重點(diǎn)藥物觀察手冊(cè)

1、重點(diǎn)藥物觀察手冊(cè)合肥市第二人民醫(yī)院重點(diǎn)藥物觀察制度1、重點(diǎn)藥物包括：抗菌藥物、心血管系統(tǒng)藥物、細(xì)胞毒化藥物、中樞性肌松藥、抗精神失常藥、中樞鎮(zhèn)靜催眠藥等。2、醫(yī)師處方前詢問病人以前是否用過該種藥物,有過何種不良反應(yīng),并告辭知病人和家屬將要使用的藥品名稱,用法用量,可能存在的不良反應(yīng),注意事項(xiàng)。用藥后每日查房時(shí)向病人和家屬詢問用藥后有無不適感，是否出現(xiàn)不良反應(yīng)。3、病人和家屬向醫(yī)師反應(yīng)用藥后不適和不良反應(yīng)時(shí)，醫(yī)師應(yīng)高度重視，認(rèn)真檢查，采取有效處置措施，注意與病人和家屬溝通的方式與技巧，避免誤解，提高病患依從性。4、護(hù)士用藥前也應(yīng)詢問病人的用藥情況，并告辭知病人和家屬將要使用的藥品名稱,用法用量,

2、可能存在的不良反應(yīng),注意事項(xiàng)。用藥后每日查房時(shí)向病人和家屬詢問用藥后有無不適感，是否出現(xiàn)不良反應(yīng)。靜脈給藥者用藥后護(hù)士必須按藥品說明書規(guī)定調(diào)節(jié)好滴速并留守20分鐘方可離開。一組輸注后更換下一組輸液后同樣應(yīng)觀察20分種,方可離開。其他方式注射給藥，在注射完成后，護(hù)士也應(yīng)觀察20分鐘，在確認(rèn)病人無方可離開?？诜盟帒?yīng)由護(hù)士在場(chǎng)指導(dǎo)病人服用，并交待注意事項(xiàng)后方可離開。當(dāng)班護(hù)士30分種巡視病房一次,詢問病人用藥后情況。5、護(hù)士交班時(shí)，交班護(hù)士應(yīng)向接班護(hù)士介紹病房?jī)?nèi)使用重點(diǎn)藥物患者的情況，以利于接班護(hù)士繼續(xù)執(zhí)行用藥后觀察。6、出現(xiàn)不良反應(yīng)及時(shí)報(bào)告當(dāng)班醫(yī)生，并安撫病人、家屬，使配合治療。7、當(dāng)班醫(yī)生接不良

3、反應(yīng)報(bào)告，應(yīng)及時(shí)對(duì)病人進(jìn)行檢查，妥善處理，并填寫不良反應(yīng)報(bào)告表上報(bào)。8、各臨床科室依據(jù)本科情況，制定本科重點(diǎn)藥物清單，用藥后觀察制度，及用藥后觀察程序。 合肥市第二人民醫(yī)院重點(diǎn)藥物觀察程序1、 給藥前評(píng)估：給藥前應(yīng)明確用藥目的，評(píng)估患者身體狀況及患者和家屬對(duì)藥物治療的認(rèn)知情況，確定有無用藥禁忌證存在，并收集用藥前各項(xiàng)檢查資料。2、 形成與用藥有關(guān)的護(hù)理診斷：護(hù)理診斷主要是針對(duì)患者因藥物治療而產(chǎn)生的反應(yīng)及問題。3、 嚴(yán)格查對(duì)患者與用藥的相符情況，并查對(duì)藥物名稱、劑型、劑量、用法以及注意事項(xiàng)。4、 告知病人和家屬將要使用的藥品名稱,用法用量,可能存在的不良反應(yīng),注意事項(xiàng)。5、 靜脈給藥者用藥后護(hù)士

