泌尿系统教学资料 2016 陈红 肾脏与药物.pptVIP

Kidney and Drugs肾脏与药物 陈 红 Hong Chen, MD, PhD hchen100@shsmu.edu.cn 上海交通大学医学院 药理学教研室 Shanghai Jiao Tong University School of Medicine Kidney, Drugs, and Medication Miscellaneous talks about drugs and the kidneys Understand how a drug is connected with the kidney and the whole body  Kidney and Medication Know the action site of diuretics Understand the role of the kidney in the action and metabolism of commonly used drugs Understand the antibiotic distribution, elimination and drug choices Know the common drug-related renal damage Know the role of the kidney in blood pressure control, pharmacology of antihypertensive drugs which act through or related with the kidney and clinical use Diuretics, osmotic diureticsThiazides, Loop diuretics, K+-sparing diureticsmannitol 利尿药与渗透性利尿药: 噻嗪类 袢利尿剂 保钾利尿剂 甘露醇 Collecting tubule Thiazides Inhibit active exchange of Cl-Na in the cortical diluting segment of the ascending loop of Henle K+-sparing Inhibit reabsorption of Na in the distal convoluted and collecting tubule Loop diuretics Inhibit exchange of Cl-Na-K in the thick segment of the ascending loop of Henle mannitol mannitol mannitol mannitol mannitol mannitol Hematuria? Renal elimination of endogenous metabolites and foreign substances Endogenous metabolic products foreign substances eliminated by the kidneys: Urea from amino acid metabolism Uric acid from nucleic acids Creatinine from muscles End products of hemoglobin metabolism Hormones their metabolites Foreign substances (e.g., drugs, pesticides, other chemicals ingested in the food) Rifampin 利福平 Up to 30% of a dose of the drug is excreted in the urine and 60% to 65% in the feces; less than half of this may be unaltered antibiotic. Adjustment of dosage is not necessary in patients with impaired renal function. Rifampin is distributed throughout the body and is present in effective concentrations in many organs and body fluids, including the CSF. This is perhaps best exemplified by the fact that the d