2015年电大专科《药物治疗学》期末复习题及答案参考小抄

电大《药物治疗学》期末复习题及答案参考小抄

一、单项选择题（从每题的四个备选答案中,选出一个正确的答案,每小题1分）

1、EBM的核心思想是

A.谨慎地、明确地、明智地根据最佳临床证据，为个别患者作出合适的治疗策略

B.大规模、多中心、随机对照试验结果

C.在批判、评价的基础上收集证据

D.定量总结、系统评价

答案：A

2、服药后，进入血液的药物呈现活性的状态是

A.络合状态

B.复合体状态

C.游离状态

D.吸附状态

答案：C

3、属于肝药酶抑制剂是

A.利福平

B.苯妥英钠

C.苯巴比妥

D.氯霉素

答案：D

4、属于快效杀菌剂的是

A.庆大霉素

B.磺胺

C.红霉素

D.青霉素

答案：D

5、糖皮质激素新制剂是

A.化可的松

B.美达松

C.他米松

D.的松药物

答案：B

6、下列哪项属于间接成本的范围

Ａ．求诊支出的食宿费Ｂ．伤残造成的误工损失

Ｃ．治疗引起的精神痛苦Ｄ．医生的工资

答案：B

7、妊娠妇女合并高血压时应该采取的措施是

A．采取抗高血压药物治疗B．终止妊娠

C．注意观察护理D．停止一切日常活动

答案：A

8、下列不属于β内酰胺酶抑制剂

A.阿莫西林

B.三唑巴坦

C.克拉维酸

D.舒巴坦

答案：A

9、老年人用药应选

A.剂量

B.用强大

C.对性强

D.合用药

答案：C

10、临床预后指标不包括下列哪一项？

A．与药物作用直接有关的指标B.长期大规模人群的观察、随访结果

C.病死率、病残率

D.降血压药降低心血管事件、卒中发生率

答案：A

11、使用专用红处方的药品是

A. 西药毒性药品

B.放射性药品

C. 麻醉药品

D. 精神药品

答案：C

12、下列哪种情况属于药物不良反应？

A.药物过量

B.药物滥用

C.伪劣药品

D.药物依赖性

答案：D

13、洗胃时应注意

A.强腐蚀性中毒患者洗胃有可能造成食道及胃穿孔

B.洗胃过程中如发生惊厥应一边洗胃一边进行对症治疗

C.挥发性烃类化合物口服中毒适宜洗胃

D.每次灌入的洗胃液越多越容易将胃内毒物清洗干净

答案：A

14、促进骨矿化的药物是

A.孕激素

B.活性维生素D3

C.雌激素

D.生素K

答案：B

15、增加胃液pH值的药物不宜与下列哪种抗菌素合用

A.头孢呋辛

B.头孢氨苄

C.头孢克洛

D.阿莫西林

答案：A

16、药物体内过程是指

Ａ．药物被机体吸收的整个过程

Ｂ．药物被机体吸收,并分布至各个组织器官的整个过程

Ｃ．药物在机体吸收、分布及代谢的整个过程

Ｄ．药物被机体吸收、分布、代谢和排泄的整个过程

答案：D

17、高血压患者合并下列哪种疾病时禁用噻嗪类利尿药

A．合并充血性心力衰竭B．合并冠心病C．合并痛风D．合并心律失常

答案：C

18、过敏的全身反应不包括

A.过敏性休克

B.药疹

C.血液病样反应

D.神经系统反应

答案：B

19、以下哪类药与糖皮质激素合用可导致心律紊乱

A.水杨酸盐

B.口服降糖药

C. 丙咪嗪

D.强心苷

答案：D

20、一例肺炎患者在使用氨苄青霉素一天后出现全身皮疹，此现象属于哪种药物不良反应？

A继发反应B、变态反应C、毒性反应D、特异质反应

答案：B

二、填空题（每空1分）

1、成本常包括___________、_____________、___________。

答案：直接、间接、隐性成本。

2、抑郁症目前提倡______________和______________相结合。

答案：药物治疗、心理治疗

3、新的糖尿病分为__________、_________、__________、_____________四大类型。

答案：1型、2型、特殊类型、妊娠。

4、个体化给药方案制定步骤___________、_____________、___________、_____________、___________。答案：明确诊断、选择适合的药物及给药途径、确定初始给药方案、观察临床疗效测定血药浓度、修改用药方案。

5、平均稳态血药浓度与______________成正比，与______________成反比。

答案：药物剂量，给药间隔时间

6、药物经济学的两大要素是______________和______________。

答案：成本分析、收益评价

7、目前认为充血性心力衰竭（CHF）治疗有四种基本药物，即_________、_________、_________和___________。答案：利尿剂、洋地黄类、血管紧张素转换酶抑制剂、Ｂ受体阻滞剂。

