƣ?

****????????ҩ?????ļ??Խ??֢״??һ?֡????????ϰ????????????????岢??֢???󲿷ּ??Խ??֢״??14??21???ʱ??ɴﵽ??ͬ?̶ȵĻ??⡣????******????ݼ???ʹ????ʹ???С?ͱȽϰ?ȫ?ضȹ????Խ???ڡ?****????????ҩ??4??6Сʱ????ֽ??֢״??ȡ??????????ҩ??İ?˥?ڳ??̣?******һ??Ϊ4??6Сʱ????48??72Сʱ???֢״??Ӧ??Ϊ???أ??˺󣬽??֢״?𽥼??ᣬ??14??21??󲿷ּ??Խ??֢״?õ??????????????

????????****?????????֢״?ص㣬?ɲ???2??3??******?ݼ????Ʒ??????????????Ӧ??ԭ?? ??

3. ????****?????????ά?????Ʒ????? 

?׶?

Ŀ??

??ҩ??????Χ

??ʼ?׶?

??????????֢״

15??30 mg

????????

ȷ??????????ˮƽ

???ӻ????5??10 mg??6??24Сʱ???ڣ?

????????

????ȷ?????ʼ???(???????)

???ӻ????5??10 mg??5??10??????ɣ?

ά?ֽ׶Σ??ȶ??׶Σ?

ά??????Ч??

40??100 mg

****?????????ά????????Ϊ?????????ö?Ʒ(******)???䵼?µ????Σ??????ȡ??һ??ҽѧ???ƴ?ʩ??******ά?????ƣ?MMT????ҩ??ѧĿ???ǣ???1????????ֽ??֢״????2??????Զ?Ʒ?Ŀ??󣻣?3??Ԥ?????????ö?Ʒ??Ϊ?ﵽMMT??ҩ??ѧĿ?ģ??㹻?????ʵļ????????ƳɰܵĹؼ????أ??????Ҫ???˶???ȷ??******?ļ??????ɲο?????????ȷ????????

??????????ɡ?

???????ܲ?ȫ?ߡ?Ӥ?׶????ٲ????????䣩???ã????︾Ů???????ˡ????????ܲ?ȫ???á?

????????Ӧ??

??****???ƣ?????Խ??ᣬ??Ҫ??ͷʹ??ѣ?Ρ????ġ?????????˯?????죨????ʱ???????ء???λ?Ե?Ѫѹ?????г???ԣ?????ʹ??Ӧע????֯????????Ĺ????ж??Լ????µ?ҩ??????????ҪΪ????????????******???µ?ҩ?????????ж????ضȣ?????ΪͻȻͣҩ?????****???֢״??????ʹ??******?????︾Ů??????????????ɳ??ֽ???ۺ?????????Ϊ?????????ǿֱ?????겻??????ޣ?????Ƿ?????硢Ż?¡???к?ȣ??ɲ?ȡ?򾲺Ͷ?֢???ơ?******?????ɵ??º??????ƣ???????????Ҫ????Ϊ???ԡ???????dz??????ͫ????С?????״?????غ??????ƿ?????ȱ????ɢ?󣩣?Ѫѹ?½????????ݿˣ??????߿?????????ƶ???????

??ע?????

1????Ʒ?ɵ??º??????ƣ??????ж?????Ҫԭ???Ƿ?ˮ?ף??ʺ??????ܲ?ȫ?߽??ã?????????ǰ??????????ҩ??******?????ж?ʱ??Ӧ??????ͪע??????ȡ?

2??????****?????Ѷ????ƺ????ά???????ߣ?Ӧ??ѭ??ͬ??????ԭ?򣬴??⣬???ݻ???ҩ?????????س̶Ⱥ???????״?????и??廯??ҩ??

3?????ڷ?????????ҩ???????????????죬??Ӧ????????ҩ?????о???????????Ч???Ͳ??˷?Ӧ??ʱ??????ҩ??????

4????Ʒ???????涡???Ͽ???ǿ????ʹ???ã???????ƽ??????Ӣ?Ƹ??Ͽɼӿ????л???շ???Ϸ?Ӧ????ҩ?ڼ??????򾲡?????ҩ?????????ơ?

5???????¡???????ࡢ??Һ????ɼ??ٱ?Ʒ??й??????ʱ???????????

6???뿹??Ѫѹҩ???ÿ???Ѫѹ?½????죬???صĿɷ??????ʡ?

