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Farmacologie > Compusi HST > Flashcards

Compusi HST Flashcards

1
Q

BENZODIAZEPINE

A

-ajung repede la SNC ,de acolo se distribuie in tesuturi pt efect
-traverseaza placenta
-ajung in lapte matern
-se acum in tesut adipos
-mai ok ca siguranta decat barbituricele
-in insomnie se fol comp Z
-

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2
Q

BZD farmacocinetica

A

-se metab in ficat prin 2 mecanisme
-oxidare microsomala si apoi glucuronoconj(diazepam,nordazepam,oxazepam)-timo lung de act
-doar glucuronoconj(lorazepam,oxazepam)

-avem si promedicamente ce trb activate(clorazepam dipotasic)

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3
Q

recep GABA A

A

BZD1(60%)-ef sedativ,amnezic,anticonvulsivant

BZD2-anxiolitic,miorelaxant

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4
Q

BZD mecan act

A

-BZD potenteaza legarea GABA de canalul de Cl pe care il deschide si det o hiperpolarizare mb(influc Cl),fiind dificil sa se aduca la depolarizare—>deci scade excitab neuronala

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5
Q

BZD dur act

A

Scurta
-oxazepam
-triazolam

Intermediara
-alprazolam
-lorazepam
-temazepam

Lunga(1-3 zile)
-diazepam
-flurazepam
-clorazepat
-clordiazepoxid

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6
Q

Efect anxiolitic/tranchilizant

A

-se recomanda cele cu timp lung de act
-Alprazolam singurul care are efect si antidepresiv

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7
Q

BZD-efecte

A

-anticonvulsivant-CLONAZEPAM-apare toleranta pt ef asta

-anestezic-doze mari se fol pt inducere anestezie generala-diazepam,lorazepam,midazolam

-pe resp-deprima resp cand
-e adm iv ,mai ales la pac cu traumatism cranian,BPOC
-in combinatie cu opioide la anestezie

-pe cardiovasc
-in doze preanestezice-scade TA,create frecv cardiaca
-diazepam-ef inotrop neg,creste flux coronarian

-pe digestiva-protectie impotriva ulcerului de stres

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8
Q

BZD ef adv

A

-sedare
-amnezie anterograda
-scad performante psihomotorii(conducatori!!!)
-astenie
-tulb vedere
-diminuare libido
-varstnici-cadere cu fracturi,pneumonie,dementa

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9
Q

BZD-intox acuta

A

FLUMAZENIL(antagonist specific)

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10
Q

BZD toxicitate

A

-apare toleranta si dependenta incrucisate
-sdr de abstinenta
-T1/2 scurt-1-3 zile
-T1/2 lumg-1-2 sapt

NU SE DA TRAT MAI MILT DE 4-6 SAPT!

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11
Q

BZD -indicatii

A

-anestezie
-anxietate
-boli interne cu componenta psiho-vegetativa(ulcer gastroduodenal,colopatii,astm,cardiopatie isch)
-insomnie-nitrazepam,triazolam
-anticonvulsivant-clonazepam,diazepam
-stari spastice
-cura detox alcoolici

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12
Q

BZD contraindic

A

-soferi
-varstnici doze mai scazute
-miastenia gravis

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13
Q

Diazepam

A

-T1/2 creste cu o ora pe an pt fiecare an dupa 40
-se metabolizeaza in nordazepam->oxazepam care e glucuronoconjugat

-anticonvulsivant,tranchilizant(mediat prin alfa 2,la doze mici),sedativ,miorelaxant
-parenteral se da lent pt ca avem risc de altfel-risc de stop resp

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14
Q

Alprazolam

A

Xanax

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15
Q

Lorazepam

A

Anxiar

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16
Q

Midazolam

A

-ed sedativ
-T1/2 scurt

17
Q

Barbiturice

A

-metab extensiva ficat inafara de fenibarbital
-elim renala facilitata de alcalinizare urina

18
Q

Fenobarbital

A

-doza mica 15 mg-sedare usoara,la copii agitatie psihomotoriw
-doza mare 100 mg hipnotic(scade somn REM)
-anticonvulsivant

-inductor enz(accelereaza propria metab si a altor compusi-bilirubina)

-5-10 g doza letala
-doza maxima admisa pe zi 600 mg
-nu se da iv(risc stop resp)
-oral sau im

19
Q

Barbiturice cu dur medie de act

A

Amobarbital
Ciclobarbital
Pentobarbital

20
Q

Barbiturice indicatii

A

-doze mici sedativ
-doze mari hipnotice-insomnie -dar nu se mai recomanda
-anticonvulsivante,antiepileptice
-anestezie

21
Q

Barbiturice toleranta

A

-apare mai devreme pt ef sedativ,hipnotic

Spre deosebire de BZD unde apare pt ef anticonvulsivant

22
Q

Barbiturice r adv

A

-sedare reziduala
-r alergice
-toleranta,dependenta

23
Q

Dependenta barbiturice

A

Apare dupa 1-2 sapt

24
Q

Intox acuta barbiturice -deces

A

Prin
-stop resp
-insuf renala acuta
-inf pulm la 1-5 zile
-colaps

25
Q

Barbiturice intox acuta

A

-initiere voma,spalaturi gastrice
-bicarbonat pt acidoza
-ventilatie mecanica
-perfuzii cu amine simpaticometice
-antib pt a nu face inf pulm
-hemodializa in stadii avansate

26
Q

Barbiturice contraindic

A

Porfirii hep
IH,IR
Cand se dau estrogeni,anticog cumarinice,antidepresive-se ajusteaza doze

27
Q

Barbiturice preparate compuse

A

EXTRAVERAL
-valeriana+fenobarbital

DISTONOCALM
-propranolol+atropina+ergotamina+amobarbital

FASCONAL
-acid acetilsalicilic+paracet+cafeina+codeina+fenobarbital

28
Q

Compusi Z

A

Zolpidem-nu anticonv nici miorelax nici anxiolitic(pe insomnia de mentinere)
Zopiclona(IMOVANE)-si anticonvulsivanr si miorelax
Eszopiclona-dur de act 6 h-ter pe term lung pt insomnie de mentinere
Zaleplenona-pt insomnie de inductie(dur scurta de act)

29
Q

Derivati de melatonina

A

Ramelteon
Tasimelteon
Agomelatina-si antag 5HT2c(dependenti alcool si insomnia-scad depresia)

30
Q

Alte medicam tranchil

A

Buspirona
-agonist partial 5HT1a
-nu cu alcool
-poate da dep
-pt stari anxioase

Farmacologie (23 decks)

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