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促胃肠动力药全解析，请收下这份超全总结！

2021-12-26 陈飞帆 纷飞之翼之住院医师学习笔记 陈飞帆 纷飞之翼之住院医师学习笔记

促胃肠动力药
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促胃肠动力药临床应用，一文解析！

1、概述

  • 胃肠道蠕动增强引起损伤时（胃肠道出血、机械性肠梗阻、穿孔），促胃肠动力药禁用
  • 大多数促胃动力类药物作用于5-HT4，不同程度地导致QT间期延长，避免与可延长QT间期药物联用
  • 电解质紊乱（低钾、低镁血症）、导致低钾药物（如呋塞米）时，联用促胃肠动力药需谨慎
     
2、多巴胺受体拮抗剂
 
图片
3、5-HT4 受体激动剂
 
图片
4、外周性脑啡肽类似物
 
曲美布汀
  • 机制
    • 胃肠运动调节剂
    • 作用于外周阿片类受体
      • 刺激小肠动力，抑制结肠动力，
      • 肠道双向调节（低负荷增加肠蠕动，高负荷减少肠蠕动）
    • 还具有一定的外周镇吐作用
  • 用法
    • 100-200mg，tid，po
  • 不良反应
    • 便秘、腹泻、腹鸣、口渴、口内麻木、心动过速、眩晕倦怠、头痛、皮疹及转氨酶升高
  • 老年人、孕妇、哺乳期妇女及儿童慎用
 5、小结
 
图片
图片

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#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1672999, encodeId=66a816e29999d, content=<a href='/topic/show?id=b79b910345c' target=_blank style='color:#2F92EE;'>#解析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91034, encryptionId=b79b910345c, topicName=解析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f42d26916490, createdName=hongbochen, createdTime=Sun Sep 18 23:36:17 CST 2022, time=2022-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1809286, encodeId=994e180928656, content=<a href='/topic/show?id=a328832e8bd' target=_blank style='color:#2F92EE;'>#胃肠动力药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83278, encryptionId=a328832e8bd, topicName=胃肠动力药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Sun Sep 18 22:36:17 CST 2022, time=2022-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182009, encodeId=02e6118200946, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b0686454051, createdName=ms8000001859380106, createdTime=Fri Jan 07 22:22:09 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084993, encodeId=45301084993cb, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:50:39 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084745, encodeId=a7971084e45e5, content=受教了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM51BQuxXgPibf2Wl7xEbHanMwNNMOgzeVPf8dxHjkQTxPg/0, createdBy=212e2182508, createdName=酒醉蓝天, createdTime=Mon Dec 27 18:33:22 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084592, encodeId=1f13108459221, content=此，熟练掌握心血管急救药物的使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Mon Dec 27 09:28:14 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2022-09-18 hongbochen

    #解析#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1672999, encodeId=66a816e29999d, content=<a href='/topic/show?id=b79b910345c' target=_blank style='color:#2F92EE;'>#解析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91034, encryptionId=b79b910345c, topicName=解析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f42d26916490, createdName=hongbochen, createdTime=Sun Sep 18 23:36:17 CST 2022, time=2022-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1809286, encodeId=994e180928656, content=<a href='/topic/show?id=a328832e8bd' target=_blank style='color:#2F92EE;'>#胃肠动力药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83278, encryptionId=a328832e8bd, topicName=胃肠动力药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Sun Sep 18 22:36:17 CST 2022, time=2022-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182009, encodeId=02e6118200946, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b0686454051, createdName=ms8000001859380106, createdTime=Fri Jan 07 22:22:09 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084993, encodeId=45301084993cb, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:50:39 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084745, encodeId=a7971084e45e5, content=受教了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM51BQuxXgPibf2Wl7xEbHanMwNNMOgzeVPf8dxHjkQTxPg/0, createdBy=212e2182508, createdName=酒醉蓝天, createdTime=Mon Dec 27 18:33:22 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084592, encodeId=1f13108459221, content=此，熟练掌握心血管急救药物的使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Mon Dec 27 09:28:14 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2022-09-18 ms1065684921169360

    #胃肠动力药#

    0

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    2022-01-07 ms8000001859380106

    不错

    0

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    2021-12-28 ms6000000487809205

    学习了

    0

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    2021-12-27 酒醉蓝天

    受教了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1672999, encodeId=66a816e29999d, content=<a href='/topic/show?id=b79b910345c' target=_blank style='color:#2F92EE;'>#解析#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91034, encryptionId=b79b910345c, topicName=解析)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f42d26916490, createdName=hongbochen, createdTime=Sun Sep 18 23:36:17 CST 2022, time=2022-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1809286, encodeId=994e180928656, content=<a href='/topic/show?id=a328832e8bd' target=_blank style='color:#2F92EE;'>#胃肠动力药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83278, encryptionId=a328832e8bd, topicName=胃肠动力药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Sun Sep 18 22:36:17 CST 2022, time=2022-09-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182009, encodeId=02e6118200946, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b0686454051, createdName=ms8000001859380106, createdTime=Fri Jan 07 22:22:09 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084993, encodeId=45301084993cb, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fcdb6159738, createdName=ms6000000487809205, createdTime=Tue Dec 28 07:50:39 CST 2021, time=2021-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084745, encodeId=a7971084e45e5, content=受教了, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmhead/Q3auHgzwzM51BQuxXgPibf2Wl7xEbHanMwNNMOgzeVPf8dxHjkQTxPg/0, createdBy=212e2182508, createdName=酒醉蓝天, createdTime=Mon Dec 27 18:33:22 CST 2021, time=2021-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1084592, encodeId=1f13108459221, content=此，熟练掌握心血管急救药物的使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Mon Dec 27 09:28:14 CST 2021, time=2021-12-27, status=1, ipAttribution=)]
    2021-12-27 查查佳佳

    此，熟练掌握心血管急救药物的使用

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