 

????******

??Dihydroetorphine?? 

???????? 

????******??70???ĩ?ϳɵ?ǿЧ??ʹҩ??1991????׼???У?????????ҩƷ???ơ???ƷΪ??ɫƬ״?ᾧ???޳???ζ???????Σ?C25H33NO4??HCl????????450.0??

??ƷΪ****????Ĵ???????????̡??ġ?????????׺?????ԶԶ????****???ر?Ԧ???????׺??????ڦĺͦ????????ǧ????????ʹ???õ???Ч??ϵ??****һ????ֱ???ͣ???Ч??ʹ????ǿ?ȱ?****ǿ1000?????ϣ?ҩЧά??ʱ???****?̣??Ժ??????????ñ?****?ᡣ??Ʒ?????򾲺ͽ⾷???ã???????ƽ????????????Ľ?ʹ????????ҩ?ɲ?????ҩ?Ժ??????ԣ???Ҫ????Ϊ?????????ԡ??????ڸ??ּ???????ʹ????ʹ??????????ǿ??Ŀǰ?ٴ????ѻ?????ʹ?á?

????Ӧ֤??

?????ڸ??ּ????ض???ʹ????ʹ?????ضȴ???????ʹ??ʹ??****?????????Ч?ļ??Ծ?????ʹ????ʹ??

??ʹ?÷?????

???º????????ü????? 20??40 ??g/?Σ???????Ҫ????3??4Сʱ???ظ???ҩ??????Ϊ60 ??g/?Σ?180 ??g/?ա?

??ע?? 10??20 ??g/?Σ???????Ҫ??2??4Сʱ1?Σ?????30 ??g/?Σ?90 ??g/?ա?

??ע????Ҫ??????????ҩ?? 0.1??0.2 ??g /kg/?Σ?????0.3 ??g /kg??

?ڿ????????ǰ??ע10 ??g/?Σ?????15 ??g/?Ρ??????û?????????30???ӡ?

?????ü????ɡ?

1. ?Ա?Ʒ?????ߡ??и????????ڸ?Ů???á?

2. ?μ?****??

3. ????????־?????߻?ι??ܲ?ȫ?߽??á?

4. ?Ρ??????ܲ?ȫ?????á?

5. ?Ǿ?????ʹ??????ʹ??ͷʹ????ʪʹ???̴?ʹ??ֲ???֯С????ʹ?ȣ?????ʹ?á?

????????Ӧ??

?ɵ???ҩ????????(??Ҫ?Ǿ?????????)??һ?㲻????Ӧ??ͷ?Ρ????ġ?Ż?¡????????????????????????ļ¡????????ѡ????Դ??Һ?ݡ????ȡ?

??ע?????

??Ʒ?????Դ?ʹ??ʱֻ?ɺ????????ɽ?ҩƬ?̷???????Ӱ??ֹʹЧ???????????ж?ʱӦ??ʱ?????˹?????????Ҫʱ?ɼ?ע??ע????????ͪ0.4mg????????ϩ??****10mg??ȡ??涨??Ʒ????????******???ʱ?Ѷ????Ƶ????ҩ???ڹ??ܱձ??档

 

?ɴ???

??Codeine?? 

???????? 

?ɴ???C18H21NO3, H2O =317.4???Ǵ??????ֲ???з????????һ????Ȼ****??????֮?󲻾?֤?????????ʹ???á?Ŀǰ?ٴ?ʹ?õĿɴ???????****??ȡ??????****???׻????Ƴɣ?Ϊ??ɫϸС?ᾧ???????ڷ?ˮ??****?????????Ҵ???0.5%??ˮ??ҺpH>9?????ڹ⡢?ܱձ??档

?ɴ????????????????Ρ??????Ρ??????Ρ????Ի????Ρ????????εȡ???ͬ???????????״???£?????ɴ???Codeine Hydrochloride????C18H21NO3,HCl,2H2O=371.9??ϸ΢?Ľᾧ???ɫ?ᾧ?Է?ĩ????????ˮ??΢??????ˮ?Ҵ????????ڻ??????С??ܹⱣ?档

????ɴ???Codeine Phosphate????C18H21NO3,H3PO4,1/2 H2O=406.4???ٴ????õ?????ɴ??򸴷??Ƽ?ͨ????????ɴ???????????????ӻ?˾ƥ?ָ????Ƴɡ????ˮ??????ͱ???ˮ??????Ϊ??ɫ?ᾧ?Է?ĩ??ϸ΢????ɫ?ᾧ???ڸ???Ŀ????ڿ??𽥷绯??????ˮ??΢?????Ҵ????ȷ¼?****??4%ˮ??Һ??pHΪ4.0??5.0???ܹⱣ?档??????ɴ????밢˾ƥ???Ƴɹ??帴???Ƽ?ʱ????ʹ?ڽϵ͵?ʪ???£?????ɴ???Ҳ???ڰ?˾ƥ???????·???????????

