Urogenital system drugs
利尿劑
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Thiazide & related drug
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Trichlormethiazide
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Fluitran (2)
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HTN, CHF, DI: 0.5-2#/day
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[副]: 低鉀,低鈉,低鎂,低氯鹼中毒, 高尿酸,高鈣
-腎差(CCr<30)效差, 加Loop可保持benefit
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Indapamide
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Natrilix SR (1.5/#)
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HTN: 1# qd
cardiac edema/利尿: 2-3#/d
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C/I: CCr <30 (因效差)
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Loop diuretics
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Furosemide
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Rasitol (40)
Fumide (10/ml, 120ml/bt)SL
Rasitol (20mg/2ml/amp)
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Edema:
PO, SL: 0.5-2#
(2-8ml) qd-bid
Iv, im 1-2支q1-2h, then SC,IV,IM qd-bid (max單ds: 8-10支)
Iv 1-2支 + 5-40mg/h
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Aldosterone antagonist
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Spironolactone
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Aldactin (25)
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CHF (II, III, IV) 0.5-1# qd (max 2#/d)
HTN: 1-2#qd,
ascites, hyper-aldo: 4-8# qd-bid
女性hirsutism/acne/alopecia:1-4#
qd-bid
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高血鉀,嗜睡,
陽痿, gynecomastia
breast 壓痛, 月經不規則
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Carbonic anhydrase inh
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Acetazolamide
(250)
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Acute Mountain
sickness (AMS)
預防: 24h前使用,當達到最高點時續用2天
Acetazolamide:
0.5# bid (2.5mg/kg)
Dexamethasone
4mg q12h
治療:
Acetazolamide: 1# bid (5mg/kg)
Dexamethasone
4mg q6h
High-altitude
cerebral edema (HACE)
預防: 同上 (Acetazolamide:
0.5# bid; dexa 4mg q12h)
治療:
PO,iv, im:
dexa 8mg st, then 4mg (0.15mg/kg) q6h
High-altitude pulm edema (HAPE):
Adalat OROS: 30mg (1#) q12h(Tx &
prev)
Sildenafil:
50mg (0.5#) q8h (prev)
Tadalafil:
10mg (0.5#高劑量) bid (prev)
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Osmotic
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Mannitol
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20%, 500ml/bt =100g/bt
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↓IOP眼內壓: iv (30-60’) 1-2g/kg
↓ICP腦壓: IV (20-30’) 0.5-1g/kg, or
200-500ml, then prn 0.25-0.5g/kg
q6-8h, keep serum osmo <300-320mOsm/L
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C/I: 肺水腫/充血, 嚴重腎病變, 嚴重脫水
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Glycetose
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10%,
500ml/bt (50g/bt) Glycerine 100mg,
Fructose 50mg
NaCl 9mg
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Iv (30’) 200-500ml or 0.5-1g/kg, then 0.25-0.5g/kg q6-8h prn
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泌尿道止痛劑
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Phenazopyridine
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Urogen (50)
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下泌尿道burning/pain/urgency
2-4# tid
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[副]: 發癢, 尿液變色, methemoglobinemia
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Anti-spasmotics
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Anti-muscarinic
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Tolterodine
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Detrusitol (2)
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不穩定膀胱: 1# bid
CCr 10-30:
0.5# bid
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Solifenacin
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Vesicare (5)
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Overactive bladder: 1-2# qd (hs)
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睡前給藥減少口乾from
23->11%
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Propiverine
(anti-muscarinic + CCB effect)
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Urostrol (15)
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不穩定膀胱: 1# b-tid
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較少用
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Drugs for dysuria
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5α-reductase inhibitor
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Finasteride
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Proscar (5)
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BPH: 1# qd
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[副]:↓射精量,↓libido,陽痿, false↓PSA 50%
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α1-blocker
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Terazosin
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Hytrin (2)
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BPH, HTN:
初: 0.5# hs, 維: 1-5#/day
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[副]: 姿態性低血壓(4-9%),心悸, 暈
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Doxazosin
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Doxaben (1)
Doxaben XL (4)
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BPH, HTN:
1-2# (1-8mg)
qd (am or pm)
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姿態性低血壓(1-2%),
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Tamsulosin (α1A)
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Harnalidge
OD (0.2)
Harlalidge OCAS (0.4)
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BPH: 1-2# (0.2-0.4mg) qd or qod
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姿態性低血壓(0.5-1%),
Ejaculatory d/o (4.5-8%)
Intra-operative floppy iris synd (IFIS)
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Drugs for sexual dysfunction
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PDE5 inhibitor
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Sildenafil
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Viagra (100) 威而鋼
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Erectile dysfxn: 1/4-1# prn (30’前服用), 持續4h
Refractory Raynaud’s phen.: 0.5# bid
Mountain sickness: 0.5# tid (上山前1天服用)
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[副]: dyspepsia, 鼻塞, 視覺異常
[小心]: 24h內勿併用 nitrate
Nitrate & viagra皆可擴張血管降壓,併用會造成血壓下降,引起angina;
性行為亦可引發angina, 故使\用上需更小心
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Tadalafil
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Cialis (5) (20) 犀利士
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BPH: 5mg qd
Erectile dysfxn: 0.5-1# (2.5-5-20mg) qd, 30’前用, 持續36h
Mountain sickness: (10mg) bid (上山前1天服用)
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[副]: ditto, 肌肉/背痛
24h內勿併用 nitrate
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腎結石用藥
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檸檬酸鉀 (potassium citrate)
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Urocit-K (10mEq (1080mg))
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Renal tubular acidosis, nephrolithiasis (Ca or尿酸結石), 尿液鹼化劑:
1-2# tid (max
100mEq (10#) /d)
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[副]: N/V/D, 胃痛, 高血鉀
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