この局面にこの一手！　Dr.長澤直伝！　腎臓病薬物療法の定跡

出版社： 金芳堂
著者：
発行日： 2021-08-16
分野： 臨床医学：内科  >  腎臓
ISBN： 9784765318761
電子書籍版： 2021-08-16 （第1版第1刷）
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どうしてその薬を使うの？　腎臓病に対する薬物療法の選択がこの1冊でわかる！
日本には多くの慢性腎臓病（CKD）の患者さんがおり、どの科に進んでも、CKDを合併している人を診療することになるでしょう。そのため、本書を用いて勉強すると普段よく診る疾患に対して、よりうまく対処できるようになります。
腎臓病薬物療法といえば、真っ先に、「どの薬を使うのがいいのかな？」に目が行きがちです。ただ実際は、どの病態にどのような薬を使うか、その副作用、患者さんへの説明など、腎臓内科において知っておくべき大切なことが他にもたくさんあります。本書を繰り返し読み、腎臓病の薬物療法の理解を深めていきましょう。

目次

  • 第1局　血圧
    その壱　薬物選択よりも降圧目標
    その弐　具体的な降圧目標を達成する。その前に、どこで血圧を測るの？
    その参　では、どこまで下げるか？
    その四　では、何を使うか？
    その五　RAA系阻害薬はキードラッグだけど使い方に注意
    その六　意外とCKDに使われていないβ遮断薬、心不全のキードラッグ
    その七　激安だがとてもお世話になる薬、サイアザイド系利尿薬
    その八　玄人好みのα遮断薬、人によっては結構下がります。ただし起立性血圧に注意

    第2局　血糖降下薬
    その壱　どの薬？　よりも、どこまでどうやって下げるか
    その弐　ファーストチョイスはどの薬？　その前に
    その参　DPP-4阻害薬は名脇役
    その四　SGLT2阻害薬は2020年代の標準治療薬
    その五　インスリンの腎臓内科的な考え方
    その六　その他の薬、GLP-1受容体作動薬など

    第3局　利尿薬
    その壱　総論
    その弐　ループ利尿薬は使う量が大事
    その参　トルバプタンの使い道
    その四　ミネラルコルチコイド受容体拮抗薬、利尿薬というよりは……

    第4局　吸着薬
    その壱　カリウム（K）吸着薬の使い方と使いどころ
    その弐　リン（P）吸着薬の極意
    その参　慢性腎不全を診ると反射的に出す人がいるが……

    第5局　知っておいたほうがよい薬
    その壱　ビタミンD投与はCaのモニタリングが必要
    その弐　Ca値は低めに管理するのが好み
    その参　Ca値を下げる薬もきちんとモニタリングが必要
    その四　尿酸値を下げる意義を再確認
    その五　NSAIDsなどの痛み止めは頻用されているからこそ注意
    その六　腎臓を悪くする可能性のある検査を行う必要は本当にあるのか？
    その七　帯状疱疹を診るときは腎機能に要注意
    その八　意外と多い血糖降下薬、フィブラート、H2ブロッカー、DOAC

    第6局　なかなか難しい問題
    その壱　腎臓が悪くなると抗凝固薬の恩恵を受けにくいかもしれない
    その弐　その抗血小板薬は何のため？
    その参　脂質を下げるエンドポイントは？
    その四　主にステロイド
    その五　シクロスポリン、シクロフォスファミド、リツキシマブ
    その六　薬剤選択は増えたがコストとベストチョイスは？

    第7局　腎臓内科のマイナーな問題
    その壱　入院中に腎性貧血の治療はどうする？
    その弐　古くて忘れ去られた問題（というか問題にすらなっていない問題）
    その参　訴える人も多い、薬は選択肢が増えてきた
    その四　ベーキングパウダーっていうと驚かれますよね

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

プロローグ

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第1局 血圧

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第2局 血糖降下薬

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第3局 利尿薬

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第4局 吸着薬

P.91 掲載の参考文献
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第5局 知っておいたほうがよい薬

P.103 掲載の参考文献
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1) Sato H, et al. Risk of cardiovascular mortality predicted by the serum calcium level and calcification score at the initiation of dialysis. Clin Exp Nephrol. 2018 ; 22 : 957-966.
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第6局 なかなか難しい問題

P.134 掲載の参考文献
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P.141 掲載の参考文献
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3) Wada T, et al. Effects of LDL apheresis on proteinuria in patients with diabetes mellitus, severe proteinuria, and dyslipidemia. Clin Exp Nephrol. 2021 ; 25 : 1-8.
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