Alpha-Agonist Approved for Treatment of Rosacea
获准用于治疗酒糟鼻的α激动剂
Mirvaso (brimonidine) was approved in late 2013 as a topical treatment for rosacea. Rosacea is a persistent facial erythema or redness, which might be related to a vascular sensitivity in certain patients. In the past, topical steroids were often used to help patients with this disorder, but the use of corticosteroids often made the condition worse. Brimonidine is an alpha-agonist and causes a local vasoconstriction at the site of application, decreasing the redness associated with vasodilation and improving the appearance of the skin. It is applied in pea-size amounts each day to the head, chin, nose, and each check. The eyes and lips are avoided. It is not for oral, ophthalmic, or intravaginal use. Patients are advised to wash their hands immediately after applying the gel and to avoid application to any area that is eroded or has open skin. In some cases, vascular insufficiency can occur, so the area should be monitored closely. Since the drug is not generally absorbed systemically, there are few systemic effects.
米尔瓦索【奥】（溴莫尼定）于2013年获准作为外用药治疗酒糟鼻。酒糟鼻是一种顽固性面部红斑或发红，可能与某些患者的血管敏感性有关。过去，局部甾类经常用于帮助患者处理这一疾病，但使用皮质甾类经常会使病情变得更糟。溴莫尼定是一种α激动剂，可在应用部位引起局部血管收缩，减少血管扩张相关性红肿，改善皮肤外貌。通常是每天减量用于头部、下巴、鼻子、面颊。避开眼睛和嘴唇。不用于口服、眼科或阴道内。建议患者用药后立即洗手，避免用于腐蚀或有开放性皮肤的区域。有些病例可能出现血管功能不全，因此，应密切监护用药部位。由于该药一般不会系统性吸收，几无系统性效应
Rapid Response for Anaphylaxis 过敏反应的快速响应
Epinephrine is available in a number of different autoinjectors for use in the emergency treatment of acute allergic reactions including anaphylaxis. Dosing varies between adults and children and it is important to make sure the correct injector is being used. The traditional EpiPen (0.3 mg/0.3 mL) and EpiPen Jr. (0.15 mg/0.15 mL) are well known to people. Adrenaclick comes in the same solutions but provides color-coded use for immediate injection into the upper thigh. In 2014 an updated Auvi-Q injector was introduced which has a protective carrying case, easy use ability to inject subcutaneously or IM through clothing, and a voice instruction system to assure proper use and actual injection. Any patient at risk for anaphylaxis should be carefully instructed in the carrying and use of these autoinjectors. They are for emergency use only and the patient should seek immediate medical care following use. Proper disposal of the autoinjector varies with the injector and should be part of the instructional session. Patients should know that they may experience sweating, tremors, anxiety, fast heart rate, weakness, dizziness, or GI upset following the use of this drug.
rosacea – n. 酒糟鼻 Mirvaso – n. 【奥】米尔瓦索（溴莫尼定商品名）
brimonidine – n. 溴莫尼定
erythema – n. 红斑
pea-sized – a. 豌豆大小的
pea-size amount – 半量，减量
erode – v. 消弱，侵蚀
vascular insufficiency – 血管功能不全
epinephrine – n. 肾上腺素
autoinjector – n. 自我注射器
anaphylaxis – n. 过敏反应 EpiPen – n. 肾上腺素笔 EpiPen Jr. – n. 小肾上腺素笔 Adrenaclick – n. 肾上腺素注射剂溶液 Auvi-Q – n. 【奥】奥维-Q注射器
1. A medical student is involved in a summer research project evaluating the potencies of the a-adrenergic agonists at different receptor sites. Which of the following a-adrenergic agonists would be expected to have the strongest potency at the a-receptor?
A. Acetylcholine
B. Epinephrine
C. Isoproterenol
D. Metanephrine
2. A 53-year-old woman with schizophrenia managed for years with chlorpromazine complains of a dry mouth, constipation, blurred vision, and feeling tired. Low-potency typical antipsychotics such as chlorpromazine are known to interfere with many neurotransmitter receptors aside from their target. Which of the following type of receptors is spared from antagonism by chlorpromazine?
A. a-Adrenergic receptors
B. b-Adrenergic receptors
C. Dopamine receptors
D. Histamine receptors
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案Answers
1. B. Epinephrine Rationale: The a-adrenoceptors show a weak response to the synthetic agonist isoproterenol, but they are responsive to the naturally occurring catecholamines: epinephrine and norepinephrine. For receptors, the rank order of potency is epinephrine, norepinephrine, isoproterenol. 2. B. b-Adrenergic receptors. Rationale: Chlorpromazine, like other antipsychotics, targets dopamine receptors in the brain. By antagonizing these receptors, chlorpromazine reduces many of the positive symptoms of schizophrenia. Chlorpromazine also antagonizes a-adrenergic receptors (causing sedation and orthostatic hypotension), histamine receptors (also causing sedation), and muscarinic cholinergic receptors (causing blurred vision, urine retention, constipation, dry mouth, and confusion). Of the receptors listed, only b-adrenergic receptors are spared from antagonism by chlorpromazine.
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