20xx年醫(yī)學(xué)專題—利尿藥和脫水藥ll-wenkub.com
2024-11-02 12:02 本頁面
【正文】 CASE STUDY,第三十頁，共三十頁。亦與耳蝸毛細(xì)胞損害(sǔnh224。ng)總結(jié),利尿藥及脫水藥 Diuretics and Dehydrant Agents。w232。,CASE STUDY,A 65yearold man comes 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 discomfort. He now has pitting edema to the knees and is acutely uncomfortable 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(f233。nɡ)應(yīng)用,心性水腫：輕中度(中效)，重度(袢利尿藥) 不利：減少心輸出量，引起代謝性堿中毒，加重心衰 不利：降低血鉀，易致心律失常和強(qiáng)心苷中毒 腎性水腫： 腎炎(sh232。ngy242。o)作用 機(jī)制: 提高腎小管液的滲透壓→尿量↑,血容量(r243。 3.不易被代謝。,第二十三頁，共三十頁。)和集合管 保鉀排鈉： 螺內(nèi)酯：競爭醛固酮→ Na+ K+交換↓ 氨苯蝶啶、阿米洛利：抑制Na+通道→ Na+ 再吸收↓→管腔負(fù)電位↓→K+分泌↓,第二十二頁，共三十頁。少單用，一般不作首選。 4 其它：光敏性皮炎，與磺胺藥有交叉過敏反應(yīng)。,【不良反應(yīng)】 1 電解質(zhì)紊亂：低血K+， 血
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