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Jingdong book

专科用药处方分析丛书·心血管内科常见病用药处方分析

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专科用药处方分析丛书·心血管内科常见病用药处方分析

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中国已有27.8万多医疗机构,建立了较为完善而庞大的医疗卫生服务体系,广大医务人员为保障民众健康而努力地工作着。中国是世界人口最多的大国,也是药品使用大国,随着国民经济的发展、民众生活水平的提高和保健意识的增强,药品用量将会有更大的提升。
我国建国初期,由于战争的破坏,制药工作的落后和国外的封锁,药品严重匮乏,只有500~600种一般常用药品,临床用药简单,没有太多药品可供选择的余地,不合理用药情况也不多。那时政府赋予医院药学部门和药师的任务是保证患者诊断和治疗疾病对药品的基本需求。医院制剂就是在此背景下兴起和发展的,鼎盛时期各医院制剂达200~400种,当时医院制剂占医师处方用药的比例:内科医师处方约占1/3,五官科处方约占1/2,皮肤科约占2/3。
Catalogue

第一章 概论
第一节 心血管疾病的病因、病理生理改变和防治策略
一、病因分类
二、病理生理改变
三、防治策略
第二节 合理使用心血管药物
一、强心药物
二、利尿药物
三、调血脂药物
四、β受体阻断剂
五、血管紧张素转化酶抑制剂
六、血管紧张素Ⅱ受体拮抗剂
七、钙离子拮抗剂
八、溶栓药物
九、抗凝血和抗血小板药物
十、抗心律失常药物
十一、硝酸酯类药物
十二、四种药物联合应用

第二章 心功能不全
第一节 概述
第二节 合理处方
A2-1缺血性心肌病伴慢性心功能不全
A2-2急性心肌梗死伴二尖瓣反流和急性心功能不全
A2-3缺血性心肌病伴心房颤动和难治性心功能不全
A2-4高血压性心脏病伴舒张性心功能不全
A2-5冠心病伴无症状性心功能不全
第三节 不合理处方
B2-1高血压性心脏病伴慢性心功能不全
B2-2风湿性心脏病伴二尖瓣狭窄、心房颤动和急性左心功能不全
B2-3高血压性心脏病伴舒张性心功能不全
B2-4肥厚性梗阻型心肌病伴舒张性心功能不全
B2-5慢性心肌炎伴无症状性心功能不全

第三章 休克
第一节 概述
第二节 合理处方
A3-1失水性休克
A3-2失血性休克
A3-3大面积心肌梗死伴心源性休克
A3-4急性心肌梗死伴室间隔穿孔和心源性休克
A3-5急性心肌梗死伴急性二尖瓣反流和心源性休克
A3-6急性右室梗死、下壁心肌梗死伴心源性休克
A3-7感染性腹膜炎伴感染性休克
A3-8创伤性休克
A3-9过敏性休克
第三节 不合理处方
B3-1失血性休克
B3-2右室心肌梗死伴心源性休克
B3-3感染性腹膜炎伴感染性休克
B3-4创伤性休克
B3-5过敏性休克

