藥理學(xué)英文作業(yè)及答案

1、 藥理學(xué)作業(yè) -周師兄General principles1. Which route of administration is most likely to subject a drug to a first-pass effect?a. Intravenousb. Inhalationalc. Orald. Sublingual (SL)e. Intramuscular2. Two drugs may act on the same tissue or organ through independent receptors, resulting in effects in opposite

2、 directions. This is known asa. Physiologic antagonismb. Chemical antagonismc. Competitive antagonismd. Irreversible antagonisme. Dispositional antagonism3. If a drug is repeatedly administered at dosing intervals that are equal to its elimination half-life, the number of doses required for the plas

3、ma concentration of the drug to reach the steady state isa. 2 to 3b. 4 to 5c. 6 to 7d. 8 to 9e. 10 or more 4. The pharmacokinetic value that most reliably reflects the amount of drug reaching the target tissue after oral administration is thea. Peak blood concentrationb. Time to peak blood conc

4、entrationc. Product of the Vd and the first-order rate constantd. Vde. Area under the blood concentration-time curve (AUC)5. Of the following, which is a phase II biotransformation reaction?a. Sulfoxide formationb. Nitro reductionc. Ester hydrolysisd. Sulfate conjugatione. Deamination 6. The gr

5、eater proportion of the dose of a drug administered orally will be absorbed in the small intestine. However, on the assumption that passive transport of the nonionized form of a drug determines its rate of absorption, which of the following compounds will be absorbed to the least extent in the stoma

6、ch?a. Ampicillin (pKa = 2.5)b. Aspirin (pKa= 3.0)c. Warfarin (pKa = 5.0)d. Phenobarbital (pKa = 7.4)e. Propranolol (pKa = 9.4) 7. Of the following characteristics, which is unlikely to be associated with the process of facilitated diffusion of drugs?a. The transport mechanism becomes saturated

7、at high drug concentrationsb. The process is selective for certain ionic or structural configurations of the drugc. If two compounds are transported by the same mechanism, one will competitively inhibit the transport of the otherd. The drug crosses the membrane against a concentration gradient and t

8、he process requires cellular energye. The transport process can be inhibited noncompetitively by substances that interfere with cellular metabolism 8. Which of the following is unlikely to be associated with oral drug administration of an enteric-coated dosage form?a Irritation to the gastric m

9、ucosa with nausea and vomitingb Destruction of the drug by gastric acid or digestive enzymesc. Unpleasant taste of the drugd. Formation of nonabsorbable drug-food complexese. Variability in absorption caused by fluctuations in gastric emptying time9. Which of the following is classified as belonging

10、 to the tyrosine kinase family of receptors?a. GABA -A receptorb. -adrenergic receptorc. Insulin receptord. Nicotinic II receptore. Hydrocortisone receptor2.Explanation of terms1、Bioavailability2、Hepatoenteral circulation3、Half-life time4、50% lethal dose5、Absorption6、Ateady state plasma concentratio

11、n7、Pharmacokinetics8、Pharmacodynamics9、adverse effect10、antagonist11、potency12、symptomatic treatment13、therapeutic index14、first-pass effect(elimination)15、enzyme inhibitor16、etiological treatment17、median effective dose18、side effects19、dose- effect relationship20、structure activity relationship21、

12、tolerance22、tachyphylaxis 1. Describe factors affecting absorption of drug.2. Describe receptor characters.3. Which is the most common process for drug transfer across cell membranes and point out its characteristics.4. List the characteristics of plasma protein binding of drugs. 5. What i

13、s the hepatic microsomal enzymes? List their main characteristics.6. What is the difference between the action and the effect of a drug?7. Use receptor-action theory to elucidate what is the difference between the competitive antagonist and the non-competitive antagonist. 1.c   

14、2c.    3b   4e   5d    6e    7d   8d   9c    1生物利用度：是藥物活性成分從制劑釋放吸收進(jìn)入血液循環(huán)的程度和速度。2肝腸循環(huán)：指由肝臟排泄的藥物，隨膽汁進(jìn)入腸道再吸收而重新經(jīng)肝臟進(jìn)入全身循環(huán)的過(guò)程。3半衰期：是指血漿消除t1/2,是指血漿藥物濃度降低一半所需的時(shí)間。4半數(shù)致死量：表示在規(guī)定時(shí)間內(nèi)，通過(guò)指定感染途徑，使一定體重或年齡的某種動(dòng)物半數(shù)死亡所需最