8、疼痛第一阶梯用药的类型是___________，第二阶梯用药的类型是_____________，第三阶梯用药的类型是____________。

答案：非阿片类、弱阿片类、强阿片类。

三、名词解释（每题3分）

1、单方

答案：比较简单1分的处方1分，通常只含一、二味药1分。

2、药源性疾病

答案：由药物1分不良反应1分引起的疾病1分。

3、治疗药物监测

答案：运用各种灵敏的现代分析技术，定量分析生物样品中药物及其代谢产物的浓度1分，以探讨患者体内血药浓度与疗效及毒性反应的关系1分从而确定有效及毒性血药浓度范围1分。

4、药学信息

答案：包括药学领域1分所有知识1分的数据1分。

5、成本--效益分析

答案：是对备选方案的成本和收益1分均以货币单位计量和描述1分，并对货币化了的成本和收益进行比较评价的一种方法1分。

6．药物治疗学：是研究药物治疗疾病的理论和方法的一门学科；是药学学科的重要组成部分；是医药的结合点。药物治疗是通过应用药物的手段达到消除和控制疾病，预防疾病和提高生活质量的目的。

7．药品：是指用于预防、治疗、诊断人的疾病，有目的调节人的生理功能并规定有适应证或者功能主治、用法和用量的物质。

8．合理用药：①药物正确无误；②用药指征适宜；③疗效，安全性，使用，价格对病人适宜；④剂量，用法，疗程妥当；⑤用药对象适宜、无禁忌证、不良反应小；⑥调配无误；⑦病人依从性良好。

9．标准治疗指南（STG）：是依据特定医疗系统的专家，利用已明确的研究证据，根据当前的知识水平和经验，对常见的健康问题优先推荐的疗效好、经济适用的药物及非药物治疗方案。

10．循证医学（EBM）：其核心思想是谨慎地、明确地、明智地应用当代最佳证据（资料），对个体患者医疗作出决策。

11．系统评价（SR）：是针对某一具体的临床问题系统全面地收集全世界所有已发表或未发表的相关的临床研究文章，用统一的科学评价标准，筛选出符合标准、质量好的文献，用统计方法进行综合，得到定量的结果，并加以说明，得出可靠的结论。

四、简述题（每题5分）

1.简述药理学与药物治疗学的区别。

答案：二者都是研究药物与人体相互作用的科学1分，但各有侧重。药理学侧重于药物作用的理论研究1分，是药物治疗学的理论基础1分。药物治疗学是药理学理论在临床的实际应用1分。着重研究在疾病防治中选择药物和用药方法，以及制定药物治疗方案等实际问题1分。

2.简述肝、肾疾病时临床用药原则。

答案：（1）用药必须有明确指征1分

（2）选无毒或毒性低，避免用毒性大的药物1分

（3）选半衰期短药物1分

（4）选疗效与不良反应易观察的药物1分

（5）以小剂量为宜，多选用间歇疗法1分

五、论述题（每题10分）

1、叙述如何调配与使用医疗毒性药品。

答案：调配处方时，必须认真负责1分，计量准确1分，按医嘱注明要求1分，

并由配方人员1分及具有药师以上技术职称的复核人员签名盖章后方可发出1分。

如发现处方有疑问时，须经原处方医生重新审定后再行调配1分。处方一次有效1分，取药后处方存二年备查1分。此类药应有专人负责1分、专柜加锁保管1分。

2、叙述抗抑郁药的分类、代表药及作用机制？

答案：

（1）单胺氧化酶抑制剂：吗氯贝胺，抑制单胺氧化酶，使单胺类递质降解减少2分

（2）三环类：丙咪嗪，阻止NA、5-HT再摄取2分；

（3）四环类：马普替林，选择性的抑制NA再摄取2分；

（4）5-HT再摄取抑制剂：氟西汀（帕罗西汀、舍曲林、西酞普兰、文拉法辛）选择性的抑制5-HT再摄取4分。

3.叙述药物经济学评价的步骤与应用范围。

答案：

（1）药物经济学评价步骤：明确研究的问题1分、确定药物经济学评价的角度1分、确定比较方案1分、选用恰当的药物经济学评价方法1分、治疗成本的估算、治疗结果的测量、确定贴现率和时间偏好、计算经济学评价指标、敏感性分析、做出合理结论与解释1分。

（2）药物经济学评价的应用范围

①为卫生资源的宏观决策提供科学依据1分②为临床医疗决策提供指导1分③药学服务质量评价1分④为新药开发提供决策依据1分

⑤为药品生产和经营提供参考依据1分

一、药物治疗学的任务和主要内容

1．疾病的治疗，包括药物治疗和非药物治疗。药物治疗是通过应用药物的手段达到消除和控制疾病，预防疾病和提高生活质量的目的。非药物治疗手段包括物理疗法，手术治疗、放射治疗、心理治疗等。不同的治疗方法都有各自不同的适应征。但药物治疗在各种治疗方法中是应用最广泛的治疗方法。

