學(xué)術(shù)論文寫作the principle of good title課件

特殊人群用藥——老年人用藥指導(dǎo)2016.11.19ACADEMICENGLISHWRITINGANDTRANSLATION

目錄一：概述二：老年人生理和生化功能的變化三：老年人藥動(dòng)學(xué)和藥效學(xué)特點(diǎn)四：老年人安全合理用藥對(duì)策

引起藥源性高血壓的藥物

①三環(huán)類抗抑郁藥：可減弱可樂(lè)定、甲基多巴和胍乙啶等藥物降壓作用。

②麻醉藥（如普魯卡因、利多卡因、丙泊酚等）可阻斷迷走神經(jīng)，興奮交感神經(jīng)，使血壓升高。

③阿片受體拮抗藥（如納洛酮等）可拮抗大劑量麻醉性鎮(zhèn)痛藥，使痛覺(jué)突然恢復(fù)，交感神經(jīng)興奮，致血壓升高、心率加快、心律失常甚至肺水腫和心搏驟停。

（1）交感神經(jīng)和副交感神經(jīng)之間平衡失調(diào)，交感神經(jīng)興奮性增加，使血壓升高：

④酒精及含酒精制劑（如左卡尼汀口服溶液、氫化可的松注射液、藿香正氣水等）⑤咖啡因及含咖啡因藥物（如復(fù)方氨酚烷胺膠囊、復(fù)方酚咖偽麻膠囊等）

⑥中樞神經(jīng)系統(tǒng)興奮藥（哌甲酯、苯丙胺等）

⑦通過(guò)腎素-血管緊張素-醛固酮系統(tǒng)激活升高血壓（如含雌激素避孕藥）

含鈉注射液（如0.9%氯化鈉注射液、10%氯化鈉注射液、乳酸鈉林格注射液等）；

含鈉抗感染藥物（如青霉素鈉、頭孢呋辛鈉等）

含鈉制酸劑（如碳酸氫鈉等）；

糖皮質(zhì)激素可促進(jìn)腎小管對(duì)鈉的重吸收；

鹽皮質(zhì)激素可促進(jìn)遠(yuǎn)端腎小管對(duì)鈉的重吸收和鉀的排泄

——均可導(dǎo)致血壓升高。（2）通過(guò)水鈉潴留引起高血壓：(3)非甾體抗炎藥可升高血壓.——抑制環(huán)氧酶活性(4)中藥甘草有效成分為甘草酸，其水解產(chǎn)物甘草次酸有醛固酮樣作用，長(zhǎng)期使用可致水鈉潴留、低鉀、低腎素、高血壓和醛固酮分泌減少，繼而高血壓?！醇傩匀┕掏龆喟Y(5)抗腫瘤藥物（如紫杉醇、順鉑、舒尼替尼、貝伐珠單抗）可使NO生成減少，內(nèi)皮肽-1系統(tǒng)激活，致急性腎衰竭，使腎素水平升高，造成——繼發(fā)腎性高血壓。

(6）曲馬多、芬太尼、萘甲唑啉、麻黃堿、偽麻黃堿、去氧腎上腺素等可、垂體后葉素、麥角堿、麥角新堿——直接收縮血管，使血壓升高；

(7）重組人紅細(xì)胞生成素

——可使血液黏度增加、血容量增多，使血壓升高：（形態(tài)功能1.皮膚松弛，發(fā)皺1.視力聽(tīng)力下降2毛發(fā)逐漸變白，脫落減少2.記憶力、思維力逐漸減退3.老年斑出現(xiàn)3反應(yīng)遲鈍、行動(dòng)緩慢、適應(yīng)力下降4.牙齒脫落，齒骨萎縮4心肺功能減弱5.性腺和肌肉萎縮5代謝失調(diào)，酶、激素活力降低6.血管硬化6免疫功能下降7.肺和支氣管彈力萎縮7.易患多種老年病心血管病、慢性支氣管炎、癌癥以及精神疾病8.細(xì)胞結(jié)構(gòu)改變IMPORTANCEofagoodtitleToGivetheFirstImpressionToGivetheThemeThenwhathappened?howfirstimpressionworksThenWhathappened?theymade3moviesfromthatTHEMEPrinciplesPART

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