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​硝酸甘油、速效救心丸、阿司匹林,急救时该用哪种?

2018-03-06 佚名 胃肠病整理

今天,就给大家讲讲,这三种药在急救时要怎么用!区别可是很大的!

今天,就给大家讲讲,这三种药在急救时要怎么用!区别可是很大的!

在心脑血管病的治疗、预防和急救中,有三种药,我们最为熟悉:硝酸甘油、速效救心丸和阿司匹林。它们中:

·有的能在心梗突发时用来急救,

·有的能很快缓解胸闷心悸等冠心病的突发症状,

·有的能帮助高危人群预防心脑血管病的发生、帮助已患病人群降低疾病复发率。

但是,这些功效和药物的对应关系到底是怎么样的呢?相信很多朋友都是不清的楚,这一个不清楚,可能就会付出生命的代价。

今天,就给大家讲讲,这三种药在急救时要怎么用!区别可是很大的!为了你与家人的生命,一定要认真阅读!

一、硝酸甘油

能急救,冠心病必备救命药

硝酸甘油片是冠心病人常备的一种药,它能迅速缓解心绞痛,但一定注意,是确诊冠心病的人才需要准备。



1、什么时候用:突然感到胸痛时

冠心病典型心绞痛为阵发性胸闷、憋气、胸痛,出现在胸骨后,可放射到心前区和左臂。心绞痛的部位有时会发生“偏离”,出现在上腹部或放射到颈、下颌、左肩或右前胸。发作时可能感觉压榨痛或闷胀,甚至感到窒息伴有濒死的恐惧感,此时可用硝酸甘油。

【急救用法】

发生心绞痛时,立即舌下含硝酸甘油 1 片。每片含量 0.5 毫克。

建议把硝酸甘油片轻轻嚼碎后再舌下含服,起效会更快,若病人口干可滴少量开水到口内。

如有条件要同时吸氧,含服五分钟后若不见效或疗效不明显,可再含服 1 片,最多可连续含服 3 次(共 3 片),每次隔 5 分钟。

一般含服 1~3 分钟症状就能有所缓解。

2、含服硝酸甘油时,坐着效果最好

坐位含服比躺着、站着都好,体位性低血压会引发脑供血不足出现头晕、低血压,甚至晕厥症状;若含服时采取平卧位,可因回心血量增加导致加重心脏负担,从而影响到药物疗效。

3、千万别用水送服!

舌下含服硝酸甘油,吸收率在80%左右,一般在服后 5 分钟达到最大效果。用水吞服起效慢,而且肝脏对其有降解作用,只有约8%的药物成分被吸收,这就让药物的作用大打折扣,失去了急救的效果。

4、服连服三片无效,一定要打120

若含服 3 次后病情不能缓解,不可继续含服硝酸甘油片,需及时呼叫120,而且不能随意搬动病人。

5、确诊冠心病的,随身携带,但别贴身保存

随身携带的硝酸甘油,尽量避免装在贴身的衣服口袋内,因为硝酸甘油挥发性很强,要避免受体温影响加速药物失效。

6、定期更换,别让药物失效

硝酸甘油在室温、密封、避光条件下有效期是在生产日期后的 3 年内,超出有效期后会无药效。但是有的硝酸甘油因反复打开瓶盖, 3~6 个月就可能会失效。非避光瓶保存更易失效。

失效的硝酸甘油,在舌下含服时,不会出现辣涩的感觉,也不会出现头胀、面红等表现。一旦失效,急救时不起作用,将会耽误抢救的时机。

7、这两类人慎用

硝酸甘油的不良反应主要有体位性低血压和颅压、眼压升高等,所以青光眼、脑出血患者应当慎用。

二、速效救心丸

应急用,冠心病高危人群必备

工作压力大、体检时发现血压血脂较高、出现过心绞痛但没有明确诊断的人,都是冠心病的高危人群,可携带速效救心丸缓解突发的胸闷症状。

速效救心丸能抗心肌缺血、保护心脏、降低血黏度、解痉镇痛,也可在医生指导下服用,用于防治心脑血管疾病。

1、什么时候用:胸闷时服用

出现胸闷、心前区不适、左肩酸沉等先兆症状时,应迅速含服速效救心丸,切不可等典型的心绞痛发作后再含服。因为每一次心绞痛的发作,都会对心脑功能造成严重损害,在有先兆症状时及时服药,能够取得更佳效果。

一般服用后几分钟就能生效,可有效防止猝死。但速效救心丸只是应急用药,不能从根本上治疗疾病,症状缓解后应尽快就诊。

【服用方法】

在急性发作时,开始服用速效救心丸时剂量要小,一般先服用 4 粒,含服时放在舌头下面。也可嚼碎再含到舌下,加速其发挥作用。用药 10 分钟症状不缓解可酌情再服用 4~6 粒。

