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