????ɴ???Codeine Sulfate????C18H21NO3,H2SO4,3H2O=750.9????ɫ??״?ᾧ???ɫ?ᾧ??ĩ??????ˮ??΢?????Ҵ??????????ȷº?****?????ܱ??????бܹⱣ?档????ɴ?????Һ??????ɴ?????Һ?ȶ???ǿ??

?ٴ??϶??????????Σ???????ɴ???Ƭ(Codeine phosphate tablet)??????ɴ???ע??Һ(Codeine phosphate injection)??????ɴ????ǽ?(Codeine phosphate syrup??ÿ??????4.7??5.4mg/ml ????ɴ???)??????????ɴ???Ƭ??Compound codeine phosphate tablets???ȡ?

ҩ??????ѧ???ԣ??ɴ?????****?еĺ???ԼΪ0.5????1?????ڷ??????տ????ȫ?????????ö?Ϊ40%??70%??????ͨ??Ѫ?????ϣ?????ͨ??̥?????ϣ?Ѫ?????׽????һ???? 25% ???ҡ??ڷ???Լ1СʱѪҩŨ?ȴ?߷壬t1/2ԼΪ3??4Сʱ????Ҫ?ڸ???????????ȩ???ϣ?Լ15%ȥ?׻????лΪ****?????????ã???Ҫ????????ȩ?????????ʽ?????ų?????ע??Ƥ??ע????ʹ??Чʱ??Ϊ 10??30 ???ӣ???ʹ??ǿ????ʱ?䣬??עΪ 30??60???ӡ????ó???ʱ?䣺??ʹΪ 4 Сʱ?????Ϊ 4??6 Сʱ??

?ɴ????????ȡ???ʹ???????ã??????????Ϊ****??1/4????ʹ???ý?Ϊ****??1/12??1/7????ǿ??һ???????ʹҩ?????ó???ʱ????****???ƣ??????ò????ԣ?ҩ??????????****??

?ɴ?????ǿЧ?????????ҩ???????????Ч?죬ֱ?????????ԵĿ??????????????ǿ????????ã?????֧??????????ڣ???ʹ̵Һճ???????Կȳ????ʲ??????ڶ?̵?Ļ??ߣ?????????̵?ɿȼ????ҡ?Ƶ???Ŀ??ԣ???????̵Һ?Ļ??ߣ???????̵ҩ???á???ȼ???ʱ???Ժ?????????????΢?????????Ա??ء???????????λ?Ե?Ѫѹ?ȸ????ã??????Լ?????Ե????þ???****????

?ɴ???Ϊ??Ч****??ҩ????????е?****?????ϣ?ģ????****?ģ??????????????á????????ڿ?ʹϵͳ?????ʹ??????????????????ʹ???á????????ж???ʹ?????ƣ????????ʹҩ??????Эͬ???á?????ʹЧ??????Դ?ڴ?л????****????****?н????????ԡ?

????Ӧ֤??

1?????ڸ???ԭ??????ĸɿȺʹ̼??Կ??ԣ????????ڰ?????ʹ?ľ??Ҹɿȡ?????????̵Һ?ľ??ҿ??ԣ?Ӧ??????̵ҩ??

2???????еȳ̶???ʹ????ƫͷʹ????ʹ??ʹ???ͼ???ʹ?Ķ?????ʹ?????????ڼ??ᷢ?Ⱥ͸?ð???е?????ͷʹ????????ʹ?ȣ??ɴ????临???Ƽ??ǰ?ʹ???˵ڶ????ݵ???Ҫֹʹҩ??

3???ڶ???????????????????ʹ????????Ч????ʹҩ???ɴ??????µ???****???????йصIJ?????Ӧ?????ʽϵͣ?????????׵Ļ??߰??????????н?Ϊ?ձ??ʹ?ã?????????????????????ѧ???????????ѵ?????¡?

??Ӧ??ԭ??