其他治疗用法,请遵医嘱。

2、要用舌下含服,吸收快

速效救心丸适合用舌下含服法,药物有效成分通过舌下黏膜吸收,可迅速进入血液循环,为更快地发挥药效,还可先将药丸咬碎后再置于舌的下方。

3、记得坐着吃,千万别站着

采取坐姿服用,这样可使回心血量减少,减轻心脏负担,使心肌供氧相对满足自身需要,从而缓解病情。病人平卧位或站位服药均不可取。

4、连服两次后无效应就诊

若连服两次症状不缓解,要及时将患者送往医院。

5、有效成分易挥发,记得定期检查更换

速效救心丸是一种棕色滴丸,有特殊香味,有效期一般为 1 年。如果发现药物变软、变黏、变色、破碎,最好马上换新的,以免因失效而延误抢救时机。

另外,如果舌下含服没有昔日的麻辣感、苦辣味,或烧灼感、清凉透心感,应迅速更换新药。

6、低血压者慎用

对于低血压的患者,应该慎服速效救心丸。速效救心丸有一定降压效果,低血压患者用药后,可能出现眩晕等症状,加重低血压病情。

此外,速效救心丸主要成分为川芎、冰片,长期使用冰片之类的药物会耗气伤阳,致使心脏功能减退。因此,使用时要注意用量不要过大,用药时间也不要过长,以免发生不良反应。

7、脾胃虚弱者,不宜常用

速效救心丸在心绞痛发作时偶尔服用一次,可以缓解症状,切记不要经常服用。因为速效救心丸的主要成分是川芎和冰片,如果脾虚微弱的人经常服用,其本身含量的性状就会让患者的消化系统出现问题,可能出现肚子不舒服、常腹泻等现象。

8、日常治疗用法,请遵医嘱

三、阿司匹林

平时用,防发病、防复发

阿司匹林学名叫乙酰水杨酸。它与青霉素、安定同列为世界三大经典药物,贡献在于大大降低了心脑血管疾病的发病率与死亡率。

阿司匹林的临床运用,主要是做一级预防治疗和二级预防治疗,就是已经发生过心脑血管疾病和极可能会发生心脑血管疾病的人群最适合用。



1、什么时候用:空腹最好

一般是晚上空腹时服用效果最好,有明显胃肠道反应的可早饭后服用。

【服用方法】

长期抗血小板聚集的阿司匹林标准剂量是每天81~162mg,一般每天100mg足矣。

具体的用法和用量,要听从临床医生更具个人病情给出用药建议。

2、阿司匹林是药,不是保健品

有些老年人认为,长期服用小剂量阿司匹林能有病治病、无病强身?才不是这样呢。

作为药物的阿司匹林也有它的适应症,有血栓高风险的患者,建议长期服用阿司匹林降低心脑血管风险,这是一级预防。其他人群不建议服用,或谨遵医嘱。

3、阿司匹林几小时才起效,不能救急

对于急性心梗,阿司匹林起效比较慢,至少几个小时,就算目前已有作用更强的抗血小板聚集药物,如替格瑞洛,也要半小时才能起效。如果身边没有其他急救药,只有阿司匹林,服用的剂量应是 300 毫克,而不是随便服下“两片”。另外,为了加快吸收效果,嚼碎服用比“喝水吞下”更有用。

4、这五类人,慎用阿司匹林

(1)胃肠道反应是阿司匹林的主要不良反应,因此,胃及十二指肠溃疡患者急性期不宜使用阿司匹林。稳定期可改服对胃黏膜损伤相对较小的阿司匹林肠溶胶囊或与食物同服,以减少对胃肠道刺激。

(2)平时有“自发”出血倾向的人,如牙龈或皮肤经常出血者,不宜服用阿司匹林。血友病或血小板减少症患者禁用阿司匹林。

(3)过敏体质者不宜用阿司匹林,因其可诱发皮疹、哮喘、血管神经性水肿或黏膜充血等过敏反应。其中又以哮喘较为常见,可在服药后数分钟出现呼吸困难与喘息,严重者甚至导致死亡,称为“阿司匹林哮喘”。

(4)孕妇应用阿司匹林有发生胎儿缺陷的危险。阿司匹林还进入乳汁,使乳儿出现出血倾向,因此哺乳期妇女也应慎用。

(5)近期内做过手术,尤其是做过眼科、颅脑、内脏手术的人禁用阿司匹林。

还有一点非常重要:

药物千万别叠加用,这样不会更保险,只会更危险,如果不把握要怎么用,在疾病突发的时候,打120,像医护人员简要的描述病人的体征,医护人员会指导用药和急救方法的。

总结下来,简单可以这样记:



硝酸甘油、速效救心丸、阿司匹林,这三种心脑血管病中常用的药物的用法,大家一定记好,急救的时候别用错了,更别在不了解自己身体的情况下,随便加量和停用!

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    2018-03-08 txqjm

    谢谢了.学习

    0

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  3. 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  4. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Tue Mar 06 07:23:26 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293463, encodeId=c5c72934633d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Tue Mar 06 07:09:48 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293461, encodeId=b9f3293461a1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 Ramsey

    具体情况分析

    0

  5. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Tue Mar 06 07:23:26 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293463, encodeId=c5c72934633d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Tue Mar 06 07:09:48 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293461, encodeId=b9f3293461a1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 龙胆草

    学习谢谢分享

    0

  6. 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channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 大爰

    学习了谢谢分享!!

    0

  7. 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channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 明月清辉

    谢谢分享.学习了

    0

  8. 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channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 lou.minghong

    学习谢谢分享!

    0

  9. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib2JlGvwpAibiaovVhfA9DbO7X7JLGGjM4Cic6oMgxLdnuS9piaP9cnG2OwIbkzHvX0qzS1boibyYNqR5vHZu7HQs5EIB/0, createdBy=298d1398341, createdName=lou.minghong, createdTime=Tue Mar 06 07:23:26 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293463, encodeId=c5c72934633d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJpBl6xwMmnsKibwxcAIltOH3nnCEQbNE6TDbYtCKe8hYI0oJrbduNqnJraM1PyyjPKU1suAzicYPaA/132, createdBy=eeaf2031798, createdName=海之蓝, createdTime=Tue Mar 06 07:09:48 CST 2018, time=2018-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293461, encodeId=b9f3293461a1, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 海之蓝

    学习

    0

  10. 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channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Tue Mar 06 07:09:29 CST 2018, time=2018-03-06, status=1, ipAttribution=)]
    2018-03-06 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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