Re: [問題] 一題國考題請教
看板pharmacist (藥學生/藥師)作者monyan (廢健保救台灣)時間17年前 (2008/02/20 16:05)推噓-10(3推 13噓 36→)留言52則, 15人參與討論串9/11 (看更多)
: 我不能接受這種說法,
: 除了少數惡名昭彰的NSAIDs具有強烈的酸性與刺激性以外,
: NSAIDs會造成潰瘍的產生主要是prostaglandins的影響
: Prostaglandins play a critical role in maintaining gastroduodenal
: mucosal integrity and repair. It therefore follows that interruption
: of prostaglandin synthesis can impair mucosal defense and repair,
: thus facilitating mucosal injury via a systemic mechanism.
: ps.NSAIDs造成潰瘍主要有endothelial effect、direct toxicity、epithelial effect
: ref.harrison's principles of internal medicine, 16th edition
: 此外,如果依製劑學的角度來看,
: 具有刺激性的NSAIDs通常會加以coating,
: 與食物同時使用反而會改變PH值,
: 使得相關保護機制失效。
潰瘍的產生不是這嘛簡單
不然你無法解釋有的人即使長期使用NSAID 也不會產生潰瘍
病人本身的情形才是主因
藥師最讓人詬病的一點就是只用藥理學來看一個問題
卻不懂得看病人整體
: 引用the washington manual of medical therapeutics 30th edition p.359
washington manual of medical therapeutics 是醫學生必讀的書
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