?ɴ?????????࣬??????????ɴ???ͨ????Ϊ?ڷ?ֹ??ҩ??Ƭ?????ڻ????????ж???ʹ???????****????ʹҩ?簢˾ƥ?ֻ???????????ӵ??Ƴɸ????Ƽ?ʹ?á?

??ͯ????ע??ɴ?????շ??鰷?ͷţ?????Ѫ?????š????ص?Ѫѹ?ͺ?????ͣ????˶?ͯ?????˲??þ?????ҩ??

???ɴ????ֹ??ҩһ?㲻?Ƽ????ڶ?ͯ????????1?????µ?Ӥ???ͼ??Ը?к???׶???

??ʹ?÷?????

???????Ƹɿ?ʱ?????˼?12???????????곣???????ڷ???Ƥ??ע?䣬 15??30 mg/?Σ? 3??4??/?ջ?30??90 mg/?գ???????100 mg/?Σ? 250 mg/?գ?5??12??Ķ?ͯ7.5??15 mg/?Σ? 3??4??/?գ?1??5??Ķ?ͯ3mg/?Σ?3??4??/?ա?

???ڻ?????ʹ?ļ???Ϊ30??60 mg/?Σ? 1??/4Сʱ??????????????240 mg/?գ?1??12??Ķ?ͯ500 ??g/kg/?Σ?4??6??/?ա?

??ͯ?ɾ??ڷ???ֱ????ע??ҩ????ʹ???ڷ???0.5??1.0 mg/kg/?Σ?3??/?ջ?????3 mg/kg/?ա????Ϊ??ʹ??????1/3??1/2??

????ɴ?????Ƭ??????Ƭ?̷??????ɽؿ?????顣

?????ü????ɡ?

1????Ʒ??ͨ??̥?????ϣ?ʹ?ú???̥??????ҩ???????????????????Ľ??֢״???????ޡ??????硢???Ƿ????к??Ż?µȣ????????ڼ???á???????Ӧ?ñ?Ʒ???????????????????ơ?

2???Ա?Ʒ?????Ļ??߽??á?

3??̵??ճ???߽??ã??Է??????ƿ??Է??䣬ʹ????̵Һ?????????????̷???Ⱦ?????ز??顣

4????Ʒ??????֭?ų????????ڸ?ŮӦ???á?

5??12?????¶?ͯ????ʹ?á?

6?????껼?????á?

7?????????Ӧ???ã???1??֧????????????2??????֢???????δ??ȷʱ????????ʹ??????ڸǼ???????????????3??????ʯ???????𵨹ܾ??Σ???4??ԭ?????ĸ?к????ʹ?????䶯?????????ḹк֢״???????5???????˻?­?ڲ??䣬??Ʒ??????ͫ?ױ?С???????ٴ?????????6??ǰ???ٷʴ???Ʒ?????????????????ز??飻??7???Ρ??????ܲ?ȫ??

????????Ӧ??

???Ƽ????Ŀɴ????????????Ӧ?Ŀ????Ա?****С?????ڻ???????ÿ??ܲ?????????????Ӧ??

1????????????Ӧ???þ??Ⱦ???֢״?????????????????򲻹???????ʧ????

2???ټ???????Ӧ?????ʡ?????????????????????????Կصļ????????ͼ???ǿֱ?ȣ??ɴ?????****???ƣ????м???????Ե??鰷?ͷ????ã???????????¾?????ҩ??ɲ?????????Ӧ????ݡ??????????̶??Ժ?ߡ??ɺ?????Ƥ?׻?????ˮ?׵ȣ?ż?????ġ?Ż?¡????غ?ѣ?Ρ?

3??????Ӧ?ÿɲ?????ҩ??ҩ????????ͣҩʱ?????????ۺ????????????????????̶Ƚ?****Ϊ???????͵?֢״Ϊ????Ƥ????ʳ?????ˡ???к????ʹ??????Ż?¡????顢??ս???????硢???Ƿ??˯???ϰ???θ???Ρ??ູ?????????Ķ????١???????????ԭ?????ķ??ȡ?

4??????????????ƺ??????࣬???οڷ?????????60mgʱ??ijЩ???˿ɳ??ַ??겻???????????˷?֢״?????ҳ??ּ????????ԡ?

