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href='/linchuangyishi/'>臨床執(zhí)業(yè)醫(yī)師</a> > <a href='/linchuangyishi/qita/'>其他信息</a></div> </div> <div id="g3ajyd4" class="layout clearfix msf new-wrap"> <div id="ahtsbbh" class="new_left fl"> <div id="fh9sv4i" class="news_mian"> <div id="rta4qfm" class="tit"> <h1>?？┻褂梅椒?/h1> <div id="sjp938q" class="mark clearfix"> <div id="d4nluzq" class="fl"> <span id="fhiraqm" class="time">2008-08-07 19:06</span> <a href="http://thedailypurge.net" title="醫(yī)學(xué)教育網(wǎng)" class="a1">醫(yī)學(xué)教育網(wǎng)</a> </div> <a href="javascript:void(0)" onclick="window.external.AddFavorite(location.href,document.title);" target="_self" class="collection ico fr"></a>  <div id="jvh4n39" class="fen fr">|</div> <div id="ph4w9zt" class="font_size fr ico"><a href="javascript:void(0);" target="_self" class="big lan ico">大</a><a href="javascript:void(0);" target="_self" class="small ico">小</a></div> </div> </div> </div>  <div style="width: 800px;text-align: left;margin: 0 auto;margin-bottom: 20px;"> <div style="width:800px; height:90px;"> <a href="http://thedailypurge.net/yishizigekaoshi/baoming/li2412107427.shtml" target="_blank"> <img title="報(bào)名預(yù)約" src="http://thedailypurge.net/upload/resources/image/2024/12/12/826342.png" width="800" height="90" style="border:0px;"></a> </div> </div> <div style="BORDER-BOTTOM: #7f8d98 1px dashed;BORDER-LEFT: #7f8d98 1px dashed;PADDING-BOTTOM: 8px;LINE-HEIGHT: 26px;MARGIN-TOP: -4px;MARGIN-BOTTOM: 20px;PADDING-LEFT: 7px;PADDING-RIGHT: 5px;FONT-SIZE: 16px;BORDER-TOP: #7f8d98 1px dashed;BORDER-RIGHT: #7f8d98 1px dashed;PADDING-TOP: 8px;"><span style="COLOR: #000000"> <p style="text-align:center"><strong><font color="#ff6600">熱點(diǎn)推薦</font></strong> </p> <table cellspacing="0" bordercolordark="#ffffff" cellpadding="0" width="100%" align="center" bordercolorlight="#000000" background="/template/listDetailGgw/" border="1" bor=""> <tbody align="center"> <tr class="firstRow"> <th style="border-top: 1px solid rgb(255, 255, 255); border-right-style: solid; border-bottom-style: solid; border-left-style: solid; border-right-color: rgb(255, 255, 255); border-bottom-color: rgb(255, 255, 255); border-left-color: rgb(255, 255, 255); color: rgb(51, 51, 51); background-color: rgb(222, 245, 255); padding: 6px 5px;" rowspan="1" colspan="3"> <span style="color: #C00000;">——●●●聚焦熱點(diǎn)●●●——</span> </th> </tr> </tbody> <tbody align="center"> <tr><td style="border-style: solid; border-color: #fff;color: #333; background-color: #f1fbff;padding: 10px 5px;"> <a href="http://thedailypurge.net/yishizigekaoshi/baoming/li2412107427.shtml" target="_blank" style="color: rgb(0, 0, 255); text-decoration: underline;"><span style="color: rgb(0, 0, 255);">報(bào)名預(yù)約>></span></a> </td> <td style="border-style: solid; border-color: #fff;color: #333; background-color: #f1fbff;padding: 10px 5px;"> <a href="http://thedailypurge.net/yishizigekaoshi/kaoshijingyan/ha2412111216.shtml" target="_blank" style="color: rgb(0, 0, 255); text-decoration: