[問題]98年第一次藥物治療學國考題

看板pharmacist (藥學生/藥師)作者everain (雨過天晴)時間16年前 (2009/02/22 20:01)推噓0(0推 0噓 0→)

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大家好小弟有藥物治療學國考題的問題在問問題之前先感謝 k2412391藥師 Lr1藥師 cmvct723d藥師百忙抽空給予見解以下是小弟的問題麻煩好心的人提出見解或建議謝謝 19 在為ClCr＝23 mL/min 的病人選用下?ACEIs 藥品治療時，何者最應依腎功能做劑量之調整？ (A)benazepril(B)enalapril(C)fosinopril(D)trandolapril 答案為(B) Applied 8th 提到ClCr傳統單位標準直為75-100 mL/min 所以此病人ClCr＝23 mL/min 明顯偏低小弟想問題目指的依腎功能做劑量之調整是看此藥物的Metabolism還是Excretion方式小弟查 MICROMEDEX Healthcare Series得以下資料我不太會用批踢踢顏色顯示功能,所以請好心的人,耐心看我查的資料之後我會問人如何使用批踢踢顏色顯示功能已顯示表達的重點謝謝^^" Benazepril Metabolism Systemic: Amlodipine- Hepatic Benazepril- Hepatic: Active metabolite: benazeprilat Excretion Systemic: Amlodipine- Fecal: 20 to 25%; Renal: 70% Benazepril- Renal Elimination Half Life Systemic: Amlodipine- 35 h Adults; 65 h Elderly Benazeprilat- 10 to 11 h enalapril Metabolism Enalapril (prodrug); hydrolysis Active metabolite: enalaprilat (active drug) Excretion Fecal and Renal: 94% as prodrug and active drug (primarily in urine) Enalaprilat (active drug), Renal: 40% Enalaprilat (active drug), Dialyzable: yes (hemodialysis); yes (peritoneal dialysis), neonates Elimination Half Life Enalaprilat (active drug): 11 h Enalaprilat (active drug), Renal insufficiency: prolonged (glomerular filtration rate of less than or equal to 30 mL/min) Fosinopril Metabolism Fosinopril (prodrug)-Hepatic; esterases; hydrolysis Metabolites: fosinoprilat (active), glucuronide conjugate of fosinoprilat and p-hydroxy metabolite of fosinoprilat Excretion Fosinopril (prodrug), Fecal: approximately half of absorbed dose Fosinopril (prodrug), Renal: approximately half of absorbed dose Fosinopril (prodrug), Dialyzable: not well dialyzed Fosinoprilat (active drug), Renal: (IV) Fosinoprilat (active drug), Dialyzable: poorly removed (hemodialysis), 2% removed; poorly removed (peritoneal dialysis), 7% removed Elimination Half Life Fosinoprilat (active drug), healthy subjects: (IV), approximately 12 h Fosinoprilat (active drug), hypertensive patients: 11.5 h Fosinoprilat (active drug), heart failure patients: 14 h Fosinoprilat (active drug), pediatric patients: 11 h to 13 h Trandolapril Metabolism Systemic: Hepatic: Metabolite: trandolaprilat Excretion Systemic: Fecal: 66%; Renal: 33%. Elimination Half Life Systemic: Trandolapril: 6 h. Trandolaprilat: 10 h. -- ※ 發信站: 批踢踢實業坊(ptt.cc) ◆ From: 140.128.67.243