15、小細(xì)菌數(shù)或毒素量。5吸收：機(jī)體從環(huán)境中吸收營(yíng)養(yǎng)物質(zhì)到體內(nèi)的過(guò)程。6穩(wěn)定血藥濃度：在給藥間隔內(nèi)消除的藥量等于給藥劑量，從而達(dá)到平衡是的血藥濃度。7藥物代謝動(dòng)力學(xué)；主要是定量研究藥物在生物體內(nèi)的過(guò)程（吸收、分布、代謝和排泄），并運(yùn)用數(shù)學(xué)原理和方法闡述藥物在機(jī)體內(nèi)的動(dòng)態(tài)規(guī)律的一門(mén)學(xué)科。8藥物效應(yīng)動(dòng)力學(xué)；主要研究藥物對(duì)機(jī)體的作用、作用規(guī)律及作用機(jī)制，其內(nèi)容包括藥物與作用靶位之間相互作用所引起的生物化學(xué)、生理學(xué)和形態(tài)學(xué)變化，藥物作用的全過(guò)程和分子機(jī)制。9不良反應(yīng)；是指按正常用法、用量應(yīng)用藥物預(yù)防、診斷或治療疾病過(guò)程中，發(fā)生與治療目的無(wú)關(guān)的有害反應(yīng)。10拮抗藥；能與受體結(jié)合，具有較強(qiáng)的親和力而無(wú)內(nèi)在活性（

16、=0）的藥物。11效價(jià)強(qiáng)度；用于作用性質(zhì)相同的藥物之間的等效計(jì)量的比較，是指能引起等效反應(yīng)（一般采用50%效應(yīng)量）的相對(duì)濃度或劑量。12對(duì)癥治療；用藥物改善疾病癥狀。13治療指數(shù)；通常將半數(shù)致死量（LD50）半數(shù)有效量（ED50）的比值稱為治療指數(shù)，用以表示藥物的安全性。14首過(guò)效應(yīng)；從胃腸道吸收入門(mén)靜脈系統(tǒng)的藥物在到達(dá)全身血循環(huán)前必先通過(guò)肝臟，如果肝臟對(duì)其代謝能力很強(qiáng)，或由膽汁排泄的量大，則使進(jìn)入全身血循環(huán)的有效藥物量明顯減少，這種作用稱為首過(guò)消除。15酶抑制劑；是一類可以結(jié)和酶并降低其活性的分子。16對(duì)因治療；針對(duì)病因進(jìn)行治療。17半數(shù)有效量；在量反應(yīng)中是指能引起50%最大反應(yīng)強(qiáng)度的藥物劑

17、量；在質(zhì)反應(yīng)中只引起50%實(shí)驗(yàn)動(dòng)物出現(xiàn)陽(yáng)性反應(yīng)的藥物劑量。18副反應(yīng)；應(yīng)用治療量藥物后出現(xiàn)的與治療無(wú)關(guān)的反應(yīng)。19量效關(guān)系；在一定的范圍內(nèi)，藥物的效應(yīng)與靶部位的濃度成正相關(guān)，而后者決定于用藥劑量或血中藥物濃度，定量地分析與闡明兩者間的變化規(guī)律稱為量效關(guān)系。20構(gòu)效關(guān)系；藥物的化學(xué)結(jié)構(gòu)與藥物效應(yīng)的關(guān)系。21耐藥性；是病原體或腫瘤細(xì)胞對(duì)反復(fù)應(yīng)用的化學(xué)治療藥物的敏感性降低。也稱抗藥性。22快速耐受性；有些藥物在短時(shí)間內(nèi)重復(fù)給予而使機(jī)體反應(yīng)減弱，最后雖然劑量加得很大也不能得到原來(lái)的反應(yīng)。藥物的此種現(xiàn)象稱為藥物的快速耐受或急性耐受，這種特性叫快速耐受性。1因素有；藥物的理化性質(zhì)、給藥途徑、制劑因素等。2