2．药物治疗过程包括四个阶段：

①药剂学阶段：是药物治疗最初阶段，指药物以不同制剂的形式，通过不同给药途径，从给药部位进入病人体内的过程。

②药代动力学阶段：进入体内的药物随血液分布到各器官组织，到达病变部位，使该部位的药物浓度达到能发挥治疗作用的水平并能维持一定的作用时间。

③药效动力学阶段：药物到达靶器官或组织后，通过与组织细胞内受体结合或其他作用途径，发挥药理作用。

④药物治疗学阶段：药物通过药理作用对病变部位或疾病的病理生理过程产生影响，从而产生治疗作用。

3．药理学与药物治疗学的区别

二者都是研究药物与人体相互作用的科学，但各有侧重。药理学侧重于药物作用的理论研究，是药物治疗学的理论基础。药物治疗学是药理学理论在临床的实际应用。着重研究在疾病防治中选择药物和用药方法，以及制定药物治疗方案等实际问题。

二、影响药物治疗的因素

生理因素、病理因素、药物相互作用、耐受性、依从性和其他因素等。

三、标准治疗指南

1．标准治疗指南的作用：引导医务工作者采取费用/效果比最好的治疗，对低收入的患者特别有用；可用于培训医务工作者、检查工作质量，也可在采购药品等方面应用。

2．标准治疗的优点：①患者可得到不同医生的标准化治疗；②给医生提供代表当前治疗水平的标准化治疗方案。③对药学工作者来说，标准治疗的好处除提高药物治疗质量外，还可方便药品供应。

四、循证医学（EBM）与合理用药

循证医学的应用过程实际上是医师或药师将个人的临床经验与外部所能获得的最佳证据相结合，提出最佳治疗方案的过程。

循证医学的各级证据

在评价时，EBM中的证据按质量和可靠程度可分为五级（可靠性依次降低）。

一级：所有随机对照试验（RCT）的系统评价（SR）/Meta-分析；

二级：单个的样本量足够的RCT结果；

三级：设有对照组但未用随机方法分组的试验；

四级：无对照的病例观察；

五级：专家意见。

请您删除一下内容，O(∩_∩)O谢谢！！！2015年中央电大期末复习考试小抄大全，电大期末考试必备小抄，电大考试必过小抄Shanghai’s Suzhou Creek has witnessed much of the city’s history. Zho u Wenting travels this storied body of water and finds its most fascinating spots. Some lucky cities can boast a great body of water, like London with the river Thames and Paris with the river Seine. Shanghai is privileged enough to have two great bodies of water: Huangpu River and Suzhou Creek.Huangpu River became famous when colonists established clusters of grand buildings on its banks on what became known as the bund. Today, the bund overlooks the breathtaking skyline of Lujiazui financial district. Sha nghai’s other body of water, however, Suzhou Creek, has been somewhat overshadowed. Suzhou Creek links the inland cities of Jiangsu province with Shanghai. When the British colonists, who arrived in the city after it was opened as a commercial port in 1843 found they could reach Suzhou, Jiangsu province, via the creek, they named it Suzhou Creek. Thanks to its location, a large amount of cargo and

travelers were transported via the creek before rail links were established. But after a century of being utilized as a waterway to transport goods and labor, the creek grew dark and smelly. Industrial factories were established along the banks. In the 1990s it became a key task of the city government to clean the creek. Suzhou Creek, which snakes 17 km from the iconic Waibaidu Bridge downtown to the outer ring road in west Shanghai, maps the changing periods of the city’s history, including the imprints of the concessions, the beginning of industrialization and the improvement in people’s living conditions. Where the Bund began In-between the shopping street of East Nanjing Road and the Bund, are a cluster of streets that give me the illusion that I am no longer in modern Shanghai. The streets are narrow and old and criss-cross each other. Any old residential house may turn out to be a former office of the British, constructed in the 1880s. Pawnshops and hardware stores that are hard to find elsewhere, are plentiful here. This area, at

the confluence of Huangpu River and Suzhou Creek, is called the Bund Origin. Countless tour buses stop at the site every day and

visitors from around the world get off to see this place, the starting point

of the concessions in the city. It all started in 1872, when the former British Consulate General was constructed and the Bund began its transformation into an the financial street of the East. Now the site of the former consulate is called “No 1 Waitanyuan”, which translates to “the Bund Origin”, to honor its beginnings. The entire complex of this historical site comprises of five buildings, the former British Consulate General, the official residence of the consul, the former Union Church, the church apartments and the former Shanghai Rowing Club. The size of the courtyard is equivalent to that of four standard soccer fields. The building of the former consulate is a two-storey masonry building on an H-shaped plan in typical English renaissance style. The building is designed with a five-arch verandah on the ground floor with a raised terrace facing the garden, while the facade features an entry portico beneath a colonnaded loggia. It has been turned into a café where dinner and afternoon tea are available. Visitors can choose to sit indoors or outdoors to enjoy the magnificent gardens with nearly 30 ancient trees. Yuanmingyuan Road behind the complex is also a historical site. The road has been revamped as a pedestrian shopping street and high-end brands have

