利尿藥和脫水藥ll-文庫吧在線文庫
【正文】 不易從 毛細(xì) 血管透入組織液 ，提高血漿滲透壓 。 CASE STUDY ? A 65yearold man es to the emergency department with severe shortness of breath. He has long known that he is hypertensive but never had symptoms, so he refused to take antihypertensive medications. ? During the last month, he has noted increasing ankle edema, reduced exercise tolerance, and difficulty sleeping lying down, but he reports no episodes of chest pain or disfort. He now has pitting edema to the knees and is acutely unfortable lying down. ? Vital signs include blood pressure of 190/140 mmHg, pulse 120/ min, and respirations 20/min. Chest auscultation reveals loud rhonchi, but an electrocardiogram is negative except for evidence of left ventricular hypertrophy(左心室肥厚 ). ? He is given a diuretic intravenously and admitted to intensive care. ? What diuretic would be most appropriate for this man’s case of acute pulmonary edema associated with heart failure? What are the possible toxicities of this therapy? 第二十八頁，共三十頁?！?2〕機(jī)制：抑制遠(yuǎn)曲小管近段 Na+Cl共轉(zhuǎn)運(yùn)子，抑制 NaCl和水的重吸收。管腔膜上的Na+K+2Cl同向共轉(zhuǎn)運(yùn)子。 甘露醇〔 mannitol〕 一、藥理作用： 脫水作用 靜注 , 血漿滲透壓 ↑, 組織間液水向血漿轉(zhuǎn)移 , 顱內(nèi)壓、眼內(nèi)壓 ↓ 2 利尿作用
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