4、必須按藥品說明書規(guī)定調(diào)節(jié)好滴速并留守20分鐘方可離開。一組輸注后更換下一組輸液后同樣應(yīng)觀察20分種,方可離開。其他方式注射給藥，在注射完成后，護(hù)士也應(yīng)觀察20分鐘，在確認(rèn)病人無藥物反應(yīng)后方可離開?？诜盟帒?yīng)由護(hù)士在場(chǎng)指導(dǎo)病人服用，并交待注意事項(xiàng)后方可離開。6、 當(dāng)班護(hù)士30分鐘巡視病房一次,觀察、詢問患者用藥后情況。7、 出現(xiàn)藥物不良反應(yīng)時(shí)，應(yīng)該暫停給予藥物，立即測(cè)量生命體征并及時(shí)報(bào)告當(dāng)班醫(yī)生，并安撫病人、家屬，使配合治療。8、 出現(xiàn)藥物不良反應(yīng)時(shí)，應(yīng)及時(shí)上報(bào)。過敏性休克應(yīng)急預(yù)案1、患者一旦發(fā)生過敏性休克，立即停止使用引起過敏的藥物，就地?fù)尵?，并迅速?bào)告醫(yī)生。2、立即平臥，遵醫(yī)囑皮下注射腎上腺

5、素1mg，小兒酌減。如癥狀不緩解，每隔30min再皮下注射或靜脈注射0.5ml，直至脫離危險(xiǎn)期，注意保暖。3、改善缺氧癥狀，給予氧氣吸入，呼吸抑制時(shí)應(yīng)遵醫(yī)囑給予人工呼吸，喉頭水腫影響呼吸時(shí)，應(yīng)立即準(zhǔn)備氣管插管，必要時(shí)配合施行氣管切開。4、迅速建立靜脈通路，補(bǔ)充血容量，必要時(shí)建立兩條靜脈通路。遵醫(yī)囑應(yīng)用晶體液、升壓藥維持血壓，應(yīng)用氨茶堿解除支氣管痙攣，給予呼吸興奮劑，此外還可給予抗組織胺類及皮質(zhì)激素類藥物。5、發(fā)生心臟驟停，立即進(jìn)行胸外心臟按壓、人工呼吸等心肺復(fù)蘇的搶救措施。6、密切觀察患者的意識(shí)、體溫、脈搏、呼吸、血壓、尿量及其他臨床變化，患者未脫離危險(xiǎn)前不宜搬動(dòng)。7、按醫(yī)療事故處理?xiàng)l理規(guī)定6

6、小時(shí)內(nèi)及時(shí)、準(zhǔn)確記錄搶救過程?！具^敏性休克急救程序】立即停用此藥平臥皮下注射腎上腺素改善缺氧癥狀補(bǔ)充血容量解除支氣管痙攣發(fā)生心臟驟停行心肺復(fù)蘇密切觀察病情變化告知家屬記錄搶救過程抗癌藥物的外滲及處理抗癌藥物按損害程度分為：腐蝕性藥物、刺激性藥物、非刺激性藥物1、腐蝕性藥物：外滲后可引起組織發(fā)皰甚至壞死。代表藥物有更生霉素、柔紅霉素、阿霉素、表柔比星、氮芥、絲裂霉素、長(zhǎng)春堿、長(zhǎng)春酰胺、長(zhǎng)春新堿、諾維本等。2、刺激性藥物：能引起注射部位或靜脈徑路疼痛，可有局部炎癥反應(yīng)、靜脈炎、局部過敏反應(yīng)等。代表藥物有博來霉素、順鉑、卡鉑、環(huán)磷酰胺、達(dá)卡巴嗪、依托泊苷、異環(huán)磷酰胺、5-氟尿嘧啶、紫杉醇等。3、非刺

