PDF(Pubmed)
Abstract：
Edema is an accumulation of fluid in the body\'s tissues that affects millions of Americans yearly. It can affect multiple body parts, for example, the brain or eyes, but often occurs in the periphery, including the feet and legs. Medications, such as dihydropyridine and thiazolidinediones (TZDs), can be the etiology of edema. Edema can develop in association with problems in the vasculature or lymphatic flow. In recent years, a better understanding of these drug-induced mechanisms has been appreciated. Specifically, dihydropyridines can increase hydrostatic pressure and cause selective pre-capillary vessel vasodilation. TZDs can cause edema through increased vascular permeability and increased hydrostatic pressure. Specifically, peroxisome proliferator-activated receptor gamma (PPARγ) stimulation increases vascular endothelial permeability, vascular endothelial growth factor (VEGF) secretion, renal sodium, and fluid retention. Other drugs that can cause edema include neuropathic pain agents, dopamine agonists, antipsychotics, nitrates, nonsteroidal anti-inflammatory (NSAIDS), steroids, angiotensin-converting enzyme (ACE) inhibitors, and insulin. There are various clinical presentations of edema. Since multiple mechanisms can induce edema, it is important to understand the basic mechanisms and pathophysiology of drug-induced edema. Edema can even become fatal. For example, angioedema can occur from ACE inhibitor therapy. In this regard, it is considered a medical emergency when there is laryngeal involvement. This review aims to thoroughly appreciate the multiple causes of drug-induced edema and the ways it can be treated or prevented.
摘要：
水肿是人体组织中的液体积聚，每年影响数百万美国人。它可以影响身体的多个部位，例如,大脑或眼睛，但经常发生在外围，包括脚和腿。药物,如二氢吡啶和噻唑烷二酮（TZDs），可能是水肿的病因。水肿可与脉管系统或淋巴流动中的问题相关联地发展。近年来,人们对这些药物诱导机制有了更好的理解。具体来说,二氢吡啶可以增加静水压力并引起选择性毛细血管前血管舒张。TZDs可通过增加的血管通透性和增加的静水压力引起水肿。具体来说,过氧化物酶体增殖物激活受体γ（PPARγ）刺激增加血管内皮通透性，血管内皮生长因子（VEGF）分泌，肾钠，和液体滞留。其他可引起水肿的药物包括神经性疼痛药物，多巴胺激动剂，抗精神病药,硝酸盐，非甾体抗炎药（NSAIDS），类固醇,血管紧张素转换酶（ACE）抑制剂，和胰岛素。有各种水肿的临床表现。由于多种机制可以诱发水肿，了解药物性水肿的基本机制和病理生理学非常重要。水肿甚至可以成为致命的。例如,血管紧张素转换酶抑制剂治疗可发生血管性水肿.在这方面,当喉部受累时，它被认为是医疗紧急情况。这篇综述旨在彻底了解药物引起的水肿的多种原因以及可以治疗或预防的方法。
