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身體從血液中過濾藥物并通過稱為藥物排泄的多步驟過程消除它們
腎臟是藥物消除的主要途徑
大多數(shù)藥物以原形或以尿液中的藥物代謝物形式排出體外
一般來說，健康專業(yè)人士將腎臟過濾血液的能力稱為腎功能
腎單位，腎臟的功能和解剖單位，
過濾血液，調(diào)節(jié)體液量和 pH 值，并控制體內(nèi)電解質(zhì)水平
每個(gè)腎單位包含腎小體和腎小管
腎小體包括鮑曼囊和腎小球
腎小管由近端小管組成，
亨利環(huán)，
遠(yuǎn)端小管,
和集合管
各成分均在腎臟藥物排泄中發(fā)揮作用，
腎臟過濾并消除體內(nèi)藥物的四步過程
這些步驟是：腎小球?yàn)V過，
被動(dòng)腎小管重吸收，
腎小管主動(dòng)分泌和排泄
血液通過直徑較大的血管流入腎小球
比從腎小球排出血液的血管
這種直徑差異會(huì)產(chǎn)生過濾血液中廢物所需的高血壓
腎小球起到分子篩的作用
水中的廢料通過篩子，
而大多數(shù)正常蛋白質(zhì)和細(xì)胞都保留在血液中
腎小球?yàn)V過從血液中去除低分子量藥物
水、溶質(zhì)和離子的被動(dòng)重吸收過程始于近端小管，
繼續(xù)在亨利環(huán)中，
并終止于遠(yuǎn)端和集合管
水溶性藥物停留在腎小管內(nèi)，
而未結(jié)合和脂溶性藥物主要通過腎小管重吸收
重吸收后，脂溶性藥物通過血流到達(dá)肝臟
其中某些肝酶，
例如細(xì)胞色素P450酶復(fù)合物，
將它們代謝成更易溶于水的形式
在這里，我們展示了戊巴比妥代謝過程的一個(gè)例子
有些藥物不通過腎小球從血液中過濾
相反，腎小管壁上有特殊的陰離子和陽離子泵
主動(dòng)將藥物從血液轉(zhuǎn)運(yùn)至腎小管和集合管
來自集合管的尿液穿過輸尿管
它被收集并儲(chǔ)存在膀胱中直到從體內(nèi)排出
雖然腎臟是藥物消除的主要途徑，
也可能發(fā)生藥物排泄
哺乳期婦女通過母乳，
通過肺部呼氣，
釋放到膽汁中，
通過唾液和汗液消除

內(nèi)容操作
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教程課件
單詞卡片
The body filters drugs from the bloodstream and eliminates them in a multi step process called medication excretion
身體從血液中過濾藥物并通過稱為藥物排泄的多步驟過程消除它們
The kidneys are the major route for drug elimination
腎臟是藥物消除的主要途徑
Most drugs exit the body either unchanged or as drug metabolites in urine
大多數(shù)藥物以原形或以尿液中的藥物代謝物形式排出體外
Generally health professionals refer to the ability of the kidneys to filter blood as renal function
一般來說,健康專業(yè)人士將腎臟過濾血液的能力稱為腎功能
Nephrons the functional and anatomical units of the kidney
腎單位,腎臟的功能和解剖單位,
filter blood regulate fluid volume and pH and control levels of electrolytes in the body
過濾血液,調(diào)節(jié)體液量和 pH 值,并控制體內(nèi)電解質(zhì)水平
Each nephron contains a renal corpuscle and renal tubule
每個(gè)腎單位包含腎小體和腎小管
The renal corpuscle includes the Bowman capsule and glomerulus
腎小體包括鮑曼囊和腎小球
And the renal tubule is composed of the proximal tubule
腎小管由近端小管組成,
loop of Henle
亨利環(huán),
distal tubule
遠(yuǎn)端小管,
and collecting duct
和集合管
Each component plays a role in renal drug excretion
各成分均在腎臟藥物排泄中發(fā)揮作用,
a four step process that allows the kidneys to filter and eliminate drugs from the body
腎臟過濾并消除體內(nèi)藥物的四步過程
These steps are glomerular filtration
這些步驟是：腎小球?yàn)V過,
passive tubular reabsorption
被動(dòng)腎小管重吸收,
active tubular secretion and excretion
腎小管主動(dòng)分泌和排泄
Blood flows into the glomerulus via a blood vessel larger in diameter
血液通過直徑較大的血管流入腎小球
than the vessel draining blood from the glomerulus
比從腎小球排出血液的血管
This difference in diameter creates the high blood pressure necessary to filter wastes from the blood
這種直徑差異會(huì)產(chǎn)生過濾血液中廢物所需的高血壓
The glomerulus functions as a molecular sieve
腎小球起到分子篩的作用
Waste materials in water pass through the sieve
水中的廢料通過篩子,
while most normal proteins and cells are kept in the bloodstream
而大多數(shù)正常蛋白質(zhì)和細(xì)胞都保留在血液中
Glomerular filtration removes low molecular weight drugs from the bloodstream
腎小球?yàn)V過從血液中去除低分子量藥物
The process of passive reabsorption of water solutes and ions begins in the proximal tubule
水、溶質(zhì)和離子的被動(dòng)重吸收過程始于近端小管,
continues in the Henle loop
繼續(xù)在亨利環(huán)中,
and ends in the distal and collecting ducts
并終止于遠(yuǎn)端和集合管
Water soluble drugs stay in the tubule
水溶性藥物停留在腎小管內(nèi),
while unionized and lipid soluble drugs are primarily reabsorbed across renal tubules
而未結(jié)合和脂溶性藥物主要通過腎小管重吸收
After reabsorption lipid soluble drugs travel through the bloodstream to the liver
重吸收后,脂溶性藥物通過血流到達(dá)肝臟
where certain liver enzymes
其中某些肝酶,
such as the cytochrome P450 enzyme complex
例如細(xì)胞色素P450酶復(fù)合物,
metabolize them into more water soluble forms
將它們代謝成更易溶于水的形式
Here we show an example of this process through the metabolism of pentobarbital
在這里,我們展示了戊巴比妥代謝過程的一個(gè)例子
Some drugs are not filtered from the blood via the glomerulus
有些藥物不通過腎小球從血液中過濾
Instead special anionic and cationic pumps in the walls of the renal tubule
相反,腎小管壁上有特殊的陰離子和陽離子泵
actively transport the drugs from the blood into the tubules and collecting duct
主動(dòng)將藥物從血液轉(zhuǎn)運(yùn)至腎小管和集合管
Urine from the collecting ducts travel through the ureters
來自集合管的尿液穿過輸尿管
where it is collected and stored in the urinary bladder until elimination from the body
它被收集并儲(chǔ)存在膀胱中直到從體內(nèi)排出
Although the kidneys are the major route for drug elimination
雖然腎臟是藥物消除的主要途徑,
medication excretion can also occur
也可能發(fā)生藥物排泄
in lactating women through their breast milk
哺乳期婦女通過母乳,
exhalation through the lungs
通過肺部呼氣,
release into bile
釋放到膽汁中,
and elimination through saliva and sweat
通過唾液和汗液消除