北京市执业药师继续教育教材临床止吐药物的合理使用北京医院药学部夏路风刘蕾目录1.病理生理........................................................................................12.呕吐的病因：................................................................................22.1反射性呕吐..........................................................................22.2中枢性呕吐..........................................................................32.3前庭障碍性呕吐..................................................................32.4神经官能性呕吐..................................................................43.诊断方法........................................................................................43.1病史......................................................................................43.2体格检查..............................................................................63.3实验室及其他辅助检查......................................................74.止吐药的分类及作用机制............................................................74.1抗胆碱药：..........................................................................74.2抗组胺药：..........................................................................84.3抗多巴胺药：......................................................................84.4皮质类固醇类：..................................................................84.5苯甲酰胺类：......................................................................94.65-羟色胺受体拮抗剂：.......................................................94.7神经激肽受体拮抗剂：....................................................115.止吐药的应用..............................................................................125.1胃肠道疾病........................................................................125.2肝脏、胆道及胰腺疾病....................................................135.3中枢神经系统病变............................................................135.4药物所致的呕吐................................................................135.5神经、精神因素所致的呕吐............................................146.手术后恶心呕吐的防治..............................................................146.1影响PONV发生率的因素...............................................156.2PONV的防治....................................................................166.3预防性止吐药的给药剂量和时机....................................176.4对未预防用药或预防用药无效的PONV病人的治疗......187.化疗所致恶心呕吐的防治..........................................................197.1化疗所致恶心呕吐的病理生理........................................197.2恶心呕吐的类型................................................................207.3抗肿瘤药物的催吐性分级................................................217.4CINV的其他相关因素.....................................................227.5CINV的治疗原则.............................................................227.6CINV的预防.....................................................................237.7发生呕吐（预防失败）后的解救性治疗........................247.8预期性恶心和呕吐的治疗................................................258.常用镇吐药物..............................................................................268.1抗胆碱药...............................
