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Farmacologie > Droguri > Flashcards

Droguri Flashcards

1
Q

Dependenta

A

-dependenta psihica,fizica
-toleranta(farmacocinetica,faemacodinamica,invatata/conditionata)
-psihotoxicitatea

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2
Q

Efect

A

-nicotina,cocaina,amfetamina-stimulant
-barbiturice,benzodiazepine,alcool-sedativ
-LSD,fenciclidina-halucinatii
-marijuana-modif disociative

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3
Q

Nicotina-istoric

A

-la doze mici stim recep Nn
-la doze mari stim recep Nm
-la doze f mari bloc recep nicotinici

-ef prin stim ggl vegetativi si a medulosuprarenalei

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4
Q

Nicotina intox acuta cu doze mari

A

-paralizie inerv vegetativa
-tremur
-convulsii
-paralizie ms striati
-colaps
-hipotensiune
-deces

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5
Q

Nicotina dependenta

A

-apar ef asupra SNC in doar 7 sec
-la cronici-stim atentie si relax ms(stim neuroni dopaminergici din nucleu accumbens)
-poate afecta secr endogena de opioide si glucocort
-fumatul scade speranta vietii cu 5-8 ani( la cei fara boli cronice) si cu 15-22 ani ( la cei cu boli cronice)

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6
Q

Nicotina-sdr abstinenta

A

-max la 2 sapt
-dur 3-6 sapt

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7
Q

Nicotina trat

A

-de substitutie-6 luni
- ef benefice apare dupa 6 sapt
-la 12 luni de abstinenta ,doar 20% au recaderi
-cel mai ok sunt aerosoli presurizati dozati-inca nu sunt aprobate
-optim-ter de substit,ter comportamentala,ter anti craving

VARENCICLINA(agonist recep nicotinici)

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8
Q

Alcool dehidrogenazA

A

-gastrica
-inhibata de aspirina
-metab gastrica a alcoolului e mai scazuta la femei

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9
Q

Alcool efecte

A

1.CV
-aritmii
-cardiomiopat
-AVC hemoragic/ischemic
-HTA

2.Ms striati
-Scade forta de contr
-Miopatie scheletala

3.temperatura-o cresc,daca o scad risc moarte subita

4.digestiv
-creste secr acida gastric
-diaree(malabs)
-pancr acuta
-steatoza hep(cant medii)
-hepatita alcoolica,ciroza hep alcoolica(cant mari)

Altele
-inh vasopresina(ef diuretic)
-hipovitaminoze
-hipoMg
-hipoCa
-osteoporoza
-disfunctii sex

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10
Q

Alcool doze

A

-20-30g/zi ef protectiv
-40-60g/zi-risc crescut

-80mg/dl intox acuta
-400mg/dl letal

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11
Q

Alcool indicatii

A

-inj in nv/ggl simpatici-nevralgie trigemen,carcinom inoperabil
-inj paravert/epidural-durere lomb inop
-sistemic-intox cu alcool metilic,etilenglicol

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12
Q

Dependenta cronica de alcool

A

-poate da ciroza
-sdr KORSAKOFF(afect memorie pt evenim noi)-reversibil dupa cateva lunil abstinenta

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13
Q

Trat intox acuta alcool

A

-risc de hipoglic(se da Glu)
-daca avem vars,risc aspiratie(intubare)
-sedative,antipsihotice(daca e agresiv)

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14
Q

Trat dependenta cronica

A

-rehidrat
-reech hidro electrolitica
-vitamine
-benzodiazepine
-anticonvulsivante

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15
Q

Medicamente trat alcool

A

-NALTREXONA(antag opioid)-se da 3 luni,trb abstinenta 5-7 zile inainte,scade ef placute ale alcoolului

-NALMEFEN(scade motivatia de a bea,scade cant ingerata)-hepatotox mai mica decat primul

-ACAMPROSAT(normalizeaza transmitere neuronala in consum cronica)
-TOPIRAMAT(scade niv dopamina )

-carbamazepina-creste dispozitia
-ondansetron-amelioreaza dependenta fizica

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16
Q

Marijuana

A

-form din THC (ef psihotrop)si CBD(potenteaza ef THC)
-in fum-61 canabinoizi
-SNC-clonati recep pt canabinoizi cu ligand endogen-anandamida
-recep gasiti in special in cortex,cerebel,corpi striati,hipocamo
-pe langa ca creste ef cognitive,atentir memorie
-mai are si alte ef-antivomitiv,anticonvulsivant,miorelax,scade pres intraoc
-ef teratogen
-daca consuma copiii-pot face coma