7、激性藥物：外滲后不對(duì)組織產(chǎn)生不良反應(yīng)。防治措施選擇一條合適的靜脈。用頭皮針建立靜脈通路。用一次性針筒沖入810ml生理鹽水，檢查注射部位有無紅腫、疼痛、回血情況，確認(rèn)靜脈回血良好。確保靜脈通暢后，才可接上稀釋好的抗癌藥物緩慢注射，阻力要小。每注射12ml應(yīng)檢查有無回血。外周靜脈發(fā)生外滲的處理如果病人訴輸注部位疼痛，即使沒有外滲的征象，也應(yīng)立即停止輸液。 根據(jù)需要原位保留針頭。用針筒盡量吸出局部外滲的殘液。使用相應(yīng)的解毒劑。解毒劑經(jīng)靜滴給藥時(shí)，量要適當(dāng)，避免局部區(qū)域壓力過大。皮下局部注射解毒劑時(shí)應(yīng)先拔去針頭抬高肢體或注射部位48小時(shí)，病人應(yīng)注意休息。必要時(shí)請(qǐng)外科會(huì)診，清除壞死組織或考慮手術(shù)治療。

8、避免外滲部位受壓。記錄外滲液量、輸注部位、藥物濃度、病人癥狀及累及范圍等。中心靜脈（CVC）發(fā)生外滲的處理一旦病人感覺CVC部位有不適、疼痛、燒灼感、腫脹、胸部不適或輸液速度發(fā)生變化，應(yīng)立即停止輸液。如果是皮下埋泵，應(yīng)評(píng)價(jià)針頭的位置是否合適盡可能回抽滲出液。如果滲出是針頭滑出埋泵所致，盡可能通過針頭吸出滲出液，如果無法吸出，則拔除針頭，從皮下抽吸殘留液。給予適當(dāng)?shù)慕舛緞?。通過埋泵輸注解毒劑應(yīng)避免液量過多引起局部壓力過大，注射后應(yīng)及時(shí)封泵。同外周靜脈外滲處理步驟。必要時(shí)拍正側(cè)位胸片，確定滲液的原因及影響范圍，并請(qǐng)外科會(huì)診進(jìn)行手術(shù)處理。部分抗癌藥物外滲的處理1、烷化劑: 順鉑 、氮芥局部解毒劑：1

9、/6或1/3M硫代硫酸鈉 處理原則：用48毫升10%硫代硫酸鈉和6毫升無菌注射用水配成1/6或1/3M溶液，外滲1mg氮芥或100mg順鉑需局部注射2毫升該溶液。2、絲裂霉素局部解毒劑 ；5099%（w/v）二甲基亞砜溶液處理原則：局部注射1.5毫升，每6小時(shí)1次，連用14天，避免覆蓋，自然晾干。3、阿霉素、柔紅霉素局部解毒劑 ：8.4%NaHCO35ml+DXM4mg處理原則：1、滲出部位iv注射，周圍多點(diǎn)ip注射。、立刻冷敷3060分鐘，然后每隔15分鐘冷敷15分鐘，連續(xù)1天。4、長(zhǎng)春新堿/長(zhǎng)春花堿局部解毒劑 ：熱敷、透明質(zhì)酸酶處理原則： 立刻熱敷3060分鐘，然后每隔15分鐘熱敷15分鐘

10、，連用1天。也可局部注射透明質(zhì)酸酶150單位。5、鬼臼乙叉甙（足葉 乙甙） 局部解毒劑 ；熱敷處理原則：與長(zhǎng)春堿類滲漏處理相同。立刻熱敷3060分鐘，然后每隔15分鐘熱敷15分鐘，連用1天。也可局部注射透明質(zhì)酸酶150單位。常見化療藥物相關(guān)的毒副作用及基本處理原則1、化學(xué)性靜脈炎化療藥物引起的化學(xué)性靜脈炎是化療藥物引起的常見毒性反應(yīng)之一，是由刺激性和腐蝕性化療藥物直接損傷輸注的靜脈而引起的一種無菌性炎癥。長(zhǎng)春堿類（NVB、VLB）、蒽環(huán)類抗腫瘤生素、氮芥、絲裂霉素以及放線菌素D等通過外周靜脈輸入時(shí)易引起不同程度的靜脈內(nèi)膜的損傷，產(chǎn)生化學(xué)性靜脈炎，且易并發(fā)血栓形成化學(xué)性靜脈炎的處理已發(fā)生但沒有明

