Objective:To evaluate the effects of dexamethasone and etomidate on cortisol secretion in elderly patients undergoing general anesthesia.Methods:One hundred and twenty-five elderly patients of either sex, aged 66-90 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, undergoing minor and medium elective surgeries under general anesthesia, were allocated into 4 groups using a random number table method: propofol and normal saline group (group PN, n=31), propofol and etomidate group (group PD, n=31), etomidate and normal saline group (group EN, n=33) and etomidate and dexamethasone group (group ED, n=30). In PN and EN groups, propofol (2 mg/kg) was used to induce and maintain anesthesia, and normal saline 2 ml and dexamethasone 0.1 mg/kg were intravenously injected, respectively, at 5 min before anesthesia induction.In PD and ED groups, etomidate (0.2 mg/kg) was used to induce and maintain anesthesia, and normal saline 2 ml and dexamethasone 0.1 mg/kg were intravenously injected, respectively, at 5 min before anesthesia induction.The serum cortisol concentrations were measured at 8: 00 after entering the operating room on the morning of operation (T 1), 1 h after the start of anesthesia (T 2), 2 h after the start of anesthesia (T 3), 8: 00 on the next day ofoperation (T 4) and 8: 00 on the 2nd day of operation (T 5). Blood glucose concentrations were measured at T 1-T 3, and the hypotension during the peri-anesthesia period, nausea and vomiting in post-anesthesia care unit, and nausea and vomiting scores were recorded at 24 h after operation. Results:A total of 122 patients completed the trial.Compared with PN group, the concentration of serum cortisol was significantly decreased at T 2-T 5, blood glucose concentrations were increased at T 2 and T 3 ( P<0.05), and no significant change was found in the incidence of hypotension, nausea and vomiting and nausea and vomiting scores in PD group ( P>0.05), and the concentration of serum cortisol was significantly decreased at T 2-T 4, the incidence of hypotension was decreased ( P<0.05), and no significant change was found in the blood glucose concentrations, incidence of nausea and vomiting or nausea and vomiting scores in EN group ( P>0.05). Compared with ED group, the serum cortisol concentration was significantly increased at T 2 and T 3, the incidence of hypotension was increased, the incidence of nausea and vomiting and nausea and vomiting scores were decreased ( P<0.05), and no significant change was found in the blood glucose concentrations in PD group ( P>0.05), and the serum cortisol concentration was significantly decreased at T 2 and T 3 and increased at T 4 and T 5, the serum cortisol concentration was decreased at T 2 and T 3, and no significant change was found in the incidence of hypotension, nausea and vomiting and nausea and vomiting scores in EN group ( P>0.05). Conclusions:Combination of etomidate and dexamethasone significantly enhances the duration and degree of inhibition of cortisol secretion in elderly patients than etomidate or dexamethasone alone.

许多人有过药物中毒的经历,多吃药、乱吃药都有可能引起药物中毒.生活中如何预防药物中毒?中毒之后怎么自救? 专家提到,药物中毒对人体危害很大,有的药物中毒会对肝肾功能产生负面影响,可能引起肝肾功能衰竭;有的药物中毒可能损害人脑中枢神经或周围神经功能,造成瘫痪、偏盲、失语、吞咽困难、智力障碍等.

早晚温差大,导致不少人患上感冒.首都医科大学附属宣武医院药剂师李晓玲主任提醒,心脑血管病人在选择感冒药时应特别注意,因为有些药可能会导致血压“失控”. 老王这几天就遇到了这样的烦心事.他患有高血压,平时血压控制得一直不错,前几天外出时不小心着凉感冒了,坚持吃了几天感冒药后,发现感冒还没好彻底,血压又居高不下,于是急忙跑到医院询问医生降压药突然“失灵”的原因.李晓玲解释说,这很可能是因为所吃的感冒药中含有易造成血压波动的成分.

美国食品和药品管理局(FDA)新药办公室副主任桑德拉·奎韦德在FDA官方博客中表示,药物在男性和女性中的差异应当引起重视.药物的吸收和代谢与不同性别间某种特殊疾病的不同特征有关,出现副作用的风险各异.大家可从以下几点考虑,预防和减轻与性别相关的药物副作用.

春季天气干燥,加上很多地区遭遇雾霾,容易出现干眼症状.人工泪液能较好地改善此症状,但选用时要注意一些问题. 由于滴药后需要闭眼一会儿,保证充分吸收,所以人工泪液一般在早起后、午睡前和晚睡前用效果较好.每次只需要滴1～2滴人工泪液就足够,用后最好再按压泪囊区(内侧眼角稍偏下方)2～3分钟,防止药物通过泪小管和鼻泪管流失.

中药到底有没有毒?“是药三分毒,无毒不入药”.然而,这些“有毒中药”常能治沉疴大疾.清代名医叶天士擅用毒虫药治病,被传为佳话.现代名医以“有毒中药”治疗癌症、痹症、瘀症等疑难病的比比皆是.道理类似我们常说的“以毒攻毒”.