利尿藥和脫水藥ll-閱讀頁
2024-10-02 06:19本頁面
【正文】 水腫： ? 腎炎：慢性時根據(jù)病情可選用中高效利尿藥 ? 腎?。狠^大劑量各型利尿藥 ? 腎衰：急性常用甘露醇，高效利尿藥〔需大劑量〕，禁用保鉀利尿藥。 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。 內(nèi)容總結(jié) 利尿藥及脫水藥 Diuretics and Dehydrant Agents。管腔膜上的Na+K+2Cl同向共轉(zhuǎn)運子。亦與耳蝸毛細胞損害有關(guān) ,忌與氨基糖苷?！?2〕機制：抑制遠曲小管近段 Na+Cl共轉(zhuǎn)運子，抑制 NaCl和水的重吸收。
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