11、顯不適者可繼續(xù)觀察，不做特殊處理早期（72小時(shí)內(nèi)）可按藥物類型不同，參照外滲處理要求進(jìn)行外敷或用解毒劑等?？捎?3%普魯卡因或加地塞米松510mg溶于生理鹽水經(jīng)受累靜脈輸注。72小時(shí)后仍有疼痛者可采用50%硫酸鎂濕熱敷或在患處外涂激素類軟膏、魚石酯軟膏或喜療妥軟膏，每天1-2次，并進(jìn)行局部按摩。疼痛明顯者，可用0.25%0.5%普魯卡因加用地塞米松或強(qiáng)的松龍局部封閉注射。2、口腔粘膜炎主要藥物：抗代謝類處理化療前尤其是接受大劑量化療前，應(yīng)仔細(xì)檢查病人口腔狀況，明確有無隱性口腔感染、牙齦炎、潰瘍、齲齒等，并在化療開始前714天完成這些疾病的治療，以免粒細(xì)胞減少時(shí)因這些潛在病灶而發(fā)展成膿毒敗血癥。

12、最好檢測(cè)單純皰疹病毒血清抗體滴度。化療后應(yīng)每天檢查口腔，行檢查時(shí)壓舌板表面應(yīng)覆著凡士林紗布，以免損傷粘膜，盡量避免用牙刷等硬物清潔口腔。在靜注5-Fu前5分鐘，讓病人口含碎冰片或冰水持續(xù)30分鐘，可明顯減少口腔粘膜的血流量，降低該部位的5-Fu濃度，減少口腔粘膜炎癥的發(fā)生率和程度，但對(duì)持續(xù)輸注5-Fu或MTX者無明顯療效。 雙盲試驗(yàn)表明，硫糖鋁可減少DDP/5-Fu引起的口腔炎癥，對(duì)預(yù)防化療引起的口腔潰瘍有一定的作用。 口腔炎病人應(yīng)避免進(jìn)刺激性、粗糙硬質(zhì)、熱、酸性等食物，建議進(jìn)松軟清淡食物。 每34小時(shí)用蘇打鹽水（5%碳酸氫鈉與生理鹽水1:1混合）漱口1次，可防止霉菌感染，或用其它無刺激性口腔

13、清潔劑，如過氧化氫與生理鹽水1:1混合液等進(jìn)行口腔消毒?？谇粷冚^輕時(shí)，可用洗必泰口腔潰瘍貼膜治療。對(duì)中度或重度口腔疼痛者，可局部用藥如利多卡因、硫糖鋁、苯海拉明等，可單用或混合應(yīng)用。苯佐卡因的療效較好，也可一試?？诜咕?、抗病毒類等藥物預(yù)防感染?？诜S生素A、服維生素E既可保護(hù)粘膜，又能促進(jìn)愈合。低能量的氦氖激光局部照射，對(duì)潰瘍的愈合也有效。含漱含有轉(zhuǎn)化生長(zhǎng)因子-3、G-CSF或GM-CSF的漱口水也有不錯(cuò)的療效。對(duì)于重度口腔炎患者應(yīng)住院治療，應(yīng)考慮使用麻醉類藥物，并行鎮(zhèn)痛、抗感染、輸液、全胃腸道外營(yíng)養(yǎng)等治療。3、惡心嘔吐極高度致吐藥：嘔吐發(fā)生率達(dá)90100%，如順鉑、達(dá)卡巴嗪、氮芥、大劑量

14、環(huán)磷酰胺(1000mg/m2)等。高度致吐藥：嘔吐發(fā)生率為6090%，如亞硝脲類、多柔吡星、鏈脲霉素、卡鉑、環(huán)磷酰胺(1000mg/m2)、甲基芐肼等。中度致吐藥：嘔吐發(fā)生率為3060%，如異環(huán)磷酰胺、紫杉醇、氟尿嘧啶、甲氨蝶呤、依托泊甙、替尼泊甙、長(zhǎng)春酰胺等。低度致吐藥：嘔吐發(fā)生率為1030%，如博萊霉素、長(zhǎng)春新堿、絲裂霉素、噻替哌、羥基脲、苯丁酸氮芥等。化療引起的復(fù)發(fā)、難治性嘔吐的處理用原來的止吐方案也能使部分復(fù)發(fā)性嘔吐停止。多數(shù)研究一致認(rèn)為，治療復(fù)發(fā)、難治性嘔吐可行的方法是在原來的止吐方案上加用D2受體拮抗劑和（或）一種鎮(zhèn)靜劑如苯二氮卓類等藥物，對(duì)嚴(yán)重的難治性嘔吐者，應(yīng)該考慮加用治療偏頭

