今天有學妹問我:Lasix為何不建議與prednisolone並用
先看英文描述
MONITOR: The concomitant use of corticosteroids and agents that deplete potassium (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins) may result in increased risk of hypokalemia. Corticosteroids can produce hypokalemia and other electrolyte disturbances via mineralocorticoid effects, the degree of which varies with the agent (from most to least potent: fludrocortisone - cortisone/hydrocortisone - prednisolone/prednisone - other glucocorticoids) and route of administration (i.e. systemic vs. local). However, large systemic doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. When used pharmacologically, adrenocorticotropic agents such as corticotropin have similar mineralocorticoid activities as cortisone and hydrocortisone.
MANAGEMENT: Patients receiving potassium-depleting agents with corticosteroids should be monitored closely for development of hypokalemia, particularly if fludrocortisone or large doses of another corticosteroid or adrenocorticotropic agent is given. Potassium supplementation may be necessary. Patients should be advised to notify their physician if they experience signs of electrolyte disturbances such as weakness, lethargy, and muscle pains or cramps.
雅葶臨床藥師幫忙翻譯的重點:
lasix與prednisolone的藥物交互作用: (屬Moderate Drug-Drug)
1. 當prednisolone併用像是potassium-washing diuretics, amphotericin B,
cation exchange resins等藥物,皆會增加血鉀的降低的危險.
2. 原則上,Corticosteroids類的藥物皆可能影響鉀離子及其他離子濃度,所以皆
須定期監測血中離子濃度.
3. 給予病患的衛教: 請補充日常所需的鉀離子,多攝取如香蕉,瓜類食物,堅果類等食品.
既然都寫到這邊了,提供一下食物的鉀離子表:
中文 | 英文 | 鉀 mg/lb. | 鈉 mg/lb. | 鉀鈉比例 |
大豆 | Soybeans | 7607 | 23 | 331 |
成熟萊豆 | Lima, Mature | 6936 | 18 | 385 |
大豆粉 | Soybean Powder | 4150 | 5 | 830 |
麥胚芽 | Wheat Germ | 3751 | 14 | 268 |
杏仁 | Almonds | 3506 | 18 | 195 |
蘇木 | Brazil | 3243 | 5 | 649 |
榛子 | Filbert | 3193 | 9 | 355 |
棗 | Dates | 2939 | 5 | 588 |
大胡桃 | Pecan | 2735 | Trace | >500 |
黑麥榖粒 | Rye, Whole Grain | 2118 | 5.1 | 423 |
白胡桃南瓜 | Butternut | 1546 | 3 | 515 |
豬火腿 | Pork, Ham | 1542 | 4990 | 0.3 |
罐裝魷魚 | Tuna, Canned | 1365 | 3629 | 0.4 |
全麥麵包 | Whole, Wheat | 1238 | 2390 | 0.5 |
杏 | Apricot | 1198 | 4 | 300 |
東南瓜 | Squash, Winter | 1189 | 3 | 396 |
香蕉 | Banana | 1141 | 3 | 380 |
玉米粉 | Corn Meal | 1125 | 5 | 225 |
南瓜 | Pumpkin | 1080 | 3 | 360 |
冷切臘腸 | Sausages, Cold Cutes | 1043 | 5897 | 0.2 |
夏南瓜 | Squash, Summer | 889 | 4 | 222 |
藨莓,覆盆子 | Raspberries | 876 | 4 | 219 |
魚子醬 | Caview | 816 | 9979 | <0.1 |
龍蝦 | Lobster | 816 | 953 | 0.9 |
桃 | Peach | 797 | 4 | 199 |
甜橙 | Oranges | 662 | 3 | 221 |
醃燻豬肉 | Bacon | 590 | 3084 | 0.2 |
丹麥圓麵包 | Roll, Danish | 508 | 1660 | 0.3 |
罐裝玉米 | Corn, Canned | 440 | 1070 | 0.4 |
罐裝豌豆 | Peas, Canned | 435 | 1070 | 0.4 |
白麵包 | Bread, White | 386 | 2300 | 0.2 |
乾酪 | Cheese | 372 | 3175 | 0.1 |
一般蛋糕 | Cake, plain | 358 | 1361 | 0.3 |
餅乾(英) 小甜麵包(美) | Biscuit | 290 | 2994 | <0.1 |
青橄欖 | Olives, Green | 132 | 5770 | <0.1 |
糖果 | Candy | 9 | 299 | <0.1 |
灑鹽餅乾 | Crackers, Saltines | 544 | 4990 | 0.1 |
什錦餅乾 | Cookies Assorted | 304 | 1656 | 0.2 |
蘋果餅 | Pies, Apple | 363 | 1365 | 0 |