第八節(jié) 注意事項(xiàng)

　　“注意事項(xiàng)”也是藥品說明書中的重要內(nèi)容之一。為了安全用藥，廠商在本項(xiàng)中特別強(qiáng)調(diào)應(yīng)注意的事項(xiàng)，其中主要包括：正確的劑量和用法，超過劑量時(shí) 的應(yīng)急措施，用藥對(duì)象，可能出現(xiàn)的較嚴(yán)重的副作用及治療方案，藥物的配伍，藥液的配制、使用及保管等、方面的注意事項(xiàng)。現(xiàn)就本項(xiàng)內(nèi)容詳細(xì)介紹如下：

　　1. 本項(xiàng)常用的英語表示法：

　　Precaution（s） 注意事項(xiàng) Special note（caution, precaution）特別注意

　　Caution（s） 注意事項(xiàng) N.B. 注意

　　Noto 注意 Warning（s） 警告

　　有時(shí)也用：

　　Important 重要事項(xiàng) Important for the patients 患者須知

　　2. 本項(xiàng)中常見的檢查項(xiàng)目：

　　blood count 血細(xì)胞汁數(shù) Kidney （renal） function 腎功能

　　blood picture（hemogram） 血象 Liver（hepatic）function 肝功

　　blood level 血濃度 serum concentration 血清濃度

　　blood pressure 血壓 serum creatinine test 血清肌酸酐檢驗(yàn)

　　clotting time 凝血時(shí)間 urine routine（examination） 尿常規(guī)

　　creatinine clearance 肌酸酐清除率

　　3. 本項(xiàng)的特點(diǎn)是內(nèi)容長短不一，有難有易；詞匯量大，涉及面廣，既有普通詞匯，也有大量的專業(yè)詞匯及編寫詞。許多詞匯、結(jié)構(gòu)和句型可在藥理作用、適應(yīng)癥、禁忌 癥、劑量和用法、副作用，貯藏等項(xiàng)中見到。從英語結(jié)構(gòu)上分析，句型變化較多，長句、難句也屢屢出現(xiàn)，是比較難讀的一個(gè)項(xiàng)目。

　　例1 Warnings and precautions: Ciprofloxacin should be used with caution in epileptics and patients with a history of CNS disorders and only if the benefits of treatment are considered to outweight the risk of possible CNS side-effects.

　　警告和注意事項(xiàng)：癲癇病人及有中樞神經(jīng)系統(tǒng)病史的患者慎用環(huán)丙沙星，僅當(dāng)認(rèn)為療效超過可能產(chǎn)生的中樞神經(jīng)系統(tǒng)副作用的危險(xiǎn)時(shí)才可使用。

　　例2 Ciprofloxacin could result in impainnent of the patients ability to drive or operate machinary, particularly in conjunction with alcohol.

　　環(huán)丙沙星能損害人們駕駛汽車或操縱機(jī)器的能力，尤其是在飲酒之后。

　　例3 Warnings: Vepeside should be administered under the supervision of a qualified physicain experienced in the use of cancer chemotherapeutic agents.

　　警告：泛必治應(yīng)該在使用治療癌癥的化療制劑方面有經(jīng)驗(yàn)、有資格的醫(yī)生的監(jiān)護(hù)下使用。

　　例4 The most serious risk associated with anticoagulant therapy with sodium warfarin are hemorrhage in any tissue or organ and less frequently, necrosis and/ or gangrene of skin and other tissues. The risk of hermorrhage is related to level of intensity and the duration of anticoagulant therapy.

　　用華注林鈉進(jìn)行抗凝治療產(chǎn)生的最嚴(yán)重的危險(xiǎn)就是組織或器官出血，以及不大常出現(xiàn)的皮膚和其他組織的壞死和（或）壞疽。出血的危險(xiǎn)與抗凝治療的藥物濃度（水平）及療程長短有關(guān)。

　　例5 The occurrence of a platelet count below 50,000/mm3 or an absolute neutrophil count below 500/mm3 is an indication to withhold further therapy until the blood counts have sufficiently recovered.

　　血小板數(shù)低于s0，000／mm3 或絕對(duì)中性白細(xì)胞數(shù)低于500／mm3 ，表明不能繼續(xù)使用本品治療，待白細(xì)胞計(jì)教充分恢復(fù)后才能繼續(xù)用藥。

　　例6 Warfarin therapy should be discontinued when warfarin is suspected to be the cause of developing necrosis and heparin therapy may be considered for anticoagulation.