5?????????ñ?Ʒʱ???ɺܿ???????ز?????Ӧ????ͷ?Ρ???˯?????ԡ????ꡢ??????ҡ?ͫ?????????С??Ż?¡???????????ʧ????Ƥ?????͡?????Ѫѹ???Ķ???????????΢??????־???塢??????????ơ???礡??????????½???Ƥ??ʪ??ͼ??????????ɵ??·?ˮ?ף?????ȱ?????ݿˡ?ѭ??˥?ߡ?ͫ??ɢ????????????

6??С????ҩ???????¾??ʣ?????????500??1000 mg??

7???ж????ȿɲ?ȡϴθ????µȴ?ʩ???ų?θ??ҩ??????׿???N-???????װ????ע????ͪ??????ʹ?û???̿??????Ӱ???׿????????գ????ֺ?????ͨ??????Ҫʱ?????˹???????

??ע?????

1????????****????ʹҩ???ƣ?????Ӧ?ÿɲ????????Ժ?ҩ???????ԡ?

2????????????ҩ????ʱ????????????á?

3????ҩ?ڼ?Ӧ?????ʻ?????????????????߿???ҵ?????þƾ????******?????ϡ?

4??ҩ???໥???ã???1????******??????****??ҩ????ʱ???ɼ????????Ժ??????????ã???2????ϩ****???׿??ɴ??????ʹ???ú??????Ժ??????????ã???3????ȫ??ҩ????????????ϵͳ????ҩ????ʱ???ɼ????????Ժ??????Ƽ???????Ѫѹ????4???뼡??ҩ????ʱ?????????Ƹ?Ϊ????????5?????????ƻ?????Ӧ????????ø?յ???ʱ????????******?????????????ҩ?Ļ??ߣ????????ã??з??????඾?Ե?Σ?գ???6?????????Ž????ȵ???????ø???Ƽ????ã?????Ӱ??Ѫѹ????7???뿹????ҩ????ʱ???ɼ??ر??ػ???????????8???뿹??Ѫҩ???ã??????ӿ???Ѫ???ã???Ҫ????????Ѫҩ??????????9???뿹????ҩ???򶨺??û????Ӷ??ԣ?Ӧ????ͬʱ???ã???10??????ù??ͬ??ʱ???????䶾?ԣ???11?????ᶡ?????ƿɴ??????ʹ??Ч??

5?????ڷ??ñ?ƷӦ???ڽ?????Ѫ???ܺ͸Ρ??????ܼ?顣

6???𳬼???ʹ?á?

7??Ӧ????С???Ӵ??????ĵط???

 

˫??ɴ???

(Dihydrocodeine) 

????????

Ϊ??ʹҩ??˫??ɴ???ڷ????????ã????????л??ҩ???ЧӦʱ??ԼΪ1Сʱ????˥??ԼΪ3??4Сʱ??

????Ӧ֤??

??????ʹ??Ҳ?????ھ??ҿ??Լ???ð?????ͷʹ??

??ʹ?÷?????

?ڷ??????˼?12?????ϵĶ?ͯ30-60mg/4-6h??˫??ɴ??򸴷?Ƭ??????????????0.5g+˫??ɴ???10mg??1??2Ƭ/4??6Сʱ??????1??8Ƭ??

?????ü????ɡ?

12?????µĶ?ͯ???ã??Ա?Ʒ?????߼????????????ƺ??к??????????Լ????Ļ??߽??á?

????????Ӧ??

?ɳ??ֶ??ġ?ͷʹ??ѣ?Σ?Ҳ?ɳ??ֱ??ء?

 

******

??Fentanyl?? 

????????

Ϊ??****???弤????????????****???ƣ???ʹǿ??ԼΪ****??75??125????֬????ǿ??????ͨ??Ѫ?????ϣ????ڴ??????·ֲ?????????????֯?????缡???֬????֯??????Ч?죬????ע??100 ??g??1??????Ч??4???Ӵ?壬ά??ʱ??Ϊ17???ӡ?2Сʱ??????ע??100 ??g????ά??1??2Сʱ????????˥?ڽϳ???t1/2Ϊ3??4Сʱ??   

******??Ҫ?ڸ???????ת????ͨ????ȥ?׻????ǻ???????????ˮ?⣬?γɶ?????ҩ?????ԵĴ?л?????Һ?͵?֭?ų???????8????ԭ?δ??????ų???

????Ӧ֤??

????????ǰ???С??????????????ʹ????????ҩ??????Ϊ??????ҩ??

??Ӧ??ԭ??

һ?㲻??????????ʹ????Ҫ??????????????ҩ??ȫ?鸴?ϡ?

