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Farmacologie > CURS 7 INFLUENTA M. NETEDE > Flashcards

CURS 7 INFLUENTA M. NETEDE Flashcards

1
Q

CLASIFICARE- substante care stimuleaza m. neteda viscerala

A
  • tract uro-genital: Neselective (histamina) si selective ( oxitocina si deriv din prostaglandine ( Dinoprostone,Carbaprost, Gemeprost, Mifepristone) si derivati din Ergot ( Ergometrina si Metilergometrina )
  • tract gastro-intestinal: purgative de volum si de iritatie
  • colecist:colecistokinina
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2
Q

Oxitocina - Mecanism de actiune

A

Agonist al receptorilor pentru oxitocina => creste influxul si concentratia de Ca2+

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3
Q

Oxitocina - Efecte farmacodinamice

A
  • induce si mentine travaliul
  • slab vasoconstrictor => creste TA
  • ejectia laptelui
  • slab antidiuretic
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4
Q

Oxitocina - Farmacocinetica

A

Administrare:i.v. sau prin mucoasa bucala/nazala
Absorbtie: buna prin mucoasa, rapid inactivata de enzimele gastrice
Transport: Nu e legata de proteine
T1/2: 5 minute

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5
Q

Particularitati oxitocina

A

Stimulata de estrogeni/inhibata de progesteron
Contractiile pot fi antagonizate de: beta2-stimulante, anestezice generale lichide volatile inhalatorii, sulfat de Mg i.v.

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6
Q

Oxitocina: Indicatii

A
  • inducerea travaliului
  • ejectia laptelui (spray nazal)
  • profilaxia mastitei
  • profilaxia/tratamentul hemoragiilor postpartum
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7
Q

Oxitocina: efecte adverse

A
  • rupturi uterine
  • morti materne si fetale (HTA)
  • intoxicatie cu apa si hiponatremie
  • hipo sau afibrinogenemie
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8
Q

Oxitocina: contraindicatii

A
  • travaliu e prematur
  • HTA
  • placenta praevia
  • bazin chirurgical
  • insuf renala
  • suferinta fetala
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9
Q

Ergometrina si Metilergometrina - Mecanism

A
  • agonist pe alfa-adrenergici
  • agonist pe dopaminergici
  • antagonist partial pe 5HT2
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10
Q

Ergometrina si Metilergometrina - Farmacodinamie

A
  • contractii uterina
  • prokinetic
  • slab vasopresor
  • potential halucinogen
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11
Q

Ergometrina si Metilergometrina - Indicatii

A
  • realizarea globului de siguranta (postpartum)
  • accelerarea delivrarii placentei
  • hemoragii postpartum
  • test la ergometrina - detectarea spasmului coronarian in angina Prinzmetal
  • involutie incompleta a uterului in periaoda puerperala
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12
Q

Ergometrina si Metilergometrina - Efecte adverse

A
  • greata varsaturi diaree
  • cresteri tensionale
  • toxicitate endoteliala - 7 exemple
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13
Q

Ergometrina si Metilergometrina - Contraindicatii

A

Absolute: Sarcina, inertie uterina, IC severa, HTA
Relativa: Boli vasculare obliterante, insuf hepatica/renala, psihoze, colagenoze

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14
Q

Ergotamina - Mecanism

A
  • antagonist partial alfa-adrenergici pre si post
  • antagonist partial 5-HT2
  • stimularea fibrelor m. netede vasculare
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15
Q

Ergotamina - Farmacodinamie

A

-vasoconstrictie a vaselor mari si cerebrale

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16
Q

Ergotamina - Indicatii

A
  • migrena

- cafeina ii potenteaza efectul

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17
Q

Ergotamina - efecte adverse

A
  • greata varsaturi diaree
  • toxicitate endoteliala
  • parestezii a musculaturii membrelor
  • cresteri tensionale
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18
Q

Ergotamina - contraindicatii

A
  • HTA, leziuni vasculare
  • sarcina
  • insuf hepatica/renala
  • boli psihice
  • septicemie
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19
Q

Dihidroergotamina - mecanism si farmacodinamie

A
  • antagonist alfa1,2-adrenergici

- vasoconstrictie + cresterea tonusului venos

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20
Q

Dihidroergotamina - indicatii + efecte adverse + contraindicatii

A 
Indicatii:
-profilaxie migrena
-tratament criza migrena
-hipotensiune arteriala
Efecte adv + contraindicatii: IDEM ERGOTAMINA
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21
Q