第四章 心律失常
第一节 概述
第二节 合理处方
一、窦性心律失常
A4-1甲状腺功能亢进伴窦性心动过速
A4-2自主神经功能紊乱伴窦性心动过速
A4-3窦性心动过缓
A4-4病态窦房结综合征
二、房性心律失常
A4-5房性期前收缩
A4-6房性心动过速
三、心房扑动与颤动
A4-7心房扑动
A4-8快速性心房颤动控制心室率和抗凝治疗
A4-9心房颤动转复心律
A4-10快速性心房颤动控制心室率和治疗心功能不全
四、交界性心律失常
A4-11交界性期前收缩
A4-12房室交界区逸搏与心律
A4-13局灶性交界性心动过速
A4-14洋地黄中毒伴非阵发性交界性心动过速
A4-15房室结折返性心动过速
五、预激综合征
A4-16预激伴房室折返性心动过速,
六、室性心律失常
A4-17急性心肌梗死伴室性期前收缩
A4-18扩张型心肌病伴室性心动过速
A4-19急性心肌梗死伴非阵发性室性心动过速
A4-20扩张性心肌病伴束支折返性室性心动过速
A4-21特发性室性心动过速
A4-22短QT综合征
A4-23Brugada综合征
A4-24致心律失常性右室心肌病伴室性心动过速
七、心脏骤停
A4-25心脏骤停一期心肺脑复苏
A4-26心脏骤停二期心肺脑复苏
A4-27心脏骤停三期心肺脑复苏
A4-28心脑肺复苏后继生命支持
第三节 不合理处方
一、窦性心律失常
B4-1风湿性心脏病伴窦性心动过速
……
第五章 高血压
第六章 冠心病
第七章 心脏瓣膜病
第八章 高脂血症
第九章 肺栓塞
第十章 肺动脉高压
第十一章 心脏感染性疾病
第十二章 心肌病
第十三章 外周血管疾病
第十四章 其他血管疾病
主要参考文献
索引
Book Abstract

这些病理生理改变涉及心肌做功、能量代谢、电生理改变、血容量异常、心血管重构、神经内分泌改变、血管内皮功能异常、血脂代谢紊乱、凝血机制、自身免疫等相关因素。在防治心血管病过程中,病因治疗和对症治疗是解除病痛、挽救生命的重要措施;但对某些心血管病来说,纠正潜在的或明显的病理生理异常改变,打断疾病发生、发展或恶化的恶性循环,是重要的治疗方法;祛除各种危险因素也是防治的重要内容。从病理生理角度去研究心血管病的最终转归及其二级预防措施时,可以发现各种不同心血管病的基础治疗和二级预防有许多相似或共同之处,这是因为各种心血管病的发生、发展过程中都有着相似的神经、内分泌、细胞因子改变和心血管重构的病理生理改变过程。
合理、安全、经济地用药,标本兼治,既消除患者的症状,又消除引发这些症状的神经内分泌和细胞因子改变,防治心血管重构,就能做到改善患者症状、延长寿命、提高生活质量。这是ACEI、β受体阻断剂、阿司匹林和他汀类四种药物已广泛用于各种心血管病防治的原因。
Introduction

中国已有27.8万多医疗机构,建立了较为完善而庞大的医疗卫生服务体系,广大医务人员为保障民众健康而努力地工作着。中国是世界人口最多的大国,也是药品使用大国,随着国民经济的发展、民众生活水平的提高和保健意识的增强,药品用量将会有更大的提升。
我国建国初期,由于战争的破坏,制药工作的落后和国外的封锁,药品严重匮乏,只有500~600种一般常用药品,临床用药简单,没有太多药品可供选择的余地,不合理用药情况也不多。那时政府赋予医院药学部门和药师的任务是保证患者诊断和治疗疾病对药品的基本需求。医院制剂就是在此背景下兴起和发展的,鼎盛时期各医院制剂达200~400种,当时医院制剂占医师处方用药的比例:内科医师处方约占1/3,五官科处方约占1/2,皮肤科约占2/3。
随着社会进步,科技发展和改革开放的深化,临床用药发生了很大变化。我国制药工业有了很大发展,外企也大量涌入,现处方药大约有7000种,从缺药转变为绝大多数药品已是供大于求。但在制药工业发展的同时,也产生了一些需要特别关注的问题:由于药品生产企业和经营企业太多,且企业产品质量参差不齐,大量药品低水平重复生产,流通领域不规范竞争严重,患者用药风险大大增加;在药品大量增加的同时还产生了另一个矛盾,即有药可用与医师、药师合理用药知识不足之间产生了较大差距,这在基层医疗机构和年轻医师以及西医师用中药。

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