利尿藥(參考版)
2024-12-29 22:48本頁面
【正文】 ascites of liver cirrhosis or edema patients who do not respond to salt restrictions or thiazides。 b. Inhibition of Na+K+2Cl― cotransport system in the thick ascending limb of the loop of henle,↓dilute and concentrate functions of kidney, excrete larger isotonic urine. Diuretic Agents They can cause 3040% of filtered sodium to be excreted, according to their natriuretic capacity, loop diuretics are highly efficacious. Large amounts of Na+, Cl― , K+ and divalent cations (Ca2+, Mg2+) are excreted and Cl― loss is more than Na+ in urine. Diuretic Agents c. Decrease renal vascular resistance。 Diuretics I. Definition II. Renal tubule transport mechanisms III. Classification of diuretics IV. High efficacy diuretics (Loop diuretics) Diuretic Agents V. Moderate efficacy diuretics VI. Low efficacy diuretics VII. Clinical uses of diuretics VIII. Osmotic agents Diuretic Agents I. Definition Diuretic agents are acting on the renal tubules, increase excretion of electrolytes water, increase the amount of urine. They are used to treat edema caused by various diseases, and also treat some nonedema diseases, . hypertension, renal stones, hypercalcaemia. Diuretic Agents II. Renal tubule transport mechanisms 1. Proximal tubule 2. Loop of henle 3. Distal convoluted tubule 4. Collecting tubule Diuretic Agents III. Classification of diuretics 1. High efficacy diuretics (Loop diuretics) 2. Moderate efficacy diuretics (thiazides) 3. Low efficacy diuretics Diuretic Agents IV. High efficacy diuretics (Loop diuretics) 1. Furosemide (呋塞米 ) 2. Bumetanide (布美他尼 ) 3. Torasemide (托拉塞米 ) 4. Etacrynic acid (依他尼酸 ) Diuretic Agents 1. Furosemide (呋塞米 ) ① Absorbed rapidly by oral, F=40%, duration 46 hr. After IV, the effects of furosemide response within 5 mins, duration 23 hr. Protein binding is 95%. T1/2=1 hr, it may be prolong to 10 hrs. in renal dysfunction. Diuretic Agents ② Pharmacological effects a. Diuretic effects are rapid, strong and short, dependent on dose。應(yīng)用與不良反應(yīng)。 ? 脫水劑：定義。附氨氯吡咪。臨床應(yīng)用。 螺內(nèi)酯 （安體舒通）對抗醛固酮而利尿。 Chapter 26 內(nèi)容 ? 主要作用于遠(yuǎn)曲小管和集合管的利尿藥：這類藥物的作用特點，留鉀，弱效。比較同類藥物的利尿強度。治療尿崩癥的作用。作用在髓袢升支粗段對 Na+Cl共同轉(zhuǎn)運系統(tǒng)。簡述丁苯氧酸的作用和應(yīng)用。臨床應(yīng)用于嚴(yán)重水腫，急性肺水腫和腦水腫，腎功能衰竭等。抑制髓袢升支粗段
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