??ʹ?÷????? 

ȫ?鸨????ҩ???????յ???ά?֣?????ע?????ע??1??2 ??g/kg??ÿ??30??60????׷??50 ??g??Ӧ????????????ͯ??2??12?꣩?????յ???????ע??50??100 ??g?????󲹳?????1??g/kg??????????????????񾭰?????ʹ????С???ִξ???ע?䣬????????******200??400 ??g??????????10??20mg??

?????ü????ɡ?

??ҩ?????뵥??????ø???Ƽ????ã???????֧?????????????????ƺ???֢???????????????Ի??ߡ??и???????ʧ?????????á?

????????Ӧ??

ż??ѣ?Ρ????ġ?Ż?¡?????ע?????????????ʱ???????رڼ???ǿֱ???ӳ??Ժ??????ơ?

??ע?????

??ҩ????????????ƺ???Ϣ?????ں???????Ѫ?ܹ??ܼ?⼰??????ʩ?걸??????£??????ʸ???о????????ҽʦ??ҩ??

????ڵ???????ø????ҩ????߻???ͪ?????????£?ͣ??14?????Ϸ??ɸ?ҩ??????Ӧ??????С??????1/4??????????????ᷢ?????صIJ???֢???ٴ?????Ϊ?ູ?????⽩ֱ??Ѫѹ?????ߺ?罵?????????ơ???礡????ԡ????ȡ????ʣ?????ѭ?????Ѷ???????

???پ???ע??******???????رں͸??ڼ???ǿֱ??Ӱ??ͨ???????ü????ɳ?ҩ??????

??????ҩ??????ѧ?ص㣬??̫?ᷴ??ע???????ע??󣬿?????ҩ????4Сʱ?????ӳ??Ժ??????ƣ??ٴ???Ӧ?????衣

??Ȼ???????پ???ע????ʹ??????ʧ???????˵?Ӧ????Ӧ??Ȼ???ڣ???????????֪????

 

********

(Sufentanil) 

????????

??ƷΪ******???????ҩ???????????Ρ???Ҫ?????ڦ?****???塣????֬??ԼΪ******????????????ͨ??Ѫ?????ϣ???Ѫ?????׽???ʽ?******?ߣ????ֲ??ݻ????******С????Ȼ????????˥?ڽ?******?̣?????????****??????׺?????******ǿ???????????ʹǿ?ȸ??󣬶??????ó???ʱ??Ҳ??????ԼΪ******??2??????********?ڸ??ھ??ܹ㷺??????ת?????γ?N-ȥ??????O-ȥ?׻??Ĵ?л????????ų???????ȥ??********??ҩ?????ԣ?Ч??ԼΪ********??1/10???༴??******?൱????Ҳ??********???ó???ʱ?䳤??ԭ??֮һ??

????Ӧ֤??

??????Ϊ???????????????յ???????????Ѫ????????????

??Ӧ??ԭ??

??Ϊ???????????????յ???ҩ??????ÿСʱ??????1 ??g/kg??

??ʹ?÷?????

???ܲ??ǰ??????????75%?????а???׷??10??50 ??g??

?????ü????ɡ?

??֪??********??????****??ҩ??????ߡ?

?????뵥??????ø???Ƽ????ã???????֧?????????????????ƺ???֢?????????ˡ?

??Ϊ********?????????????????????ƣ????Է????ڼ???ʸ????????ڼ?Ӥ?????????֮ǰ?????ܾ???????ҩ???????????????????????ڻ????ڵĸ?Ů??????????ڸ?Ů????ʹ??********????Ӧ????ҩ??24Сʱ?????ٴβ???Ӥ????

????????Ӧ??

?Ժ????????????ã???̶????Ч??????******???ƣ???????ʱ???????????????ġ?Ż?º??رڼ??⽩ֱ????????******???ơ?

??ע?????

??ҩ????????????ƺ???Ϣ?????ں???????Ѫ?ܹ??ܼ?⼰??????ʩ?걸??????£??????ʸ???о????????ҽʦ??ҩ??

???????¼????IJ????У??磺?Ǵ????Լ?״?ٹ??ܼ??ˡ??β????????????Ǻ??????????ܽ??͵ļ????????κ?/???????ܲ?ȫ?????ֺ;ƾ??ж??ȣ?????ҩ??Ӧ??????١?????Щ???ߣ????????ϳ?ʱ???????۲졣???????ߡ????겡???Լ??Ѿ?ʹ?ù????ƺ?????ҩ??IJ??ˣ?Ӧ????????????????Щ???ܹ?****??ҩ?????ƵĻ??й?****??????ʷ?Ļ??ߣ?????Ҫʹ?ýϴ?ļ?????

