在老年人中呈现为跌倒的化物诱导的低血症
Stephanie Pagliuca1,2, Caroline Wagner3, Brittany L Pietruszka3
1New England Geriatrics Research, Education, and Clinical Center (GRECC), Veterans Affairs Boston Healthcare System, Massachusetts.
概括
开始服用 thiazide 利尿剂的老年人面临低血症的风险,这是一种严重的电解质障碍. 在开始老年人这种常见的高血压治疗之前,仔细考虑这种风险至关重要.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 无复杂的高血压治疗通常涉及提亚齐德利尿剂,通道阻断剂和氨酸 - 血管新生素系统抑制剂.
- 老年人更容易受到药物不良事件的影响,但针对这一群体的特定抗高血压指南有限.
- 高血压在老年人中很普遍,需要意识到潜在的药物相关并发症,如电解质失衡.
研究的目的:
- 为了突出电解质障碍的风险增加,特别是低血症,与老年人使用 thiazide 利尿剂有关.
- 强调需要对老年人群中 thiazide 诱导的低血症保持临床警.
主要方法:
- 一例病例介绍,一名90岁以上的患者在开始服用甲酸后出现了低血症.
- 实验室分析证实了二次性对 thiazide 启动的低血压低度低度低度.
- 观察患者在停止用甲治疗后的恢复情况.
主要成果:
- 在老年患者中,启动甲酸的治疗导致hypovolemic hypoosmotic hyponatremia. 在老年患者中,启动甲酸导致hypovolemic hypoosmotic hyponatremia.
- 停用甲酸导致水平在两周内逐渐正常化.
- 患者经历了一次跌倒,可能与药物的不良影响有关.
结论:
- 虽然提亚齐德利尿剂被推作为一线高血压治疗,但在老年人中可能会带来重大风险.
- 临床医生在给老年患者开这些药物之前,应仔细评估化物诱导的低血症的危险因素.
- 老年人中 thiazide 利尿剂的危害潜力需要谨慎考虑和监测.
相关概念视频
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Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
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01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
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01:29Disorder of Water Balance
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Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
356
01:25Regulation of Water Intake
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Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
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01:22Heart Failure Drugs: Diuretics
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01:24Renal Tubule and Collecting Duct
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Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...
Proximal Convoluted Tubule (PCT):
The PCT is the initial segment of the renal tubule, extending from the Bowman's capsule that encloses the glomerulus. Its convoluted structure and microvilli-lined cells increase the surface area for reabsorption. The PCT reabsorbs glucose, amino acids, sodium, and water from the filtrate, ensuring essential...
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