18、特性有；靈敏性、特異性、飽和性、可逆性、高親和力等。3最常見(jiàn)的是簡(jiǎn)單擴(kuò)散，特點(diǎn)有；不需要能量、不需要載體、無(wú)飽和現(xiàn)象、無(wú)競(jìng)爭(zhēng)性抑制等。4特性有；飽和性、競(jìng)爭(zhēng)性抑制、疾病對(duì)藥物與血漿蛋白結(jié)合的影響。5肝微粒體酶即肝臟微粒體細(xì)胞色素p450酶系統(tǒng)，該系統(tǒng)主要酶為細(xì)胞色素p450，由于該酶能促進(jìn)數(shù)百種藥物的代謝，又稱肝藥酶。特性有；選擇性低、變異性大。6區(qū)別為；藥物作用是藥物對(duì)機(jī)體組織發(fā)揮的原發(fā)作用，而藥物效應(yīng)是藥物原發(fā)作用引起的機(jī)體器官組織能夠被觀察、記錄、測(cè)定到的功能、代謝等的變化。7區(qū)別為；競(jìng)爭(zhēng)性拮抗劑的效應(yīng)給藥被增加激動(dòng)劑濃度所對(duì)抗，而非競(jìng)爭(zhēng)性拮抗劑不行。競(jìng)爭(zhēng)性拮抗劑可以提高ED50值，而非

19、競(jìng)爭(zhēng)性拮抗劑不行。 Autonomic Nervous System 1.Compare the Pharmacology of physostigmine and neostigmine.2.Compare ocular effects of pilocarpine, physostigmine, atropine and phenylephrine.3.Compare the Pharmacology of Noradrenaline, adrenaline, and isoprenaline?4.List the indications and the contraindica

20、tions of propranolol?5. List the steps in the synthesis, storage, release and inactivation of acetylcholine。6. Describe the types and subtypes of adrenergic receptors, their locations, and physiologic response to activation. 1. The drug of choice for the treatment of anaphylactic shock is:(A) h

21、istamine (B) epinephrine (C) norepinephrine (D) isoproterenol(E) diphenhydramine 2. Phentolamine often causes an increase in heart rate and in the force of contraction by which of the following mechanisms:(A) Directly stimulating cardiac b1 receptors(B) Antagonizing the vagal tra

22、nsmitter(C) Releasing histamine from mast cells, which stimulates the heart(D) Blocking peripheral vasoconstriction, which produces reflex stimulation of the heart(E) Increasing the amount of calciumavailable to the heart 3、If a drugs half-life is 10h，when it is repeatedly administered at dosin

23、g intervals that are equal to its t1/2, the time of the drug to reach the steady state concentration is （）  A、20 to 30h         B、30 to 40h     C、40 to 50h    D、60h or more       4、 At

24、small dose, atropine effects on secretions are (   )A. sweat and salivary gland secretions are greatly reduced. B. intestinal gland secretions are greatly reduced.C. bronchial secretions are greatly reduced D. gastric acid secretion are greatly reduced 5、搶救心跳驟停的藥物是：（    

25、; ）A、adrenaline      B、noradrenaline       C、isoprenaline    D、digoxin       6、The drug of choice for the treatment of allergic shock is(   )A、isoprenaline      B、Ad

26、renaline   C、Atropine     D、Noradrenaline  7、伴尿量減少的中毒性休克最好用（   ） A、isoprenaline   B、noradrenaline   C、adrenaline   D、 dopamine     1:毒扁豆堿作用與新斯的明相似，但無(wú)直接激動(dòng)受體作用。其結(jié)構(gòu)為叔胺類化合物，可進(jìn)入中樞。眼內(nèi)局部應(yīng)用時(shí)，其作用類似于毛