15、痛的藥物，如麥角胺咖啡因、西比靈、苯噻啶等?？梢约佑肗K-1受體拮抗劑。4、脫發(fā)能引起明顯脫發(fā)的抗癌藥物：阿霉素、表阿霉素、柔紅霉素、鬼臼乙叉甙、VM26、泰素、泰素帝（Taxotere）、羥基喜樹堿、環(huán)磷酰胺、5-Fu、氮烯咪胺、博萊霉素、亞硝脲類、NVB、VCR、VLB、Ara-c、放線菌素D、甲基芐肼等。脫發(fā)防治措施化療開始前，剪短頭發(fā)，理成易梳理的發(fā)式，梳理時(shí)要順其自然，避免用力梳理。洗頭時(shí)動(dòng)作要輕柔，要使用含蛋白質(zhì)的軟性洗發(fā)劑，洗后頭發(fā)宜自然風(fēng)干。避免燙發(fā)，尤其是化學(xué)燙發(fā)和染發(fā)?；熯^程中戴冰帽，以降低頭皮溫度，使頭皮血流減少，毛囊生發(fā)細(xì)胞代謝下降可減少脫發(fā)，但白血病、淋巴瘤或易轉(zhuǎn)移

16、的腫瘤病人不宜采用。可口服維生素E等自由基清除劑，但臨床療效并不十分確切。試用毛發(fā)營(yíng)養(yǎng)劑如臺(tái)毛利斯等，每天3次，均勻地涂在頭部，到達(dá)頭皮，可以降低脫發(fā)的發(fā)生率。5、腹瀉引起腹瀉的主要抗癌藥物：依利諾特肯(CPT-11)、5-氟尿嘧啶(5-FU)、去氧氟尿苷(氟鐵龍，F(xiàn)loxiuridine，F(xiàn)UdR)、高劑量甲氨蝶呤、大劑量白消安、鬼臼乙叉甙(VP-16)、鬼臼噻吩甙(VM-26)、順鉑、阿霉素、阿糖胞苷、拓?fù)涮乜希═opotecan）等。腹瀉的處理每天腹瀉次數(shù)超過5次，或出現(xiàn)血性腹瀉，立即停止化療，并及時(shí)補(bǔ)充水和電解質(zhì)，維持水和電解質(zhì)平衡，并補(bǔ)足營(yíng)養(yǎng)，以及給予止血治療。對(duì)大多數(shù)非感染性的分泌

17、性腹瀉，首選阿片類制劑止瀉治療，口服鹽酸洛哌丁胺療效較好，首次口服4mg，以后每腹瀉1次再服2mg，直到腹瀉停止，但每日劑量不能超過16mg，且須分次給予。阿片制劑治療無效的分泌性腹瀉(不包括由腸梗阻、感染等引起的腹瀉)可用奧曲肽治療，權(quán)威機(jī)構(gòu)推薦的劑量為每8h皮下注射奧曲肽100g，以后可適當(dāng)增加劑量，直到腹瀉得到控制。對(duì)于接受高劑量化療者可以每日給300g滴注共48h，以后劑量可增加到2400g/日。常規(guī)治療無效者可考慮使用可樂定、利達(dá)脒或一些吸附劑等藥物治療。止瀉的同時(shí)可使用各種粘膜保護(hù)劑如思密達(dá)等。及時(shí)檢查大便常規(guī)或培養(yǎng)，如提示感染，馬上選用敏感抗生素抗感染治療，一般不應(yīng)用阿片類制劑止

