问题 单项选择题

药物相互作用是双向的,既可能产生对患者有益的结果,使疗效协同或毒性降低,也可能产生对患者有害的结果,使疗效降低或毒性增强,有时会带来严重后果,甚至危及生命。 患者同时服氢氯噻嗪与地高辛,出现心律失常的机制是()

A.协同作用

B.敏感化作用

C.减少不良反应

D.致使毒性增加

E.竞争性拮抗作用

答案

参考答案:B

解析:

增加毒性或药品不良反应:肝素钙与阿司匹林、非甾体类抗炎药、右旋糖苷、双嘧达莫合用,有增加出血的危险。氢溴酸山莨菪碱与哌替啶合用时可增加毒性。甲氧氯普胺与吩噻嗪类抗精神病药合用可加重锥体外系反应。氨基糖苷类抗生素与依他尼酸、呋塞米或万古霉素合用,可增加耳毒性和肾毒性,且停药后仍可能发展至耳聋。分析各选项:

A.氢氯噻嗪联用强心苷——敏感化作用

B.青蒿素联用乙胺嘧啶——延缓或降低抗药性,以增加疗效

C.铁剂联用维生素

C——促进吸收,增加疗效

D.普萘洛尔联用硝酸酯类——减少药品不良反应

E.庆大霉素联用呋塞米——增加毒性或药品不良反应延缓或降低抗药性,以增加疗效:抗疟药青蒿素可诱发抗药性,与乙胺嘧啶、磺胺多辛联合应用可延缓抗药性的产生。

磷霉素与β-内酰胺类、氨基糖苷类、大环内酯类、氟喹诺酮类抗菌药物联合应用具有相加或协同作用,并减少耐药菌株的产生。

敏感化作用:一种药物可使组织或受体对另一种药物的敏感性增强,即为敏感化现象。如排钾利尿剂可使血浆钾离子浓度降低,从而使心脏对强心苷药敏感化,容易发生心律失常。应用利血平或胍乙啶后能导致肾上腺素受体发生类似去神经性超敏感现象,从而使具有直接作用的拟肾上腺素药的升压作用增强。

阅读理解

阅读理解

     People are more likely to wash their hands properly after using the toilet if they are shamed into it or

think they are being watched, scientists said on Thursday.

     Hand-washing is the cheapest way of controlling disease but less than one third of men and two thirds

of women wash their hands with soap after going to the toilet, a British study by the London School of

Hygiene and Tropical Medicine showed.

     But when prompted by an electronic message flashing up on a board asking: "Is the person next to you washing with soap?," around 12 percent more men and 11 percent more women used soap.

     Health authorities around the world are stepping up efforts to persuade people to be more hygienic and wash their hands properly to help slow the spread of H1N1 swine flu, which was declared a pandemic

(大流行病) by the World Health Organization in June.

     "Hand-washing with soap has been ranked the most effective way for the worldwide control of

disease," the study's authors wrote.

     "It could save more than a million lives a year from diarrhoeal diseases, and prevent respiratory(呼吸)

infections -- the biggest causes of child mortality(死亡) in developing countries."

     In developed nations, hand-washing can help prevent the spread of viral infections like flu and sickness and diarrhea bugs like norovirus and rotavirus, as well as hospital-acquired infections like MRSA and

C-difficile, the authors said.

     The researchers studied the behavior of a quarter of a million people using toilets at motorway service

stations in Britain over 32 days. Use of soap was monitored by sensors.

     The study, published in the American Journal of Public Health to mark Global Hand-washing Day,

showed that with no reminders, 32 percent of men and 64 percent of women used soap.

1. In which of the following situation can people wash their hands properly?

A. After they going to toilet.

B. when they think they are being watched.

C. When they think their hands are dirty.

D. When they find soap nearby.

2. Which of the following is the main advantage of hand-washing?

A. people can always get their hands clean.

B. People can save a lot of time and water.

C. It is the cheapest way of controlling disease.

D. It wastes no any time and energy.

3. What is the biggest cause of child death in developing countries?

A. respiratory infections.

B. diarrhoeal diseases.

C. H1N1 swine flu.

D. hospital-acquired infections.

4. Which of the following is true according to the seventh paragraph?

A. Hand-washing is popular in the developed countries.

B. They authorities persuaded the people to wash their hands daily.

C. More and more people know to wash their hands properly.

D. The spread of viral infections is a serious problem.

5. We can conclude from the passage that _______.

A. Most people wash their hands after going to toilet.

B. Many people can not wash their hands properly.

C. Few people know Global Hand-washing Day.

D. H1N1 swine flu was declared a pandemic.

问答题