27、果蕓香堿，但較強(qiáng)而持久，表現(xiàn)為瞳孔縮小，眼內(nèi)壓下降。吸收后外周作用與新斯的明相似，表現(xiàn)為M、N膽堿受體激動(dòng)作用，進(jìn)人中樞后亦可抑制中樞 AChE活性而產(chǎn)生作用。中樞作用較強(qiáng)，可作為中藥麻醉時(shí)的催醒藥。現(xiàn)主要局部滴眼用于治療青光眼，作用較毛果蕓香堿強(qiáng)而持久，但刺激性大。2:毛果蕓香堿、毒扁豆堿：縮瞳、降低眼內(nèi)壓、調(diào)節(jié)痙攣。阿托品、苯腎上腺素：擴(kuò)瞳、升高眼內(nèi)壓、調(diào)節(jié)麻痹。毒扁豆堿。3腎上腺素是、受體激動(dòng)藥，藥理作用變現(xiàn)為興奮心血管系統(tǒng)、抑制支氣管平滑肌和促進(jìn)新陳代謝；而去甲腎上腺素是1、2受體激動(dòng)劑，它對(duì)冠狀血管產(chǎn)生舒張作用，對(duì)其它血管產(chǎn)生收縮作用，可使心率減慢，小劑量可使脈壓加大，大劑量可使脈壓

28、減??；異丙腎上腺素是1、2受體激動(dòng)劑，可使心率加快，心收縮力增強(qiáng)，可使血管舒張，骨骼肌舒張，可松弛支氣管平滑肌。4：適應(yīng)癥：高血壓、心絞痛、心率失常；禁忌癥：心功能不全、竇性心率過(guò)緩、房室傳導(dǎo)延擱、支氣管哮喘、肝功能不全。5:a生物合成：膽堿和乙酰輔酶A在膽堿乙?；复呋?，合成ACh。b釋放：胞裂外排。c消除：被乙酰膽堿酯酶水解。6：1受體：主要分布于血管平滑肌、瞳孔開(kāi)大肌、心臟和肝臟，激活后產(chǎn)生縮瞳、血管平滑肌收縮等；2受體：主要存在于去甲腎上腺能及膽堿能神經(jīng)末梢的突觸前膜，也存在于肝細(xì)胞、血小板、脂肪細(xì)胞、血管平滑肌上，激活后可產(chǎn)生血管平滑肌收縮等；1受體：主要分布于心臟、腎小球旁細(xì)胞，

29、激活后可使心臟產(chǎn)生正性變化；2受體：主要分布于支氣管平滑肌、骨骼肌、和肝臟，激活后可使支氣管平滑肌舒張、骨骼肌舒張；3受體：主要分布于脂肪細(xì)胞、心臟，激活后可對(duì)脂肪的分解起調(diào)節(jié)作用。1：B    2：D   3：C   4：A   5：A   6：B    7：D Cardiovascular System Dry cough  is a common, annoying side effect to the use

30、 of which of the following drugs? （  ）A. Angiotensin-converting enzyme inhibitors    B.calcium channel-blockers C. - blockers  D. M- blockers22 Which of the following drug is the first choice for hypertensive crisis （ ）A. clonidine B. sodium nitroprusside

31、 C. -receptor blocker D .thiazides diuretics  33Adverse reaction of ACEI include all of the following EXCEPT A. hypotension   B. cough   C. hyperkaliemia   D. hypokaliemia 44Which of the following drugs is considered to be most effective in relieving and preventing

32、 ischemic episodes in patients with variant angina? （ ）A. propranolol B. diltiazem C. nifedipine D. verapamil 55A drug that decreases blood pressure by a CNS action is （ ）A. captopril B. Propranolol C. nitroprusside sodium D. Clonidine66.Which of the following

33、 is unlikely to occur with nitroglycerin? （  ）A. Decreased heart rate    B. Decreased end-diastolic blood pressure C. Decreased myocardial oxygen demand  D. Decreased preload and afterload 77Propranolol is a potent blocker of beta-adrenergic sympathetic activity. It has been

34、 found to be detrimental in patients with: （  ）A. bronchial asthma B. hypertension C. hyperthyroidism D. atrial fibrillation 88Which of following antihypertensive drug is AT1 antagonist:（  ）A. captopril   B. nifedipine C. losartan D. thiazides 99Vera

35、pamil exerts its effects through which of the following actions? （  ）A. Preventing entry of calcium through slow channels B. Enhancing potassium effluxC. Increasing sodium entry D.Antagonizing the opening of the fast sodium channel 10The drugs could be used for treatment of CHF (congestive