18、瀉治療。中藥注射劑臨床使用基本原則1選用中藥注射劑應(yīng)嚴(yán)格掌握適應(yīng)癥，合理選擇給藥途徑。能口服給藥的，不選用注射給藥；能肌內(nèi)注射給藥的，不選用靜脈注射或滴注給藥。必須選用靜脈注射或滴注給藥的應(yīng)加強(qiáng)監(jiān)測(cè)。2辨證施藥，嚴(yán)格掌握功能主治。臨床使用應(yīng)辨證用藥，嚴(yán)格按照藥品說明書規(guī)定的功能主治使用，禁止超功能主治用藥。3嚴(yán)格掌握用法用量及療程。按照藥品說明書推薦劑量、調(diào)配要求、給藥速度、療程使用藥品。不超劑量、過快滴注和長(zhǎng)期連續(xù)用藥。4嚴(yán)禁混合配伍，謹(jǐn)慎聯(lián)合用藥。中藥注射劑應(yīng)單獨(dú)使用，禁忌與其他藥品混合配伍使用。謹(jǐn)慎聯(lián)合用藥，如確需聯(lián)合使用其他藥品時(shí)，應(yīng)謹(jǐn)慎考慮與中藥注射劑的間隔時(shí)間以及藥物相互作用等問題

19、。5用藥前應(yīng)仔細(xì)詢問過敏史，對(duì)過敏體質(zhì)者應(yīng)慎用。6對(duì)老人、兒童、肝腎功能異?；颊叩忍厥馊巳汉统醮问褂弥兴幾⑸鋭┑幕颊邞?yīng)慎重使用，加強(qiáng)監(jiān)測(cè)。對(duì)長(zhǎng)期使用的在每療程間要有一定的時(shí)間間隔。7加強(qiáng)用藥監(jiān)護(hù)。用藥過程中，應(yīng)密切觀察用藥反應(yīng)，特別是開始3O分鐘。發(fā)現(xiàn)異常，立即停藥，采用積極救治措施，救治患者。合肥市第二人民醫(yī)院重點(diǎn)藥物目錄一、 抗菌藥物1.1 青霉素類····················&#

20、183;·········································13青霉素·······

21、83;·················································

22、83;··········13芐星青霉素······································&#

23、183;·························14注射用美洛西林·······················

24、;·····································14注射用美洛西林鈉舒巴坦··········

25、3;·········································15注射用磺芐西林·······&

26、#183;·················································&

27、#183;··15氨芐青霉素··············································

28、··················16注射用呋芐西林······························

29、83;·····························16注射用哌拉西林···················

30、·········································17注射用苯唑西林·······

31、83;·················································

32、83;··17注射用阿洛西林··············································

33、··············18注射用阿莫西林鈉氟氯西林·································

34、3;················18注射用阿莫西林鈉舒巴坦·······························

35、83;····················19注射用阿莫西林鈉克拉維酸鉀···························

36、·····················19注射用替卡西林鈉克拉維酸鉀··························

37、83;·····················20注射用哌拉西林鈉他唑巴坦··························&

38、#183;·······················201.2 頭孢菌素類注射用頭孢唑啉·······················&

39、#183;····································21注射用頭孢硫脒···········

40、3;················································21注射用頭孢孟多酯

41、··················································

42、········22注射用頭孢美唑········································

43、83;···················22注射用頭孢西丁·····························

44、·······························23注射用頭孢地嗪·················

45、83;··········································23注射用頭孢替安······

46、··················································

47、····24注射用頭孢甲肟············································

48、83;···············24注射用頭孢米諾·································

49、···························25注射用頭孢噻肟·····················

50、83;······································26注射用頭孢噻肟鈉舒巴坦·········&#

51、183;··········································26注射用頭孢哌酮······

52、;··················································

53、;····27注射用頭孢哌酮鈉他唑巴坦···········································

54、83;······27注射用頭孢哌酮鈉舒巴坦·········································&#

55、183;··········28注射用頭孢唑肟······································

56、;······················29注射用頭孢他啶··························&#

57、183;·································29注射用頭孢匹胺···············

58、;·············································30注射用頭孢曲松···&#

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60、183;······31注射用頭孢曲松鈉他唑巴坦·········································

