今天有學妹問我:Lasix為何不建議與prednisolone並用

Prednisolone-2D-skeletal.png 


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
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
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
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

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