rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2020-4-60-71rmt-1941Research ArticleОБЗОРЫ И КРАТКИЕ СООБЩЕНИЯREVIEWS & SHORT COMMUNICATIONSБаклофен: механизмы терапевтического и токсического действия (обзор)Baclofen: Therapeutic and Toxic Mechanisms of Action (Review)РомановаО. Л.RomanovaО. L.

Ольга Леонидовна Романова

107031, г. Москва, ул. Петровка, д. 25, стр. 2; 

117198, г. Москва, ул. Миклухо-Маклая, д. 6

 

Оlga L. Romanova

25 Petrovka Str., Build. 2, 107031 Moscow; 

6 Miklukho-Maсlaya Str., 117198 Moscow

olgpharm@yandex.ruБлагонравовМ. Л.BlagonravovM. L.

117198, г. Москва, ул. Миклухо-Маклая, д. 6

КисловМ. А.KislovM. A.НИИ общей реаниматологии им. В. А. Неговского ФНКЦ РР; Российский университет дружбы народовРоссияV. A. Negovsky Scientific Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples’ Friendship University of RussiaRussian FederationРоссийский университет дружбы народовРоссияPeoples’ Friendship University of RussiaRussian FederationПервый Московский государственный медицинский университет им. И. М. Сеченова Минздрава РоссииРоссияI. M. Sechenov First Moscow State Medical University, Ministry of Health of RussiaRussian Federation2020290820201646071Copyright © Романова О.Л., Благонравов М.Л., Кислов М.А., 20202020Романова О.Л., Благонравов М.Л., Кислов М.А.Romanova О.L., Blagonravov M.L., Kislov M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1941

Баклофен — миорелаксант, представляющий собой бета-р-хлорфенильное производное одного из тормозных медиаторов — ГАМК. При применении этого препарата возможно развитие серьезных побочных эффектов. Развитие угрожающих жизни состояний при применении Баклофена может быть следствием непреднамеренной передозировки препарата, назначенного врачом, идиосинкразии, суицидального поведения, криминальных действий.

Цель обзора

Цель обзора: рассмотреть механизмы терапевтического и токсического действия Баклофена, его воздействия на клеточные рецепторы для прояснения патогенеза жизнеугрожающих состояний, которые вызывает отравление этим препаратом.

Поиск проводили по базам данных PubMed и Scopus, окончательный отбор 82-х источников осуществили в соответствии со следующими критериям: полнота соответствия теме данного обзора и характер статьи. В обзор включали как результаты рандомизированных исследований, так и отдельные сообщения.

В обзоре кратко представили историю синтеза Баклофена и его введения в клиническую практику, показания к применению, механизм действия и особенности метаболизма этого препарата, его влияния на центральную нервную систему, особенности синдрома отмены, основные симптомы передозировки и острого отравления, а также взаимодействия Баклофена с другими препаратами.

Заключение

Заключение. Многочисленные исследования не позволяют сделать однозначных выводов о механизмах токсического действия Баклофена. Для того, чтобы полностью раскрыть патогенез опасных для жизни состояний при его применении требуется дальнейшее изучение молекулярных и клеточных эффектов данного препарата, в том числе с учетом генетических факторов, определяющих особенности его метаболизма в организме.

Baclofen is a muscle relaxant, which is a beta-p-chlorophenyl derivative of an inhibitory neurotransmitter GABA. This drug may have serious side effects and cause life-threatening conditions which may recellular receptors to clarify the pathogenesis of life-threatening conditions caused by poisoning with this drug.The search was done using the PubMed and Scopus databases, and the final selection of 82 sources was made based on the relevance to the topic of this review and the type of article. The review included both the results of randomized studies and individual reports.The review briefly discusses the history of baclofen synthesis and its application in clinical practice, indications for prescription, mechanism of action and the specific features of its metabolism, its effect on the CNS, signs and symptoms of withdrawal syndrome, overdose and acute poisoning, as well as the interaction of baclofen with other drugs.Conclusion. Multiple studies failed to make definite conclusions about mechanisms of baclofen toxicity. To completely reveal the pathogenesis of life-threatening conditions occurring due to baclofen use, further studies of molecular and cellular effects of this drug, as well as genetic factors controlling its metabolism, are warranted.

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The authors declare that there are no conflicts of interest present.