61、·········31注射用頭孢吡肟·······································

62、83;····················32注射用拉氧頭孢····························

63、································321.3碳青霉烯類和其他一內(nèi)酰胺類注射用亞安培南西司他汀鈉·············

64、·····································33注射用美羅培南···········

65、83;················································33注射用氨曲南&

66、#183;·················································&

67、#183;···········341.4大環(huán)內(nèi)脂類注射用紅霉素···································

68、83;··························34注射用乳糖酸阿奇霉素·····················

69、83;································351.5 氨基糖苷類硫酸慶大霉素注射液··············&

70、#183;·········································35硫酸阿米卡星注射液······&#

71、183;·················································36

72、硫酸異帕米星注射液················································

73、83;·······37注射用鏈霉素·········································&

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75、183;····························381.6喹諾酮類洛美沙星氯化鈉注射液··················&

76、#183;···································39環(huán)丙沙星氯化鈉注射液············&

77、#183;·········································39培氟沙星注射液······

78、3;·················································

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80、#183;··············41注射用甲磺酸帕珠沙星·································&

81、#183;····················41鹽酸左氧氟沙星注射液···························&

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85、··················································

86、········431.9硝基咪唑類奧硝唑葡萄糖注射液·······································

87、;·················44替硝唑注射液·······························

88、83;······························441.10抗真菌藥氟康唑注射液·················

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92、3;·······················46異煙肼··························

93、;··········································46利福霉素鈉注射液······&

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95、#183;·47吡嗪酰胺片···············································

96、·················47鹽酸乙胺丁醇片·······························

97、83;····························48二、 心血管系統(tǒng)藥物···················

98、83;····································482.1抗心律失常藥 鹽酸普羅帕酮注射液··········

99、··············································49鹽酸胺碘酮注射液··&#

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101、183;·····49鹽酸普萘洛爾···········································

102、···················50酒石酸美托洛爾·····························

103、83;······························51鹽酸艾司洛爾注射液·················

104、3;······································522.2抗心絞痛藥硝酸甘油注射液·········

105、;··················································

106、;·52單硝酸異山梨酯片···············································&

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108、;························532.3抗心力衰竭藥地高辛·······················

109、83;············································54去乙酰毛花苷····&

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113、183;···································56馬來酸依那普利·············

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116、83;········58尼群地平········································

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118、183;······································59苯磺酸氨氯地平··········

119、;·················································60賴諾普

120、利膠囊·················································

121、83;···········60厄貝沙坦片·····································&#

122、183;·························61替米沙坦·······················&#

123、183;·········································61吲達(dá)帕胺·······&#

124、183;·················································&#

125、183;·······62氯沙坦鉀氫氯噻嗪片········································

126、83;··············62尼莫地平注射液··································

127、·························64硝苯地平控釋片·······················

128、83;···································64非洛地平緩釋片·············

129、··············································652.5抗休克的血管活性藥鹽酸腎上腺素注射液&

130、#183;·················································&

131、#183;····65鹽酸多巴胺注射液···········································

132、83;·············66去甲腎上腺素注射液··································

133、3;····················66鹽酸去氧腎上腺素····························

134、·····························67重酒石酸間羥胺···················

135、83;·······································67氫溴酸東莨菪堿·········

136、··················································

137、68鹽酸多巴酚丁胺················································

138、83;··········682.6調(diào)節(jié)血脂藥阿托伐他汀鈣·····································

139、;························69非洛貝特·························

140、;········································69三、影響腦血管藥、腦代謝及促智的藥物······

141、83;······························7031腦血管藥馬來酸桂哌齊特注射液················

142、83;·····································70注射用葛根素···········&

143、#183;·················································&

144、#183;71注射用川芎嗪················································

145、;··············71注射用長(zhǎng)春西汀··································&#

146、183;·························72依達(dá)拉奉注射液·······················

147、;·····································72奧扎格雷鈉注射液 ···········

148、··············································73前列地爾注射液··

149、83;·················································

150、83;·······73鹽酸法舒地爾注射液········································

151、3;···············74天麻素注射液·································&#

152、183;······························7432腦代謝及促智藥注射用單唾液四己糖神經(jīng)節(jié)苷脂鈉···············

