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[慢性肾脏病患者麻醉相关药物的药代动力学]

[Pharmacokinetics of anesthesia related drugs in patients with chronic kidney disease].

作者信息

Tsubokawa Tsunehisa

机构信息

Department of Anesthesiology, Postgraduate School of Medicine, Kanazawa University, Kanazawa 920-8641.

出版信息

Masui. 2013 Nov;62(11):1293-303.

Abstract

For anesthetic management, various kinds of drugs are administered to the patient. When unchanged drugs or their active metabolites are eliminated from the kidney, renal function has significant effects on the pharmacokinetics of the drugs. Generally, in such cases, drug or metabolite clearance shows a positive relation with glomerular filtration rate. When these drugs are administered to patients with renal impairment, drug concentrations are increased, prolonging the pharmacological effects or causing side-effects. In anesthesia related drugs, morphine, muscle relaxants, antibiotics and phosphodiesterase III inhibitors require special attention. Their dosages should be adjusted according to parameters of renal function such as creatinine clearance.

摘要

对于麻醉管理,会给患者使用各种药物。当未变化的药物或其活性代谢产物经肾脏排出时,肾功能对药物的药代动力学有显著影响。一般来说,在这种情况下,药物或代谢产物的清除率与肾小球滤过率呈正相关。当给肾功能损害的患者使用这些药物时,药物浓度会升高,从而延长药理作用或引起副作用。在麻醉相关药物中,吗啡、肌肉松弛剂、抗生素和磷酸二酯酶III抑制剂需要特别关注。它们的剂量应根据肌酐清除率等肾功能参数进行调整。

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