36、 heart failure) (  )a  digoxin  b hydrochlorothiazide   c captopril   d all of a, b and c  Questions1.What is the signs of cardiac glycosides intoxication and how to prevent or treatment?2.List the pharmacological actions and indications of the

37、cardiac glycosides.3.List the mechanism and indications of antiangina agents including nitroglycerin, propranolol and calcium channel blocker.4.Describe the pharmacological basis of treating angina pectoris in combination of nitroglycerin and propranolol.5. Classify the drugs for antihypertention an

38、d give examples.6.List the mechanism and indications of ACEI and lorsartan. 1.A   2.B  3.D  4.C  5.D  6.A  7.A  8.C  9.A  10.D  1:中毒癥狀有：胃腸道反應(yīng)：厭食、惡心、嘔吐、腹瀉等；中樞神經(jīng)系統(tǒng)：眩暈、頭痛、疲倦、失眠、視覺(jué)障礙等；心臟反應(yīng)：各種心律失常癥狀。防治：若出現(xiàn)癥狀，應(yīng)及時(shí)減量或停用強(qiáng)心苷和排鉀利尿藥?？焖傩托穆墒С?，應(yīng)及時(shí)補(bǔ)鉀，對(duì)重癥快速

39、性心律失常，用苯妥英鈉救治；利多卡因可用來(lái)治療強(qiáng)心苷引起的嚴(yán)重室性心動(dòng)過(guò)速和心室纖顫，對(duì)于房室傳導(dǎo)阻隔、竇性心動(dòng)過(guò)緩、竇性停博，可用阿托品經(jīng)脈注射治療。2：強(qiáng)心苷藥理作用：正性肌力作用、減慢心率作用、對(duì)心臟的負(fù)性傳導(dǎo)作用；適應(yīng)癥：慢性心功能不全：對(duì)心瓣膜病、先天性心臟病、動(dòng)脈粥樣硬化及高血壓引起的心力衰竭效果良好，對(duì)伴有心房顫動(dòng)或心室率過(guò)快者療效最好；某些心率失常如：心房纖顫、心房普動(dòng)、陣發(fā)性室上性心動(dòng)過(guò)速。3：硝酸甘油的基本藥理作用為松弛平滑肌，能降低心臟前后負(fù)荷，降低心肌耗氧量，改變冠脈血液分布，增加缺血區(qū)血液灌注；可用與緩解各種類型心絞痛癥狀或預(yù)防心絞痛的發(fā)作，如：心絞痛、急性心肌梗死、

40、慢性心力衰竭及用于控制血壓。普萘洛爾可以降低心肌耗氧量、改善心肌缺血區(qū)供血，可用于治療心絞痛及心肌梗死。4.因?yàn)檫@2種藥物可以取長(zhǎng)補(bǔ)短，硝酸甘油的優(yōu)點(diǎn)是：降低心室壁張力、心室容積及心室壓力，缺點(diǎn)是：升高心率和心肌收縮力；普萘洛爾的優(yōu)點(diǎn)是：降低心率及心肌收縮力，缺點(diǎn)是：心室容積增大。5：1腎素-血管緊張素系統(tǒng)抑制藥：ACEI：卡托普利；AT1受體阻斷藥;氯沙坦；2Ca+通道阻滯藥：硝苯地平；3：利尿藥：氫氯噻嗪；4交感神經(jīng)抑制藥：中樞性降壓藥：可樂(lè)定；神經(jīng)節(jié)阻斷藥：美加明；去甲腎上腺素能神經(jīng)末梢阻斷藥：利血平；腎上腺素首體阻斷藥：哌唑嗪、普萘洛爾及拉貝羅爾；5血管擴(kuò)張藥：直接擴(kuò)血管藥：硝普鈉；鉀

41、通道開(kāi)放藥：二氮嗪。6：作用機(jī)制：抑制循環(huán)及局部組織的ACE、減少緩激肽的降解、抑制交感神經(jīng)遞質(zhì)的釋放、自由基清除作用，可用于治療高血壓、慢性心功能衰竭、治療急性心肌梗死與預(yù)防心腦血管意外、治療糖尿病性腎病及其他腎??；氯沙坦對(duì)AT1受體有選擇性阻斷作用，可用于高血壓的治療。Central Nervous System The use of morphine is contraindicated in(A) myocardial infarction   (B) acute pulmonary edema   (C) simple diarrhe