　　當(dāng)懷疑華法林治療引起壞死時(shí)，則須停止治療，并且考慮使用肝素治療。

　　例7 Dosage should be controlled by periodic determinations of prothrombin time（PT） or other suitable coagulation tests.

　　必須定期檢查凝血酶原時(shí)間（PT），或做其他相應(yīng)的凝血試驗(yàn)來控制劑量。

　　例8 Please note Cerebral convulsive disease is regarded as a relative contraindication for examinations in the subarachnoid space. If after careful consideration, these examinations are nevertheless performed, all equipment and medicines necessary to counter any convulsions may occur must be prepared ready for use beforehand.

　　請注意：腦驚厥被認(rèn)為相對(duì)禁止進(jìn)行蛛網(wǎng)膜下腔檢查，如經(jīng)謹(jǐn)慎考慮后、仍要進(jìn)行這些檢查時(shí)．必須事先備妥應(yīng)付可能發(fā)生驚厥所需的所有設(shè)備與藥品。

　　例9 Caution must be exercised in the case of hypersensitivity to iodinated contrast media, latent hyperthyroidism and bland nodular goitre.

　　對(duì)碘造影劑過敏、隱匿性甲狀腺亢進(jìn)和輕微甲狀腺腫的病例，應(yīng)慎重。

　　例10 Caution Alcohol intake may enhance nitrate effects and occasionally induce hypotension with subsequent impairment of reactivity. During the first three months of pregnancy drugs should only be used on the express direction of the attendant physician. Isket spray should not be stored at temperatures above 25.C! Temperatures above 40 ℃ are to be be avoided, even for bried periods! Do not force canister open, even when empty!

　　注意：飲酒可增強(qiáng)硝酸鹽的作用、偶爾引起低血壓，繼而損害反應(yīng)力。妊娠三個(gè)月時(shí)，只有在監(jiān)護(hù)醫(yī)生明確指導(dǎo)下才可使用本品。異舒吉噴霧劑的貯存溫度不應(yīng)超過25℃！避免超過40℃。即使短時(shí)間也不可！不要用力開罐，即使空罐時(shí)也不可用力開！勿使兒童接觸本品

　　例11 As with all new drugs， patients should be followed carefully so that any side-effects or unusual manifestations of drug idiosyncrasy may be detected. If any allergic reaction to Keflex occurs, the drug should be discontinued and the patient treated with the usual agents.

　　像使用所有新藥一樣，應(yīng)細(xì)心地隨訪患者，以便觀察任何副作用或藥物特異反應(yīng)。如果出現(xiàn)對(duì)頭抱菌素IV的過敏反應(yīng)，應(yīng)停藥，并用常規(guī)藥物治療患者。

　　例12 In patients with normal renal function, chronic hypercalcemia may be associated with an increase in serum creatinine. While this is usually reversible, It is important in such patients to pay careful attention to those factors which may lead to hypercalcemia.

　　對(duì)于腎功能正常的患者,慢性高鈣血癥可能與血清肌酸酐增多有關(guān)。這通常雖然是可逆的，然而對(duì)這樣的病人，密切注意可能導(dǎo)致血鈣過多的各種因素是很重要的。

　　例13 Precautions 一Avoid the concomitant use, in the absence of special monitoring laboratory of parameters, of anticoagulants or aspirin. 一Inform the attending physician in the event of bleeding or of the occurence of a hematoma.

　　注意事項(xiàng)：在無化驗(yàn)室參考指標(biāo)的專門監(jiān)測情況下，避免與抗凝劑或阿司匹林合用。如發(fā)生出血或出現(xiàn)血腫，應(yīng)通知主治醫(yī)生。

　　例14 Periodical examination of hepatic or renal function and blood picture is desirable since Kedacillin may increase SGOT. SGPT and BUN, and decrease erythrocyte and leucocyte.

　　磺芐青霉素鈉可使血清谷-草轉(zhuǎn)氨酶，血清谷-丙轉(zhuǎn)氨酶和血液尿素氮增高，使紅細(xì)胞和白細(xì)胞減少．所以最好要定期檢查肝、腎功能和血象。

　　例15 N.B.Transference from insuline to Glutril may be attempted in case of maturity-onset diabetes with obesity;dosage is based upon the result of the necessarily frequent metablic tests.

　　注意：伴有肥胖癥的成年型糖尿病患者，可試從胰島素改用格路特利治療，劑量應(yīng)以必須經(jīng)常進(jìn)行的代謝試驗(yàn)為依據(jù)。