Central nervous system stimulants: basic pharmacology and relevance to anaesthesia and critical care

摘要

Sympathomimetic agents are commonly encountered in anaesthetic and critical care settings. Some only act on autonomic nervous system reflexes, whilst others affect higher mental function — thus these agents are used frequently in the clinical setting, as well as being drugs of abuse (e.g. the amphetamines). Competition for various metabolic and transport processes can lead to dangerous drug interactions, with sympathetic nervous system overactivity being the major consequence leading to morbidity. They are an important group of drugs and a detailed understanding of their pharmacology is vital to the safe practice of anaesthesia and critical care medicine. Respiratory stimulants also have their place in modern medical treatment. Doxapram and the methylxanthines are used clinically as respiratory stimulants in both adults and infants.