42、a(D) kidney colic            (E) bronchial asthma 2. Effects of phenothiazines include all the following EXCEPT(A) orthostatic hypotension, constipation, and urinary retention(B) Parkinson-like syndrome (C) hypoprolactinemia 

43、  (D) antiemesis(E) control of psychotic behavior 3. Akathisia, Parkinson-like syndrome, galactorrhea, and amenorrhea are side effects of perphenazine, caused bya. Blockade of muscarinic receptorsb. Blockade of -adrenergic receptorsc. Blockade of dopamine receptorsd. Supersensitivity of do

44、pamine receptorse. Stimulation of nicotinic receptors4. The pharmacologic effects of morphine include all EXCEPT:a. behavioral changesb. miosisc. respiratory depressiond. diarrheae. postural hypotension Questions1.What is the mechanism of central actions of benzodiazepines?2.How do chlorpromazi

45、ne compare with aspirin in reducing hyperthermia?3.How do pethidine compare with aspirin in analgesic actions?4.What is the site and mechanism of antipsychotic actions of chlorpromazine?5.List the CNS actions and main adverse reactions of chlorpromazine?6.List the CNS actions, mechanism and indicati

46、ons of morphine.7.How dose aspirin influence blood clotting?8.What is the relationship between dose and pharmacology of aspirin?9.What is the untoward effects of aspirin and how to prevent it?10. Describe how barbiturates affect CNS function and the differences between barbiturates and benzodiazepin

47、es. 1:E  2:C  3:C  4:D    1:苯二氮卓類作用機(jī)制為：它通過(guò)增加GABA控制的Cl-通道的開(kāi)放頻率，使得神經(jīng)細(xì)胞超極化，產(chǎn)生突觸后抑制效應(yīng)，從而加強(qiáng)對(duì)突觸的抑制作用。2：阿司匹林的降溫作用是因?yàn)樗种屏讼虑鹉XCOX，阻斷了PGE2合成，使體溫調(diào)節(jié)中樞的體溫調(diào)定點(diǎn)恢復(fù)正常，與環(huán)境溫度無(wú)關(guān)，只對(duì)發(fā)熱病人有影響；而氯丙嗪降溫作用是因?yàn)樗种屏讼虑鹉X體溫調(diào)節(jié)中樞，使體溫調(diào)節(jié)失靈，與環(huán)境溫度有關(guān)，它也可降低正常人的體溫。3：哌替啶的鎮(zhèn)痛作用是它可以激動(dòng)阿片受體，從而鎮(zhèn)痛作用；而阿司匹林是通過(guò)抑制外周病變部位的C

48、OX，使PGs合成減少而減輕疼痛。4：作用部位大腦的中腦-邊緣系統(tǒng)和中腦-皮質(zhì)系統(tǒng)，作用機(jī)制為氯丙嗪可以阻斷這2個(gè)系統(tǒng)的D2樣受體。5.中樞神經(jīng)系統(tǒng)作用有：抗精神病作用、鎮(zhèn)吐作用、對(duì)體溫調(diào)節(jié)作用、加強(qiáng)中樞抑制藥作用；主要不良反應(yīng)有嗜睡、困倦、無(wú)力等中樞抑制作用，還有視力模糊、心動(dòng)過(guò)速、口干、便秘等阿托品樣作用，還有藥源性帕金森綜合癥、靜坐不能、急性肌張力障礙、遲發(fā)性運(yùn)動(dòng)障礙、過(guò)敏反應(yīng)等。6：中樞神經(jīng)系統(tǒng)作用為鎮(zhèn)痛和鎮(zhèn)靜、抑制呼吸、鎮(zhèn)咳、催吐、縮瞳、對(duì)體溫的影響等；機(jī)制為通過(guò)激動(dòng)阿片受體；適應(yīng)癥為劇烈疼痛、心源性哮喘、腹瀉等。7：小劑量阿司匹林可以不可逆地抑制血小板的COX，由于成熟血小板不再合