Suzhou Creek. The church, designed in the style of the English countryside, has a capacity of 500 people. It was very popular during the concession period but was converted into factory offices after 1949. The church we see today is a replica, the original burned down in 2007. There used to be an outdoor swimming pool, the first of its kind in Shanghai, beside the church but has been filled-in and is now a small garden. Bridge of romance There is perhaps no other place that’s more representative of Shanghai than this bridge, which appears in quite a lot of movies about the city. Dozens of couples visit every day to pose for their pre-wedding photos on the bridge where Suzhou Creek begins and interconnects with Huangpu River. This is Waibaidu Bridge, or the Garden Bridge. The soon-to-be-wed couples pose in splendid attire on the bridge, leaning against the railing or sitting on the wooden floor. Some even risk walking into the middle of the road to get the perfect shot.Colorful lights illuminate the bridge throughout the night, making it a picturesque place for pre-wedding portraits and lovers to meet. Constructed in 1873 and designed by a British

company, the 106-meter-long bridge was the first-ever major bridge in Shanghai. In 1856, the first large wooden

bridge, Wells Bridge, was built over Suzhou Creek but the bridge toll led to complaints from citizens. So 17 years

later, another wooden bridge, which did not require tolls,

was built. People called it Waibaidu, which means “going

across for free”. The bridge was renovated as a steel truss

structure in 1907. Because nearly 40 bridges have now

been built over Suzhou Creek, the bridge is no longer a traffic

artery but is more of an observation deck for tourists. It is a

tradition in Shanghai for a grandmother to walk across a

bridge with their grandchild when he or she reaches one

month. This represents that the newborn has overcome all

the twists and turns and its journey will be safe and smooth

throughout his or her life. "Waibaidu Bridge is always

the best option because it’s the icon of Shanghai. The picture

of my daughter when she was a baby held by her g randmother was also taken here. It’s like a family tradition," says Wang Xuefen, a Shanghai native who has a newborn grandson. Changning Riverside There is a 5-km stretch of waterfront by Suzhou Creek in Changning district on Changning Road from the intersection of Hami Road to Jiangsu Road. It has become a popular place to take a walk and sunbathe on the lawn. There is an overpass at the intersection of Changning Road and Gubei Road for people to enjoy the view of the creek and a

3-km plastic runway on both sides of Changning Road, which attracts people of all ages, Chinese and expat. "Jogging on the two sides gives a different feeling because the north side is next to the creek, and the south side is adjacent to the residential highrises, which is like jogging in the jungle," says Xiao Xu, a 27-year-old woman who lives nearby. The riverside used to be completely different. Dozens of textile mills, chemical plants and machine manufacturing factories were set up along the creek in the 1920s. They brought industrialization but also pollution. From the 1930s the creek could no longer be used as a source for tap water, and no living fish or shrimp could be found. "Suzhou Creek in my memory is dark and smelly. I used to go to the riverbank to watch the sewage disp osal running out from the chemical plants when I was a little girl. We didn’t know it was pollution. We thought it was a red waterfall," says Huang Qi, a 57-year-old Shanghai resident. "So the residential houses along the creek were unpopular, and only migrants with low incomes would live in that area," she says. However, things have changed. The plants were closed and turned into riverside parks and the apartments in the new highrises, especially those facing the creek, are much sought after. East China University of Political Science and Law This is the famous former Saint John’s University, China’s first-ever modern institution of higher education established by missionaries from the United States in 1879. The buildings combine Chinese and Western elements. Address: 1575 Wanhangdu Road, Changning district The old residential area After you leave the university from its east gate you will enter a shabby neighborhood that retains its original look. The alleys are narrow and the houses are overcrowded. Some things have not changed for many generations, such as raising chickens at home. Address: West Guangfu Road Moganshan Road This is an artsy street that has become very popular among artists and fashionistas in recent years. Graffiti covers the walls on the winding street, where you can find a cluster of art galleries and creative industry offices. Sihang Warehouse Four banks jointly funded the construction of this warehouse, so it is named sihang, or four banks. The warehouse, built in 1931, was used for the storage of food, first-aid supplies and ammunition during the years of war. The building, which is also a masterpiece left by the Hungarian architect Laszlo Hudec in the 1930s, has been recently transformed into a center of creative industry workshops. Address: 1 Guangfu Road, Zhabei district