underline;"><span style="color: rgb(0, 0, 255);">有問(wèn)必答>></span></a> </td> <td style="border-style: solid; border-color: #fff;color: #333; background-color: #f1fbff;padding: 10px 5px;"> <a href="http://thedailypurge.net/OtherItem/baomingpingce/index2.shtml" target="_blank" style="color: rgb(0, 0, 255); text-decoration: underline;"><span style="color: rgb(0, 0, 255);">報(bào)考測(cè)評(píng)>></span></a> </td> </tr> </tbody> </table> <p></p> </span> </div>  <div id="9pb4pab" class="news_con"> <div id="i9sr4bg" class="jxbox clearfix"> <P><STRONG>　　藥理：</STRONG></P> <P>　　本品系常山乙素改造結(jié)構(gòu)所得。其作用類似奎尼丁，具有抗迷走和輕度局麻作用。電生理研究表明，本品能降低0相最大上升幅度，延長(zhǎng)心房及房室結(jié)的有效不應(yīng)期。實(shí)驗(yàn)研究表明，本品能對(duì)抗烏頭堿所致的實(shí)驗(yàn)性<a href="http://thedailypurge.net/jibing/xinlvshichang/" target="_blank" title="心律失常" class="hotLink">心律失常</a>，提高致室顫閾值?？墒瓜Ｊ鲜妶D中AH及HV間期延長(zhǎng)，部分抑制細(xì)胞膜上的Na<SUP>+</SUP>、K<SUP>+</SUP>、ATP酶，但作用不及奎尼丁強(qiáng)，尚有輕度負(fù)性肌力作用，使心輸出量和左室功能下降。</P> <P>　　藥動(dòng)學(xué)</P> <P>　　口服吸收良好，3～4h達(dá)血藥濃度峰值。靜脈滴注后10～30min起效，作用持續(xù)時(shí)間約4h.有效血藥濃度為216±0.7μg/ml，血中半減期α相為4.1min，β相為3.2h.清除率為20.7ml/min.主要在肝內(nèi)代謝，50％由尿排出。</P> <P><STRONG>　　適應(yīng)癥：</STRONG></P> <P>　　適用于治療頑固性室性早搏、短陣室性心動(dòng)過(guò)速療效顯著。對(duì)房性早搏、陣發(fā)性室上性心動(dòng)過(guò)速、陣發(fā)性房顫也有一定效果。靜脈滴注，適用于頻繁室性早搏、預(yù)激綜合征伴室上性心動(dòng)過(guò)速或室性心動(dòng)過(guò)速等。由于本品口服后易致皮膚色澤改變等，因此，臨床應(yīng)用受到限制。</P> <P><STRONG>　　用法用量：</STRONG></P> <P>　　口服，成人一般一次0.2g，一日3-4次；小兒用量酌減。維持量一次0.2g，一日1-2次，一療程一般為一個(gè)月。靜脈滴注一次0.25g，溶于葡萄糖溶液中滴注。醫(yī)學(xué)教育網(wǎng)搜集整理</P> <P>　　[用法及用量]口服，每次200mg，每日3～4次。<a href="http://thedailypurge.net/jibing/xinlvshichang/" target="_blank" title="心律失常" class="hotLink">心律失常</a>控制后可改為維持量，每次200mg，每日1～2次。</P> <P>　　靜脈滴注，以500mg加于5％葡萄糖液500ml中，以3.5mg／min開(kāi)始，有效后改為2.5mg／min維持。</P> <P>　　靜脈推注，每次30～50mg加于25％葡萄糖液20ml中緩慢靜脈推注。</P> <P>　　服藥期間，應(yīng)定期檢查血白細(xì)胞計(jì)數(shù)、肝功能和心電圖。</P> <P>　　經(jīng)常注意皮膚粘膜色澤改變，體溫變化，如發(fā)現(xiàn)異常，應(yīng)減量或停用。</P> <P>　　如發(fā)現(xiàn)血清谷丙轉(zhuǎn)氨酶增高，應(yīng)立即停藥，必要時(shí)，給以保肝藥物。</P> <P>　　如出現(xiàn)藥疹或藥物熱，應(yīng)及時(shí)停藥，并給以抗過(guò)敏藥物。</P> <P>　　如出現(xiàn)血白細(xì)胞減少，除及時(shí)停藥外，并給以維生素B4、鯊肝醇、利血生等升高白細(xì)胞的藥物。</P> <P>　　[劑型與規(guī)格]片劑：200mg／片。注射劑：100mg/2ml.避光、密閉保存。</P> <P><STRONG>　　禁用慎用：</STRONG></P> <P>　　孕婦禁用，肝、腎功能不全、嚴(yán)重心臟傳導(dǎo)阻滯、原有心力衰竭者慎用。老年人宜減量使用。</P> <P><STRONG>　　給藥說(shuō)明：</STRONG></P> <P>　　服藥期間，應(yīng)定期檢查血白細(xì)胞計(jì)數(shù)、肝功能和心電圖。</P> <P>　　經(jīng)常注意皮膚粘膜色澤改變，體溫變化，如發(fā)現(xiàn)異常，應(yīng)減量或停用。</P> <P>　　如發(fā)現(xiàn)血清谷丙轉(zhuǎn)氨酶增高，應(yīng)立即停藥，必要時(shí)，給以保肝藥物。</P> <P>　　如出現(xiàn)藥疹或藥物熱，應(yīng)及時(shí)停藥，并給以抗過(guò)敏藥物。</P> <P>　　如出現(xiàn)血白細(xì)胞減少，除及時(shí)停藥外，并給以維生素B4、鯊肝醇、利血生等升高白細(xì)胞的藥物。</P> <P><STRONG>　　不良反應(yīng)：</STRONG></P> <P>　　頭暈，乏力，惡心，嘔吐，少數(shù)病人可出現(xiàn)皮疹，發(fā)熱，視物模糊?？梢鸶文I損害，白細(xì)胞減少。</P> <P>　　口服常見(jiàn)不良反應(yīng)為皮膚粘膜色澤改變（17.8％），呈淡黃、深褐或死灰色，口唇及眼圈發(fā)黑，這與藥物結(jié)品所致色素沉著引起黑變病有關(guān)。少數(shù)見(jiàn)血清谷丙轉(zhuǎn)氨酶升高、白細(xì)胞減少。藥疹、藥物熱，心電圖示有PR間期延長(zhǎng)或ST-T改變，需停藥，在停藥后可自行消失。此外，尚有頭暈、乏力、胃腸道不適、皮膚瘙癢、口唇皰疹等，但均不影響治療。靜脈推注可引起低血壓。</P> </div> </div>  <div 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