 

********

(Remifentanil) 

????????

??ҩΪ******?????е????³?Ա???Ǧ?****???弤??ҩ???ٴ???Ч????******???ƣ?ע?????ЧѸ?٣?1???ӿɴ???ЧŨ?ȣ?ά??ʱ??̣???5??10 ???ӡ???ʱ????ע?򷴸?ע????ҩ???л?????ޱ仯?????????????********?????ڱ???֯??Ѫ???з?????????øѸ??ˮ?⣬???л?????Ч?۽?Ϊ********??0.1%??0.3%?????????ų?????????ʲ??????ء??Ա???????Ӱ?죬Ҳ???????ڸ??????ܣ???ʹ?????ظ?Ӳ?????ˣ???ҩ??????ѧ?뽡????????????????

********????ǿ??????????Ч?ܣ?????????ͷ?????ЧŨ?ȣ?Minimum Alveolar Concentration MAC??????̶?????????أ???40???????ߣ?ѪҩŨ??1.2 ??g/Lʱ???????MAC????50????32 ??g/Lʱ??????ⶥЧӦ??

????Ӧ֤??

????ȫ???յ???ȫ????ά????ʹ??

??Ӧ??ԭ??

ֻ?????ھ?????ҩ???ر??????ھ?????????ע??ҩ??

??ʹ?÷?????

?????յ????????ҩ(??????ӵ?)??ͬ??ҩ?????????յ???

???ܲ?ܲ??˵?????ά?֣??????ܲ?ܺ?Ӧ??????????????ҩ??????????ٱ?ҩ??ע???ʡ???????Ч?죬????ʱ??̣??????еĸ?ҩ???ʿ???ÿ2??5????????25%??100%???С25%??50%???Ի??????Ħ?****?????????ҩ?????á???????dzʱ??ÿ??2??5???Ӹ???0.5??1 ??g/kg??????????ע??ҩ???Լ?????????ȡ?

?????ü????ɡ?

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1.??ҩΪ?????????????????ҩƷ???????ϸ񰴹????йع涨???????ϸ???Ӧ֤ʹ?á?

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3.??ҩ???????Ժ???ҩ???????̶????****?ᣬ??????ʹ???????γ?ҩ????????

4.?????ض???ʹ?????ڰ?֢???˲??˳???ʹ?á?

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?ڷ???ҩ????ʹ?ij?????50??100 mg/?Σ?200??400 mg/?գ?????150mg/?Σ?600 mg/?ա????????????Բ????????ݲ???????״μ????ɴ??ڳ????????

Ƥ??ע?䣺??ʹ?ij?????25??100 mg/?Σ?100??400 mg/?գ?????150 mg/?Σ?600 mg/?գ???????ҩ???????????4Сʱ??

????ע?䣺??1????ʹ?ļ??????÷?ͬƤ??ע?䡣??2????????ʹ25??50 mg/?Σ?ÿ4??6Сʱ?ɸ?????Ҫ?ظ???ҩ??????Ϊ50??75 mg/?Ρ???3??????ǰ??ҩΪ??ǰ30??60????1??2 mg/kg??

????ע?䣺??ʹ??????0.3 mg/kg/?Ρ?

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Ӳ??Ĥ??ע?䣺??????????ʹ?򻺽????ڰ?֢???ض???ʹ??24Сʱ??????????2.1??2.5 mg/kg?????ڰ?֢???˸??廯??ҩ???????ɽϳ???󣬲???????????ֹʹ??Ч???⡣

??ͯ?ڷ???ҩ????????1.1??1.76 mg/kg/?Ρ?

??ͯ????ע?䣺?????????????????????Ƹ?ҩ10??15???Ӻ?ҩ1mg/kg??????0.5 mg/kg??ϡ????10ml????ע?䡣

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2.???Լ?Һѹ???ߡ???????ѹ?????ߡ?Ƥ??ע??ֲ??д̼??ԣ?????ע???ɳ???????Ѫ?????ţ?Ѫѹ?½??????????ȱ?຺?????????ҩ????ʱ??

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2.??Ӧ???????????ڷ?????ʹʱ??ע?Ȿҩ?????????ĺ??????????á?

