Zusammenfassung
Physostigmin, ein reversibler Acteylcholinesterasehemmer, ist Mittel der Wahl in der Therapie postoperativer Vigilanzstörungen. Sie entstehen durch Blockade zentral cholinerger Neurone und/oder Acetylcholinmangel und werden unter dem Begriff Zentral-Anticholinerges Syndrom zusammengefasst. Physostigmin findet seinen Einsatz ebenfalls in der Therapie des postoperativen shiverings, bei Intoxikationen, in der antideliranten Therapie und in der Schmerztherapie.
Abstract
The central anticholinergic syndrome should be considered in patients with altered mental status following anaesthesia. Physostigmine, a reversible acetylcholinesterase inhibitor, is a first-line medicament for the therapy of the central anticholinergic syndrome. Physostigmine crosses the blood-brain barrier and elevates acetylcholine levels in the brain. For prevention of postanaesthetic shivering, for treatment of intoxications and postoperative pain, and for patients suspected of having antimuscarinic delirium physostigmin is also indicated.
Schlüsselwörter:
Pharmakotherapie - Anästhesie - Acetylcholin - Physostigmin - ZAS
Key words:
Phamacotherapy - Physostigmine -Anticholinergic syndrome
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Dr. med. Ulrike Haase
Email: ulrike.haase@charite.de
PD Dr. med. Ingrid Rundshagen
Email: ingrid.rundshagen@charite.de