17
Q

Marijuana trat pt dependenta cronica

A

-dronabinol
-buspirol
-litiu
-timostabilizatoare
-antidepresive

18
Q

Substante inhalatorii folosite ca droguri

A

-fenciclidina-anestezic de uz veterinar(act pe recep pe aminoacizi excitatorii)-dg pe baza anamnezei si analiza suc gastric
-da coma 5-7 zile
-nu avem antidot,acidifiere urina(semn ca se elimina)

-GHT(gamahidroxibutirat)-ecstasy lichid

19
Q

Opioide -exemple

A

-opium,codeina,morfina
-semisintetice-heroina,hidromorfona
-sintetice-fentanil,tramadal,petidina

20
Q

Alcaloizi in opiu

A

-fenantrenici(codeina,morfina)-dau abuz
-benzilizochinolonici(papaverina)-efecte periferice

21
Q

Opioide intox acuta

A

Naloxona iv

22
Q

Sindrom abstinenta opioide

A

-apare la 10h de la oprire consum
-max la 36-48h
-simot dispar cam dupa 5 zile

23
Q

Durata de act opioide

A

-scurta(heroina,morfina)
-lunga(metadona)

24
Q

Trat dependenta opioide

A

-se trece de la subst cu elib rapida la cele cu elib lunga(metadona cu elib sustinuta)
-daca avem hipertonie simpatica-se da clonidina
-NALTREXONA(antag opioid)

25
Q

Heroina

A

-diacetil morfina
-ef ce dureaza 3-5h
-pac isi adm de 2-4 ori pe zi
-sdr de abstinenta tine aprox 5-6 luni

26
Q

Heroina trat dependenta

A

-se tece pe morfona initial 20-30 g dupa se scade cu 20%/zi treptat
-in caz de dependenta fizica majora se asoc cu naltrexona
-pt hipertonia simpatica-clonidina(adm transdermica da hipotens),lofexidina(mai rar hipotens)

-pt scadere craving-burprenorfina(agonist partial de opioizi)-sublingual sau inj(+naloxona)

Dupa detox dam Naltrexona de tip depot+psihoter

27
Q

Psihostimulante-util benefice

A

-ADHD
-oboseala
-depresie usoara
-narcolepsie
-cocaina e fol ca anestezic in ORL

28
Q

Psihostimulante mec act

A

-inh recaptare serotonina si catecolaminte
-act pe recaptare dopamina
-creste dopamina in zone critice
-inh sist transport specific transmembranar

29
Q

Cocaina

A

-T1/2 de 5 min
-se doreste adm la 10-30 min
-euforia depinde de cant ei in corpi striati
-se gaseste in urina pana la 72h(10 zile la util cronici)

30
Q

Psihostimulante supradozare trat

A

1.agitaie
-benzodiazepine(diazepam)
-barbiturice cu dur scurta de act(ciclobarbital)
-pt manif psihotice-clordelazin sau alt neuroleptic cu potenta mare
AVEM GRIJA LA HALOPERIDOL sau alt neuroleptic-hipertermie,diskinezii,convulsii

2.TAD>110-alfa cu beta bloc(IMPREUNA DOAr!!),BCC,vasodil
-se prefera nitroprusiat iv

3.convulsii cu diazepam sau barbiturixe

4.hipertermia prin metode fizice

5.rabdomioliza-alcalinizare urina +manitol/furosemid

IN CAZURI SEVERE-curarizare cu PANCIRONIU sau adm de DANTROLEN

31
Q

Sdr de abstinenta cocaina

A

-faza de crash-imd dupa oprire
-sdr de abstinenta propriu zis pana la 3 sapt
-faza de excitatie-simptome asemanatoare,dar diminuate(1-3 luni)

32
Q

Trat dependenta cronica psihostimulante

A

Pt reducere craving
-antidepr triciclice-au ef adv(TOPIRAMAT,BACLOFEN)
-agonisti dopaminergici
-inh selectivi recaptare serotonina
-carbamazepina
-partial agonisti opioizi(burprenorfina)

33
Q

Cofeina

A

-creste NA,dopamina
-traverseaza BHE
-antag recep adenozina
-inh fosfodiesteraze

Farmacologie (23 decks)

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