Emergency pharmacological management of renal colic caused by urinary stones 1. Mechanism of renal colic: During an attack of renal colic, the synthesis and release of intrarenal prostaglandins increase, which can cause a decrease in renal vascular resistance and an increase in renal blood flow, and a relative increase in urine volume by antagonizing the effect of diuretic hormone. In the case of acute ureteral obstruction, it causes renal colic due to a sharp increase in intrapelvic ureteral pressure and severe pain caused by sudden spasm of smooth muscle. 2, commonly used drug treatment options: reduce prostaglandin production: diclofenac sodium and other antipyretic analgesics are prostaglandin synthase inhibitors, which can reduce the synthesis and release of prostaglandins in the body, thereby reducing renal blood flow and urine volume, reducing the pressure in the renal pelvis and ureter, so that the pain is relieved or disappears. Dilate ureter and release smooth muscle spasm: 1. Progesterone: it can inhibit aldosterone secretion, affect sodium reabsorption by renal tubular epithelial cells, produce solute diuresis, make ureteral smooth muscle relaxation and expansion, reduce tension so as to relieve renal strangulation; 2. M receptor blocker: atropine can release smooth muscle spasm; 3. Calcium channel blocker: nifedipine can have a more complete blocking effect on smooth muscle cell calcium channel. 3, calcium channel blockers: nifedipine can have a more complete blocking effect on the calcium channels of smooth muscle cells, so that the excitation-contraction coupling is “disconnected” and its autonomic and phasic contraction is inhibited, and the ureteral tone is decreased and relaxed; 4, glucagon: it is a peptide hormone containing 29 amino acids secreted by pancreatic islet a cells, which can increase the glomerular filtration rate and inhibit ureteral peristalsis, so that the smooth muscle is relaxed, thus relieve renal colic. 5.Lidocaine: The drug is excreted from urine in its original form by 3% – 5%, and relieves pain by antispasmodic and ureteral expansion. 6, dronavirine hydrochloride: it is a very strong antispasmodic, direct action on smooth muscle fibers, no anticholinergic effect. 7, magnesium sulfate: this product can block nerve impulse conduction, with antispasmodic, sedative, urinary and analgesic effect.