153、································75銀杏達(dá)莫注射液················

154、83;·············································75小牛血去蛋白提取物注射液··&

155、#183;·················································&

156、#183;76注射用腦蛋白水解物···············································&#

157、183;···········76胞磷膽堿注射液·····································

158、;·························77四、影響血液及造血系統(tǒng)的藥物 ······················

159、·······················7741抗凝血藥低分子肝素鈉注射液························&

160、#183;································78低分子肝素鈣注射液···············&#

161、183;·········································78達(dá)肝素鈉注射液·······

162、;··················································

163、;····79注射用尿激酶············································

164、83;··················79華法林鈉······························

165、83;····································80蚓激酶腸溶膠囊············

166、·················································8042促凝

167、血藥酚磺乙胺注射液················································

168、83;············81氨甲環(huán)酸注射液····································

169、·························81氨甲苯酸注射液·······················

170、83;·····································82維生素K1注射液···········

171、;················································82二乙酰氨乙酸乙二胺

172、注射液·················································

173、83;·83注射用卡洛磺鈉···············································

174、··············83魚精蛋白注射液··································

175、83;··························84注射用血凝酶······················&

176、#183;········································84蛇毒血凝酶注射液·······

177、83;·················································

178、83;·8543抗血小板藥物阿司匹林腸溶片·············································

179、3;···············85硫酸氫氯吡咯雷片·································

180、··························86西洛他唑片·······················

181、;··········································8644抗貧血藥重組人促紅素注射液·····

182、··················································

183、··87五、抗腫瘤藥··············································

184、3;···············87注射用鹽酸吡柔比星·································

185、;·······················88注射用鹽酸多柔比星·························

186、·······························88注射用鹽酸平陽霉素·················&

187、#183;······································89注射用環(huán)磷酰胺·········

188、3;·················································

189、3;90注射用硫酸長(zhǎng)春新堿················································

190、;········90注射用羥喜樹堿········································&#

191、183;···················91高三尖杉酯堿注射液····························

192、83;···························91注射用鹽酸阿糖胞苷····················

193、3;···································92酒石酸長(zhǎng)春瑞濱注射液············

194、3;·········································92注射用吉西他濱·······&

195、#183;·················································&

196、#183;··93注射用甲氨喋呤·············································

197、3;··············93注射用順鉑··································

198、83;·····························94注射用奧沙利鉑···················

199、·········································95注射用鹽酸表柔比星·······&

200、#183;················································95紫杉醇注射

201、液··················································

202、;············96氟尿嘧啶注射液····································&#

203、183;·······················96多西他賽注射液·························

204、;···································97依托泊苷注射液·············&#

205、183;··············································97替加氟注射液··

206、··················································

207、··········98注射用柔紅霉素······································

208、83;·····················98利妥昔單抗···························&#

209、183;····································99亞葉酸鈣注射液············

210、;················································99六、鎮(zhèn)靜藥、催眠藥

211、··················································

212、·····100地西泮注射液···········································

213、83;··················100注射用苯巴比妥鈉·····························

214、3;····························101咪達(dá)唑侖注射液····················

215、········································101艾司唑侖·········

216、;··················································

217、;·······102七、抗抑郁癥藥·········································&

218、#183;··················102鹽酸氟西汀······························

219、;··································103鹽酸阿米替林··············&#

220、183;···············································103鹽酸帕羅西汀·

221、;··················································

222、;···········104八、骨骼肌松弛藥·····································

223、·····················104注射用維庫溴胺···························&#

224、183;································105氯化琥珀膽堿注射液···············&#

225、183;········································105九、電解質(zhì)平衡調(diào)節(jié)藥·······&

226、#183;··············································10610氯化鉀注射液·&#

227、183;·················································&#

228、183;······10610氯化鈉注射液·········································

229、83;················10710葡萄糖酸鈣注射液··············································