頁籤選單縮合
題 名 | Nephrotoxicities of Nonsteroidal Anti-Inflammatory Drugs=非類固醇抗炎劑的腎毒性 |
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作 者 | 溫崧峰; | 書刊名 | 臺灣醫學會雜誌 |
卷 期 | 96:3 1997.03[民86.03] |
頁 次 | 頁157-171 |
分類號 | 418.285 |
關鍵詞 | 非類固醇抗炎劑; 腎毒性; Nonsteroidal anti-inflammatory drugs; Renal toxicity; Prostaglandins; |
語 文 | 英文(English) |
英文摘要 | While the relative incidence of serious nephrotoxicities in the population consuming nonsteroidal anti-inflammatory drugs (NSAIDs) is very low,the frequency of adverse events in patients at risk has considerably increased due to the rising popularity of the use of the drugs in recent years. Under normal conditions, NSAIDs have relatively little effect on the kidney because of low renal production of prostaglandins.However, in the presence of renal hypoperfusion in which local synthesis of vasodilator prostaglandins is increased to protect the glomerular hemodynamics and to maintain appropriate renal tubular transport of fluid and electrolytes, inhibition of prostaglandin synthesis by NSAIDs can lead to vasoconstrictive acute renal failure as well as fluid and electrolyte disorders such as sodium retention and resistance to diuretics, hyponatremia and hyperkalemia. Conditions that increase the risk for NSAID-induced nephrotoxicities include volume depletion from diuretics and other causes, edematous states such as congestive heart failure and cirhosis of the liver, old age and underlying renal disease, especially in the presence of renal functional impairment. In addition, renal parenchymal diseases may develop in susceptible patients taking NSAIDs. These include acute tubulointerstitial nephritis, Frequently associated with nephrotic syndrome, and chronic prog ressive renal disease, with or without renal papillary necrosis. Rare cases of vasculitis and glomerulonephritis have also been reported. Finally, NSAIDs may aggravate hypertension by interacting with antihypertensive drugs, especially with diuretics and �� -blockers. Withdrawal of NSAIDs in patients at risk can frequently reverse or improve the nephrotoxicities. It is recommended that physicians be aware of the clinical settings that increase the risk for NSAID-induced nephrotoxicities and take preventive or therapeutic measures accordingly. |
本系統中英文摘要資訊取自各篇刊載內容。