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Penehyclidine hydrochloride clinical application of new progress

[Abstract] This paper reviews the Penehyclidine hydrochloride (PQN) pharmacological research and clinical application of new progress. PQN can be used against organophosphate poisoning, administration of anesthesia preoperative against saliva secretion, inhibit gastric and bladder contraction. [ ,],[of anesthesia, gastric spasm, inhibition of bladder contraction. Chinese papers League finishing. 1 PQN against the toxicity of organic phosphorus [1] organophosphorus pesticides in developing countries remains as the main insecticide, and therefore a lower incidence of poisoning higher, dichlorvos (DDVP) poisoning is most common. DDVP poisoning, serious performance of central inhibition, respiratory and circulatory failure and even death. Drugs currently used anti-drug and anti-cholinergic drugs and cholinesterase still risen mainly two types of agents. Clinical application of anticholinergic drugs are atropine up. Atropine is effective, but often require repeated administration, there will be a serious overdose toxicity when, or even death [2]. PQN selective cholinergic receptors on the role of M, and atropine (non-selective effect) compared to its less toxic effects, light, and the anticholinergic effect of strong, comprehensive, continuing role for a long time [3]. Most of the drug in the country promote the use of medical units, a significant effect [4]. After intravenous injection of small doses of DDVP visible heart rate, respiratory rate decreased and ventilation decreased; transient increase in blood pressure first and then decreased, confirmed that DDVP poisoning can cause serious respiratory and circulatory depression, but the first occurrence of respiratory depression, blood pressure and heart rate reduction slowly appeared later, and cardiac arrest is the second after the cessation of breathing that DDVP poisoning death of respiratory failure is the main reason for this phenomenon in other organophosphorus compounds poisoning often can be seen. When the body after application of methyl atropine, DDVP respiratory depression can not be improved, and after systemic application of atropine or PQN the effect could be antagonized. Both drugs are available by post  blood brain barrier, indicating that inhibition of central respiratory DDVP dominant component, so that only the central role of both drugs to combat the toxicity of DDVP, suggesting PQN has a strong role of central cholinergic. Organophosphate poisoning involving the central nervous convulsions often occur, accompanied by EEG changes. DDVP induced changes in EEG can be completely against the PQN, atropine only part of the confrontation; experiments show that when the atropine dose increases, although the number of surviving animals increased, but to the number of synchronization and also increased the incidence of epilepsy, and PQN yet potentially lead to convulsions the above role. PQN is a new synthetic anticholinergic drugs, mainly to block the M cholinergic receptor, also have some role in blocking the N cholinergic receptors [5]. M drug and brain cholinergic receptor affinity than atropine [6], and against soman, such as arecoline caused convulsions, increased glandular secretion and miosis and so on. Generally believed that in addition to convulsions organophosphate poisoning, the respiratory and circulatory failure are the main central nervous system involvement, and PQN DDVP significantly against the above three reasons of death, and its antagonist atropine DDVP the ED50 is only 1 / 3 has shown strong resistance to organophosphate poisoning effect, which may be stronger with the PQN central effects. In short, the study suggests PQN DDVP in the rescue and other aspects of organophosphate poisoning may have a better treatment prospects. 2 PQN for preoperative administration of anesthesia against saliva secretion [7] anesthesia before tracheal intubation before surgery or regular application of atropine against the secretion of chemicals, although the effect has played a good, but the main disadvantage of atropine is no selective effect on the M cholinergic receptor, often resulting in patients sensitive to atropine heart rate, especially for the needs surgery under general anesthesia or endotracheal intubation in elderly patients or those with cardiovascular disease are very unfavorable. PQN the state of the selective anti-cholinergic drugs on the central and peripheral anticholinergic effects are strong, but also for M2 receptors had no significant role in the continuing role of efficacy for a long time and have strong anti-saliva secretion characteristics, The administration of anesthesia before surgery results in patients indicate that, PQN effect of anti-saliva secretion was significantly better than atropine. This is consistent with the results of animal pharmacological experiments, and PQN can substitute atropine as anesthesia or endotracheal intubation premedication, especially for the elderly or patients with cardiovascular disease is very useful. In addition, PQN longer duration on the efficacy of clinical practice for a long time the major surgery to reduce intraoperative additional anticholinergic drugs are also very beneficial, worthy of clinical application.