利尿药和脱水药双语版定稿课件.pptVIP

第23章 利尿药和脱水药 Diuretics and Dehydrate agents;本次课要求掌握的主要内容;中文：利尿药是直接作用于肾脏，增加电解质和水的排出，使尿量增多的药物。;但是，并非增加尿量的药物都是利尿药，如强心苷改善心衰，增加心排量，也使尿量增加，但其不作为利尿药。;利尿药 增加尿量和排钠，在用高血压、心衰、肾衰、肾病综合征和肝硬化等病变时，来调节体液的量和/或成份。;利尿药是直接作用于肾小管上皮细胞、增加尿液形成率的物质。 ;利尿药是一类促进钠和水排泄、使尿量增加的药物。 ;利尿药 用于高血压、心衰、肾衰、肾病综合征和肝硬化等病变时，调节体液的量和/或成份。;临床用于：治疗各种水肿、高血压、尿崩症、肾结石等。 ;Renal Anatomy and Physiology;Figure 28-5.. NaHCO3 reabsorption in proximal tubule. A, antiporter; S, symporter; CH, ion channel. (The actual reaction catalyzed by carbonic anhydrase is OH-?+ CO2→HCO3-; however, H2O →OH-?+ H+, and HCO3-?+ H+?→H2CO3, so the net reaction is H2O + CO2→ H2CO3.) Numbers in parentheses indicate stoichiometry. BL and LM indicate basolateral and luminal membranes, respectively. ;S, symporter; CH, ion channel. Numbers in parentheses indicate stoichiometry. Designated voltages are the potential differences across the indicated membrane or cell. The mechanisms illustrated here apply to the medullary, cortical, and post macular segments of the thick ascending limb. BL and LM indicate basolateral and luminal membranes, respectively.  GG 11th，2006;Figure 28-7. NaCl reabsorption in distal convoluted tubule;Figure 28-8. Na+ reabsorption in late distal tubule and collecting duct. Cl- reabsorption (not shown) occurs both paracellularly and transcellularly, and the precise mechanism of Cl- transport appears to be species-specific. A, antiporter; CH, ion channel; CA, carbonic anhydrase. Numbers in parentheses indicate stoichiometry. Designated voltages are the potential differences across the indicated membrane or cell. BL and LM indicate basolateral and luminal membranes, respectively. ;AIP, aldosterone-induced proteins; ALDO, aldosterone; MR, mineralocorticoid receptor; CH, ion channel; ①activation of membrane-bound Na+channels; ②redistribution of Na+ channels from cytosol to membrane; ③de novo synthesis of Na+ channels; ④activation of membrane-bound Na+, K+-ATPase; ⑤ redistri-bution of Na+,K+-ATPase from cytosol