推 wangea:謝謝小雨 06/27 08:17
推 ctyang:謝謝丁丁同學 > < 06/27 17:13
※ 引述《wangea (射鵰)》之銘言：
: 補上參考答案:
: 41.(D) 好像高血壓比較嚴重(http://www.goohi.net/viewthread.php?tid=148)
: HPA axis 抑制一般於停藥後會立即恢復，也許比較次要吧
: 42.(C) 共筆P14.
: 43.(D) (http://www.uptodateonline.com/online/content/topic.do?topicKey
: =minmetab/14899#2)
: 有說越低劑量越好 不是很確定要不要選以上皆非(因為補鈣藥物補充也很重要)
: 44.(E)
: 45.(D)
: 46.(E) (http://www.tccf.org.tw/medecine/nm_25.htm) ABCD是對的 E是錯的
: 47.(C?) (http://en.wikipedia.org/wiki/COX-2_inhibitor)
: Cox-2-selectivity does not seem to affect other adverse-effects of
: NSAIDs (most notably an increased risk of renal failure),
: 不過在(UPTODATE: Overview of selective COX-2 inhibitors )
: 和(COX-2 selective inhibitors: Adverse cardiovascular effects)
: 使用COX-2亦有腎衰竭的危險
The effects of selective COX-2 inhibitors on renal function and blood
pressure are attracting increasing attention. In the kidney, COX-2 is
constitutively expressed and is highly regulated in response to alterations
in intravascular volume. COX-2 metabolites have been implicated in the
mediation of renin release, regulation of sodium excretion, and maintenance
of renal blood flow. Similar to nonselective NSAIDs, inhibition of COX-2 may
cause edema and modest elevations in blood pressure in a minority of
subjects. COX-2 inhibitors may also exacerbate preexisting hypertension or
interfere with other antihypertensive drugs. Occasional acute renal failure
has also been reported. Caution should be taken when COX-2 inhibitors are
prescribed, especially in high-risk patients (including elderly patients and
patients with volume depletion).
總而言之COX-2 inhibitor 跟 NSAID都會造成GFR下降
: 48.(E) (http://www.rheumatology.org.tw/edu_b.htm)
: 49.(B) 屬於NSAID
: 50.(D)
: ---
: 不一定對...好像很多都沒教過
: 請大家參考囉
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