49、成新的COX，所以受小屋影響的血小板永久性地喪失了合成TXA2的能力，而TXA2是誘發(fā)血小板聚集和血栓形成的重要內(nèi)源性物質(zhì)。8：小劑量阿司匹林可以不可逆地抑制血小板的COX，所以受小屋影響的血小板永久性地喪失了合成TXA2的能力，這是阿司匹林抗血栓形成機(jī)制；而大劑量也同時(shí)血管內(nèi)皮細(xì)胞合成PGI2，從而促進(jìn)血小板和血栓形成。9：胃腸道反應(yīng)：應(yīng)餐后服用、出血及凝血障礙：使用維生素K預(yù)防及手術(shù)前一周停用阿司匹林、水楊酸反應(yīng)：一旦出現(xiàn)立即停藥，加服或靜脈滴注碳酸氫鈉、瑞夷綜合癥：病毒感染時(shí)慎用阿司匹林、阿司匹林哮喘：用腎上腺素可部分對(duì)抗。10：巴比妥類藥物對(duì)中樞神經(jīng)作用為:它可以激動(dòng)GABAA受體，增

50、加Cl-內(nèi)流的時(shí)間，而苯二氮卓類作用機(jī)制為：它通過(guò)增加GABA控制的Cl-通道的開(kāi)放頻率，使得神經(jīng)細(xì)胞超極化，產(chǎn)生突觸后抑制效應(yīng)，從而加強(qiáng)對(duì)突觸的抑制作用。 Glucocorticoids 1.Glucocorticoids can be used for relief of the severe inflammatory symptoms caused by severe septic diseases. In that case, glucocorticoids must be used with        . 2.

51、List the mechanism and indications of glycocorticoids.3.To a patient suffered from Addisons disease, how and why a doctor use the glycocorticoids. 4.List the effects of glycocorticoids on blood cell components.1.足量有效抗菌藥物。2。作用機(jī)制：這類藥物大部分效應(yīng)系糖皮質(zhì)激素受體介導(dǎo)的基因效應(yīng)，即與細(xì)胞內(nèi)GR結(jié)合，通過(guò)啟動(dòng)基因轉(zhuǎn)錄或抑制基因轉(zhuǎn)錄，促進(jìn)合成某些特異性蛋白質(zhì)，或抑制某些特異性

52、蛋白質(zhì)的合成，從而產(chǎn)生藥理效應(yīng)。適應(yīng)證：嚴(yán)重感染或預(yù)防炎癥后遺癥、自身免疫病、器官移植排異反應(yīng)、過(guò)敏性疾病、抗休克治療、替代療法、局部應(yīng)用、血液病。3.因?yàn)椴∪嘶加羞@一疾病，腎上腺皮質(zhì)功能減退，導(dǎo)致糖皮質(zhì)激素分泌不足，故需要糖皮質(zhì)激素來(lái)治療，這是一種替代療法。補(bǔ)充可維持正常神力功能的生理劑量的糖皮質(zhì)激素即可。4.糖皮質(zhì)激素可以降低外周血單核細(xì)胞、淋巴細(xì)胞、嗜酸性和嗜堿性粒細(xì)胞，可使紅細(xì)胞和血紅蛋白含量增加。大劑量可使血小板和纖維蛋白原增加、中性粒細(xì)胞數(shù)增多。 Chemotherapy The most active aminoglycoside against Mycobacteri

53、um tuberculosis is（  ）A. Streptomycin B. Amikacin   C. Neomycin   D. Kanamycin   2 The use of chloramphenicol may result in（  ）A. Bone marrow stimulation B. Phototoxicity C. Aplastic anemia D. Staining of teeth    3characteri

54、stics of the third-generation cephalosporins EXCEPT （ ）A .broad-spectrum of activity   B .easy permeation the blood-brain barrier C. activity to gram-positivegram-negative D. little renal toxicity    4 An inhibitor of DNA-dependent RNA polymerase, useful in tuberculosis

55、, is （ ）A. isoniazid    B. streptomycin   C. rifampin.   D. penicillin.    5Ototoxicity is a rare but serious manifestation of A. hydrochlorothiazide B. ethacrynic acid C. spironolactone D. triamterene    6Adverse effects resultin