大家好 小弟有药物治疗学国考题的问题 在问问题之前 先感谢 k2412391药师 Lr1药师 cmvct723d药师 百忙抽空给予见解 以下是小弟的问题 麻烦好心的人提出见解或建议 谢谢 19 在为ClCr＝23 mL/min 的病人选用下?ACEIs 药品治疗时， 何者最应依肾功能做剂量之调整？ (A)benazepril(B)enalapril(C)fosinopril(D)trandolapril 答案为(B) Applied 8th 提到ClCr传统单位标准直为75-100 mL/min 所以此病人ClCr＝23 mL/min 明显偏低 小弟想问题目指的依肾功能做剂量之调整 是看此药物的Metabolism还是Excretion方式 小弟查 MICROMEDEX Healthcare Series得以下资料 我不太会用批踢踢颜色显示功能,所以请好心的人,耐心看我查的资料 之後我会问人如何使用批踢踢颜色显示功能已显示表达的重点 谢谢^^" Benazepril Metabolism Systemic: Amlodipine- Hepatic Benazepril- Hepatic: Active metabolite: benazeprilat Excretion Systemic: Amlodipine- Fecal: 20 to 25%; Renal: 70% Benazepril- Renal Elimination Half Life Systemic: Amlodipine- 35 h Adults; 65 h Elderly Benazeprilat- 10 to 11 h enalapril Metabolism Enalapril (prodrug); hydrolysis Active metabolite: enalaprilat (active drug) Excretion Fecal and Renal: 94% as prodrug and active drug (primarily in urine) Enalaprilat (active drug), Renal: 40% Enalaprilat (active drug), Dialyzable: yes (hemodialysis); yes (peritoneal dialysis), neonates Elimination Half Life Enalaprilat (active drug): 11 h Enalaprilat (active drug), Renal insufficiency: prolonged (glomerular filtration rate of less than or equal to 30 mL/min) Fosinopril Metabolism Fosinopril (prodrug)-Hepatic; esterases; hydrolysis Metabolites: fosinoprilat (active), glucuronide conjugate of fosinoprilat and p-hydroxy metabolite of fosinoprilat Excretion Fosinopril (prodrug), Fecal: approximately half of absorbed dose Fosinopril (prodrug), Renal: approximately half of absorbed dose Fosinopril (prodrug), Dialyzable: not well dialyzed Fosinoprilat (active drug), Renal: (IV) Fosinoprilat (active drug), Dialyzable: poorly removed (hemodialysis), 2% removed; poorly removed (peritoneal dialysis), 7% removed Elimination Half Life Fosinoprilat (active drug), healthy subjects: (IV), approximately 12 h Fosinoprilat (active drug), hypertensive patients: 11.5 h Fosinoprilat (active drug), heart failure patients: 14 h Fosinoprilat (active drug), pediatric patients: 11 h to 13 h Trandolapril Metabolism Systemic: Hepatic: Metabolite: trandolaprilat Excretion Systemic: Fecal: 66%; Renal: 33%. Elimination Half Life Systemic: Trandolapril: 6 h. Trandolaprilat: 10 h. --

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