3.????????ø???Ƽ?2??3?ܺ?ſ?Ӧ?ñ?ҩ??????Ӧ?ȴ?С??????ʼ??

4.?????백??******?ࡢ????Ӣ?ơ?̼?????ơ??????ơ??⻯?ơ??ǰ???व?ҩ????ע?䡣

5.??******??ҩ????????ҩ??**********???????࿹????ҩ?????????࿹?Ľ?ʹ??ҩ????ʱ???????

6.??ҩҺע?䵽?????񾭸ɸ?????

7.??ȫ??ҩ??????ҩ?????????????????ҩ???????࿹????ҩ????ʱ??????غ??????ơ??׷?????Ѫѹ?????غͲ???ҩ????????ԡ?

8.Ѫѹҩ??????ҩ?뱾ҩ???ã??з???ֱ???Ե?Ѫѹ??Σ?ա?

9.????ǿ????þ??????ҩ?????????????á?

10????ҩ?????ж?ʱ?ɳ???Ƥ??ʪ?䡢??礡???????Ѫѹ?½???????????????????????˯?????????ԡ?ż?ɳ??ְ???Ʒ???ж?֢״????ͫ??ɢ???Ķ????١??˷ܡ??????????????ʡ?


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??Diphenoxylate?? 

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???ڸ???ԭ??????ļ??????Թ????Ը?к?????Գ??׵ȡ?

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?ڷ???2.5??5 mg/?Σ? 2??4??/?գ?????к??????ʱ??Ӧ???ټ?????

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1.?ι??ܲ?ȫ?????ڷ??ÿ?????????ҩ??Ļ??????ã???Ӳ???߿??շ??λ??ԣ?Ӧ???á?/span>

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ż?ж??ġ???˯??ͷ?Ρ?ͷʹ??ʧ?ߡ???????Ƥ????͡??????ż??????衣??????ͣҩ??????ʧ?????????40??60 mg????????????У????ڷ??ÿ????????ԡ?

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????ǿ******?????ࡢ****?༰????????????ҩ?????ã????˺??á????ڷ???ʱ???ð???Ʒ?ɼ???ҩ???????Է??????ܷⴢ?档????ҩ??????DZ????Ӧ?ϸ񰴹????йع涨??????ʹ?ã???ֹ??ҽ????;????ʧ??

 

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(Ketamine) 

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******???н?ǿ??ҩ??????DZ????Ӧ?ϸ񰴹????йع涨??????ʹ?á?

 

????ຣ?Bucinnazine??  

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???᲼???Ϊ??Ч??ʹҩ????ʹ????Ϊ****?? 1/3?????Ƚ?????ʹҩ????ǿ??Ϊ???????ֵ?4??20??????Ƥ?????Ĥ???˶????ٵ???ʹ?????????????ã??????????ٵ???ʹЧ???ϲ?????Ƴ??䶯???ã???ƽ???????ε?????Ч??????????ȣ???Ʒ???׳?񫣬???в?ͬ?̶ȵ??????ԡ????˿ɿڷ???ע?????ڹ??̣??ڷ???10??30???ӻ?Ƥ??ע???10??????Ч??20???????ô?߷壬????3??6Сʱ????Ҫ?Դ?л????ʽ???????????ų??????????ƺ?θ??????Ӧ??΢?????ÿɳ?񫡣?Ƽ??͹???????Ƭ????30 mg/Ƭ??60 mg/Ƭ??ע??Һ??50 mg/1ml??100 mg/2ml??

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?????Ϊ?е?ǿ?ȵ???ʹҩ????Ƥ?????Ĥ???˶????٣??????ؽڡ????⡢????ȣ?????ʹ?????????????á??ٴ???????ƫͷʹ????????ʹ????֢?Լ?????????ʹ???ؽ?ʹ????ʹ??ʹ??????????ʹ????????????ʹҩ????????????ʹ??????ʹ?ȡ?

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??ʹ?÷?????

?ڷ???????30??60 mg/?Σ?3??4??/?ջ?ʹʱ???á???ͯ1 mg/kg/?Σ?????50??100 mg/?Σ?Ƥ?»???ע?䣬1??2??/?ա???ʹ????ʱ?????????????ӡ?

???????????ضȰ?ʹ???ˣ????????????ӡ?????ʵ????????״????????????Բ??ܳ???????????ƣ?????ʹ?á?

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Ҷ???? ?й?ҽѧ??ѧԺ????Э??ҽԺ

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