Methysergid - Mecanism

A
  • agonist slab pe alfa 1,2 - adrenergici
  • agonist slab dopaminergici
  • antagonist partial pe 5-HT2
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22
Q

Methysergid - indicatii

A
  • tratament de FOND al migrenei
  • alternativa in profilaxia migrenei
  • alternativa tratament tumori carcinoide producatoare de serotonina
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23
Q

Methysergid- Efecte adverse

A
  • modif fibrotice ale venelor
  • fibroze retroperitoneale, miocardice, pleurale
  • cresteri tensionale
  • aritmii
  • toxicitate endoteliala
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24
Q

Methysergid - contraindicatii

A

IDEM ERGOTAMINA

25
CLASIFICARE | Blocante de canale de Ca vasculare si pe cord
- Dihidropiridine: Nifedipina, Amlodipina, Nitrendipina, Nicardipina - Fenilalchilamine:Verapamil - Benzotiazepine:Diltiazem
26
CLASIFICARE | Blocante de canale de Ca relativ selectiv vascular
Dihidropiridine:Felodipina, Isradipina, Nisoldipina, Lacidipina, Lercanidipine
27
CLASIFICARE | Blocante de canale de Ca relativ selectiv cerebral
- Dihidropiridine: Nimodipina | - Deriv piperazinici: piperazina
28
CLASIFICARE | Blocante de canale de Ca relativ selectiv cord
Bepridil
29
CLASIFICARE | Deriv izocinoleinici din opiu
Papaverina, Eupaverina, Ethaverina, Proxifyline, Diproxiphyline, Enprofyline
30
CLASIFICARE | Metilxantine
- Naturale: Teofilina, Teobromine, Cafeina | - De sinteza: Pentoxifilina, Propentofilina, Pentifiline, Dyphyline
31
Blocante de canale de calciu - mecanism
Blocarea canalelor de Ca de tip L prin: - cresterea efluxului de Ca din celula - inhibarea Ca-calmodulina - stimularea inactivarii miozin-kinazei cu lanturi usoare
32
Blocante de canale de calciu - Farmacodinamie
- vascular: scaderea TA sistolice si diastolice - bronsic: bronho dilatator pt Verapamil si Diltiazem - cord inotrop cronotrop dromotrop negative: sunt antiaritmice de clasa IV - efect analgezic pt Verapamil Diltiazem si Nifedipina
33
Verapamil- farmacodinamie
- inhibarea eliberarii de insulina - inhibarea glicoproteinei P - creste HDL - reduce depozitarea de Ca - reduce hipertrofia ventriculara
34
Blocante de canale de calciu - farmacocinetica
- peste 90% se leaga de proteine plasmatice - traverseaza BHE si ajunge in lapte - Efectul primului pasaj hepatic la Verapamil si Diltiazem (acesta se elimina prin fecale)
35
Blocante de canale de calciu - Indicatii
- HTA care? - tahiaritmii care? - angina pectorala - cardiomiopatie hipertrofica obstructiva - tulburari de irigatie cerebrala care? - sdr Raynaud - mgirena - prevenirea rezistentei la chimioterapice
36
Blocante de canale de calciu - contraindicatii
- bradicardie sinusala - bloc AV - sarcina - insuf cardiaca severa
37
Blocante de canale de calciu - efecte adverse
- edeme ale fetei/mb inf - hipotensiune - bloc AV/agravarea insuf cardiace - hiperglicemii - sedare - tahiaritmii - r. imunologice de tip I - torsada varfurilor - constipatie, varsaturi, disconfort abdominal
38
Derivati izochinoleinici din opiu: Papaverina, Eupaverina, Ethaverina, Proxyfilina, Diproxiphyline, Enprofylline: - mecanism - farmacodinamie - farmacocinetica
- inhibarea neselectiva a fosfodiesterazelor, nu actioneaza pe R opiacei, nu det adictie, nu au efecte analgezice/euforizante - relaxarea musculaturii netede - papaverina t1/2 = 1-2, 90% legata de prot plasmatice
39
Derivati izochinoleinici din opiu: Papaverina, Eupaverina, Ethaverina, Proxyfilina, Diproxiphyline, Enprofylline: -indicatii
- antispatic - preeclampsie, eclampsie, vasospasm - disfunctie sexuala masculina
40
