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Farmacologie > Antivomitive > Flashcards

Antivomitive Flashcards

1
Q

Cauze de varsatura

A

Anomalii ale tubului digestiv - obstructive sau non-obstructive
DZ, uremie, ICSR
Migrena, anorexia nervoasa
Medicamente (chimioterapice anticanceroase)
Sarcina
Kinetoze, sdr Meniere

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2
Q

Stimuli care pot declansa varsatura

A 
Substante chimice (medicamente/toxice) din sg
Aferente nv de la TGI, ap vestibular sau SNC
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3
Q

Mediatori si receptori ai reflexului de voma

A 
Serotonina -> R 5HT3, r 5ht4
Dopamina -> R D2
His -> R H1
Ach -> R M
Endocanabinoizii -> R CB1
Substanta P -> R NK1
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4
Q

Vomitive - utilizare, reprezentant, CI

A

IPECA - in intoxicatii

CI: pacienti inconstienti, convulsii, ingestie de subst caustice sau corozive

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5
Q

Utilizarile clinice ale antivomitivelor

A

Adjuvant in chimio si radioterapie - combate voma indusa de medicamentele citotoxice
Varsaturi post-op
Kinetoze, afect vestib
Disgravidie precoce - DOAR atunci cand sunt neaparat necesare
Altele - diskinezii biliare, dispepsii

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6
Q

Setroni - mecanism de actiune

A

Blocarea R 5HT3 de la niv aferentelor vagale, NTS, area postrema si CV

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7
Q

Setroni - reprezentanti

A

Ondansetron
Granisetron
Palonosetron

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8
Q

Setroni - indicatii

A

voma produsa de citostatice, radioterapie
varsaturi de sarcina
varsaturi postoperatorii
NU este eficient in kinetoze

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9
Q

Setroni - farmacocinetica

A

efecte de lunga durata (1 doza/zi)
abs buna din TGI
metabolizare hep extensiva - !ajustarea dozelor in IH
eliminare urinara

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10
Q

Setroni - administrare

A

iv in perfuzie cu 30 min inaintea administrarii chimioterapicelor

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11
Q

Setroni - RA

A

dureri musculare, sedare/anxietate, prelungirea intervalului QT

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12
Q

Antagonistii R D2 - clase

A

Fenotiazine
Butirofenone
Benzamide

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13
Q

Fenotiazine - reprezentanti

A

Clorpromazina

Proclorperazina

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14
Q

Fenotiazine - indicatii

A 
Varsaturi post-op
Uremie
ELECTIE - gastroenterite virale
Varsaturi induse de medicamente
Sarcina
Preventiv in kinetoze
Varsaturi post-chimioterapie de intensit moderata (eficacit < setronii)
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15
Q

Fenotiazine - RA

A

Somnolenta
hTA ortostatica
Tulburari extrapiramidale

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16
Q

Fenotiazine - CI

A

IH, IR, epilepsie, asocierea cu alcool

17
Q

Butirofenone - reprezentanti

A

Haloperidol

Droperidol

18
Q

Benzamide - reprezentanti

A

Metoclopramid

Domperidon

19
Q

Metoclopramid - actiune

A

antagonist al R D2 de la niv TV -> ef antivomitiv

actiune perif -> ef prokinetic mai ales in portiunea sup a TGI

20
Q

Metoclopramid - farmacocinetica

A

A rapida dupa admin orala
sufera primul pasaj hepatic
E urinara

21
Q

Metoclopramid - indicatii

A 
Boala de iradiere
Uremie
Gastrita, UGD, BRGE, tulb motilitate digestive
Cancer gastric/intest
Varsatura post anestezica/medicamente
Varsatura post chimio si radioterapie
22
Q

Metoclopramid - RA

A 
Somnolenta, nervozitate
Distonii acute, tulb extrapiramidale
Tulb de menstruatie
Galactoree
MetHb la nn
23
Q

Metoclopramid - CI

A

Obstructie mecanica TGI, hemoragii digestive, feocromocitom

24
Q

M-colinolitice - reprezentant si indicatie

A

Scopolamina

I: kinetoze - po. sau TTS retroauricular

25
Q

Antihistaminice H1 - reprezentanti

A 
GENERATIA I
Ciclizina, cinarizina
Prometazina
Difenhidramina, dimenhidrinat
Betahistina
26
Q

Antihistaminice H1 - indicatii

A

Kinetoze
Iritatia directa a stomacului
Varsaturi post-op

27
Q

Canabinoizi - reprezentanti

A

Dronabinol

Nabilona

28
Q

Canabinoizi - farmacocinetica

A

Admin orala
Leg extensiva de P plasmatice
M hep
E biliar

29
Q

Canabinoizi - indicatii

A

Varsaturi post-chimioterapie

Anorexia pacientilor cu SIDA - dronabinol

30
Q

Dronabinol - RA

A

Stimulare Sy (tk, palpitatii, hTA)
Congestie conjunctivala
Potential addictiv

31
Q

Nabilona - RA

A 
Somnolenta, ameteala
Palpitatii
hTA ortostatica
xerostomie
euforie, anxietate, tulb de gandire, reactii psihotice
32
Q

Canabinoizi - CI

A

persoane cu istoric de dependenta de subst de abuz

33
Q

Steroizii

A

Potenteaza efectul altor antivomitive

Dexametazona, metilprednisolon, prednison

34
Q

Benzodiazepinele

A

Nu au ef antivomitiv propriu-zis
Voma anticipatorie - datorita ef anxiolitic, sedativ, amnezic
Lorazepam, alprazolam

35
Q

Antagonistii R pentru subst P

A

I: varsaturile tardive post-chimioterapie
Reprezentanti: Aprepitant, Fosaprepitant

36
Q

Prevenirea varsaturilor precoce si tardive post chimioterapie

A

Ondansetron + dexametazona iv in perfuzie cu 30 min inainte de inceperea cisplatinului
Aprepitant 125 mg po cu 30 de min inaintea admin cisplatin
Aprepitant 80 mg po dimineata in Z2-3 post-chimioterapie

37
Q

Combaterea varsaturilor din disgravidia precoce - masuri non-farmacologice

A

Mese frecvente, reduse cant, bogate in P
Hidratare
Lichide reci
Cola

38
Q

Combaterea varsaturilor din disgravidia precoce - masuri farmacologice

A

Prometazina/ Metoclopramid

! doar dupa evaluarea raportului risc/beneficiu

Farmacologie (8 decks)

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