55歲女性，身高155.7 cm，體重55 kg，serum creatinin..-阿摩線上測驗

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55歲女性，身高155.7 cm，體重55 kg，serum creatinine 1.5 mg/dL，罹患high grade B cell lymphoma。依序回答下列四題。
【題組】80.欲避免或治療前題之狀況，下列處置何者不適當？
(A) sodium bicarbonate tablet 300 mg/tab 3 tablets tid PO
(B) normal saline IV hydration
(C) rasburicase 0.2 mg/kg IV over 30 mins qd x 5 days
(D) allopurinol tablet 100 mg tid PO

專技 - 藥物治療學- 104 年 - 104-2 專技高考_藥師、藥師（二）：藥物治療學#23928

答案：A
難度： 適中

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	Swear 幼兒園下 (2015/10/29) 將尿液鹼化可以則增加尿酸的溶解度，降低尿酸沉積在腎小管，過多的bicarbonate反而容易與鈣及磷結合後沈積，且血液鹼化後對患者臨床頗有危害，因此，鹼化尿液不宜過當。大量的水分在投入人體的當下可以稀釋這些細胞溶解物質，替細胞內平衡爭取時間，而後續再利用尿液將這些物質從身體中帶出，水分補充可以.....觀看完整全文，請先登入檢舉

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	4F Chelsea Chen 高二下 (2018/07/16) NS就有效，bicarb 反而還容易讓 CaP 亂沉澱 The role of urinary alkalinization with either acetazolamide and/or sodium bicarbonate is unclear and controversial. In the past, alkalinization to a urine pH of 6.5 to 7 or even higher was recommended to increase uric acid solubility, thereby diminishing the likelihood of uric acid precipitation in the tubules. However, this approach has fallen out of favor for the following reasons: ●There are no data demonstrating the efficacy of this approach. In addition, the only available experimental study suggested that hydration with saline alone is as effectiv... 查看完整內容 NS就有效，bicarb 反而還容易讓 CaP 亂沉澱 The role of urinary alkalinization with either acetazolamide and/or sodium bicarbonate is unclear and controversial. In the past, alkalinization to a urine pH of 6.5 to 7 or even higher was recommended to increase uric acid solubility, thereby diminishing the likelihood of uric acid precipitation in the tubules. However, this approach has fallen out of favor for the following reasons: ●There are no data demonstrating the efficacy of this approach. In addition, the only available experimental study suggested that hydration with saline alone is as effective as alkalinization in minimizing uric acid precipitation. ●Alkalinization of the urine has the potential disadvantage of promoting calcium phosphate deposition in the kidney, heart, and other organs in patients who develop marked hyperphosphatemia once tumor breakdown begins. UpToDate Tumor lysis syndrome: Prevention and treatment 檢舉
	5F ㄨㄚˊ我什麼都不會高三上 (2018/07/16) Prophylaxis ☆☆☆☆☆☆☆☆☆ ☆☆☆ ... (內容隱藏中) 查看隱藏文字
	6F Amphetamine 高二下 (2020/07/22) TPN中防止鈣磷沉澱：降低pH值 (A) sodium bicarbonate 過度鹼化尿液，升高pH值，會使腫瘤溶解症候群(高血磷、低血鈣)發生鈣磷沉澱在腎等其他器官。檢舉

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55歲女性，身高155.7 cm，體重55 kg，serum creatinin..-阿摩線上測驗

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