Derivati izochinoleinici din opiu: Papaverina, Eupaverina, Ethaverina, Proxyfilina, Diproxiphyline, Enprofylline: -efecte adverse
- furt sanguin (ce e?) - efecte de tip chinidinic (care sunt?) - hepatotoxicitate
41
Metilxantine - mecanism
- antagonist pe R adenozinici A1 si A2 | - inhiba neselectiv fosfodiesterazele
42
Metilxantine - efecte SNC
- vasoconstrictie - dependenta - irascibilitate, convulsii - tremuraturi ale extr - efect psihoanaleptic
43
Metilxantine - efecte periferice
- cord: inotrop cronotrop dromotrop pozitiv, creste rezistenta periferica, scade TA (PENTOXIFILINA: efect antiagregant plachetar, scade vascozitatea sangelui, creste capacitatea de deformare a hematiilor) - bronsic: bronhodilatator, creste miscarea ciliara - antiinflamator, imunosupresor - antialergic - renal: slab diuretic - stimuleaza secretia glandelor gastrice - analgezic
44
Teofilina- indicatii
Mai mult sub forma teofilina-etilendiamina - astm bronsic - BPOC - apnee la nou-nascut - adjuvant in IC
45
pentoxifilina - indicatii
- arteriopatii obstructive - ulcere trofice, flebite, tromboflebite - mielom multiplu
46
Metilxantine - efecte adverse
- digestive: inapetenta greata varsaturi dureri abominale - cardiovasculare: hipotensiune, palpitatii - SNC: iritabilitate, cefalee, insomnie, anxietate, tremuraturi - imnunosupresie
47
Metilxantine - contraindicatii
- IMA, tahiaritmii - epilepsie, insomnie - insuf hepatica - ulcer peptic - imunosupresie - asociere cu psihostimulante, chinolone de gen III
48
inhibitori de PDE5 | Sildenafil Tadalafil Vardenafil - indicatii
- disfunctii sexuale erectile - hipertensiune arteriala pulmonara - sdr Raynaud - afrodisiac
49
inhibitori de PDE5 | Sildenafil Tadalafil Vardenafil - efecte adverse
severe: priapism, hTA severa, IM, AVC, moarte subita moderate: cefalee, roseata, palpitatii, fotofobie, greata si varsaturi
50
inhibitori de PDE5 | Sildenafil Tadalafil Vardenafil - contraindicatii
- IM recent, hTA - insuf hepatica/renala - afectiuni degenerative retiniene - asociere cu nitriti, inhibitori de proteaze
51
Hidralazina - farmacodinamie
- vasodilatatia vasculara - inotrop cronotrop dromotrop pozitiv - creste renina plasmatica - creste retentia de apa si Na
52
Hidralazina- efecte adverse
- dupa prima doza: cefalee roseata transpiratii - dupa tratament indelungat: polinevrite, fenomene autoimune, edeme, fen de inhibitia a maduvei hematopoietice, lacrimare conjunctivite rinoree, cefalee, vertij, hipersecretie gastro-intestinala, diaree, spasme intestinale
53
Minoxidil - mecanism si farmacodinamie
- deschiderea si activarea canalelor de K+ | - dilata selectiv arteriolele, creste renina, retentia de apa si Na, CRESTEREA FIRELOR DE PAR
54
Minooxidil - indicatii si efecte adverse
- HTA severa si alopecie | - retentie hidrosalina si hirsutism
55
Diazoxid - mecanism si farmacodinamie
idem Minoxidil + | - inhiba si alti muschi netezi + inhiba eliberarea de insuline
56
Diazoxid- ef adverse + indicatii
- crize acute de HTA | - retentie hidrosalina, hirsutism, hiperglicemie
57
Nitriti si nitrati- mecanism
interactioneaza cu gruparile tiol din tesuturi determinand eliberarea de NO care determina: -activarea guanilat-ciclazei -stimularea producerii de PGI2 Ambele au ca efect relaxarea musculaturii netede
58
Nitroglicerina + ceilalti nitrati - indicatie + ef adverse
- angina pectorala | - hTA pana la sincopa, cefalee bitemporala pulsatila, tahifilaxie, anemie, methemoglobinemie, criza de glaucom
59
Nitroprusiat de Na- indicatii
- feocromocitom | - hipotensiune dirijata in chirurgie

Farmacologie (10 decks)

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