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lp 5 Flashcards

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1
Q

efecte produse de sedativ hipnotice

A

IN FUNCTIE DE DOZA:
-sedativ
-hipnotic
-somn anestezic
-moarte

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2
Q

efect sedativ. ce inseamna si la ce doze apare

A

-deprimare psihomotorie cu linistire
-scadere performante psiho-motorii
-uneori somnolenta
- doze mici

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3
Q

efect hipnotic. ce inseamna

A

instalare somn asemanator fiziologic
-pac poate fi trezit prin stimuli obisnuiti

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4
Q

somn anestezic. ce inseamna?

A

=narcoză
- somn asem celui produs de anestezice generale
-pac nu poate fi trezit prin stimuli obisnuiti

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5
Q

cum se produce moartea din sedativ hipnotice

A

stop respirator/ colaps

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6
Q

categorii hipnotice

A

-barbiturice
-benzodiazepinice
-alte hipnotice

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7
Q

ce alt efect pot avea hipnoticele barbiturice

A

anticonvulsivante

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8
Q

ce efecte pot avea benzodiazepinicele

A

-hipnotic
-anxiolitic ( majoritatea)
- anestezie generala IV
anticonvulsivante

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9
Q

benzodiazepine folosite ca anestezice generale IV

A

-midazolam
-diazepam

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10
Q

benzodiazepine cu efect anticonvulsivant

A

-clonazepam
-diazepam
-lorazepam

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11
Q

benzodiazepine cu efect hipnotic

A
  • nitrazepam
    -flurazepam
    -flunitrazepam
    -triazolam
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12
Q

alte hipnotice

A

-zopiclona (Imovane)
zolpidem ( stilnox)
-zaleplon
-cloralhidrat
-ramelteon

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13
Q

tipuri de insomnii

A

-prin deficit de adormire (de inductie)
-de mentinere

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14
Q

medicamente insomnia prin deficit de adormire

A

-pac nu poate sa adoarma
- barbiturice cu durata scurta de actiune

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15
Q

medicamente insomnie de mentinere

A

-hipnotice benzodiazepinice
-hipnotice cu alta structura
sau mai putin eficiente barbiturice cu efect lunga durata

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16
Q

cum modifica barbituricele modelul fiziologic al somnului

A

scad proportia somn REM (ala cu vise)
cresc somn cu unde lente

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17
Q

consecinte privare de somn REM

A

tulburari de comportament
stari de nevroza

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18
Q

ce produc barbituricele

A

inductie enzimatica
autoinductie enzimatica

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19
Q

mecanism actiune barbiturice

A

-agonisti fata de reveptori GABA A

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20
Q

efect fenobarbital descriere

A

instalare lenta
durata lunga- peste 8 ore

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21
Q

pt ce se utilizeaza fenobarbitalul

A

-hipnotic- rar- produce sedare diurna
-sedativ
-anticonvulsivant
-injectabil im

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22
Q

doza fenobarbital sedativ

A

doze mici 15-30 mg

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23
Q

doze fenobarbital hipnotic

A

100 mg/zi
seara

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24
Q

fenobarbital ca anticonvulsivant

A

doze medii
adm oral
tratament cronic epilepsie

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25
fenobarbital injectabil im
in crize convulsive
26
efect+ actiune hipnotice benzodiazepinice
efect rapid, durata medie de actiune -nu scad REM -nu produc inducție enzimatica
27
medicamente sedative cu efect intwnsitate mica, posibil placebo
-extract Crataegus -extract Passiflora -bromuri- nu se mai fol
28
enumerare sedative blocante receptori histaminergici H1 de prima generatie
-hidroxizina -prometazina -difenhidramina -clorfeniramina
29
efect sedative blocante receptori histaminergici H1 de prima generatie
antialergic antiemetic sedativ
30
enumerare anxiolitice
diazepam oxazepam medazepam lorazepam - Anxiar alprazolam - Xanax - pt depresie nevrotica bromazepam clordiazepoxid
31
mecanism actiune anxiolitice benzodiazepine
agonisti receptori GABA ergici se fixeaza pe situsuri BZ1 si BZ2
32
efecte diazepam
anxiolitic anestezic general IV criza convulsiva inj IM sau intrarectal miorelaxant central- tetanos/ afect cerebrale
33
etape metabolizare benzodiazepine
1. oxidare microzomiala 2. glucuronoconjugare exceptie- Lorazepam+ oxazepam metabolizate doar prin glucuronoconjugare
34
contraindicatii benzodiazepine si dc
- varstnici - alcoolici -prematuri -hepatici pt ca proces oxidare este mai lent EXCEPTIE- LORAZEPAM+ OXAZEPAM
35
tipuri de crize epileptice
-majore= mare rau epileptic / grand mal -minore= crize de absenta/ mic rau epileptic/ petit mal - status epilepticus
36
criza epileptica majora descriere
- pierderea cunoștinței - cadere bolnav - aparitie contractii tonice, apoi clonice, apoi tonico-clonice generalizate
37
descriere criza epileptica minora
-nu se manif prin cadere/ convulsii - intrerupere brusca activitate obisnuita -pierderea contactului cu mediu exterior perioada timp scurta
38
status epilepticus descriere
= criza epileptica lunga durata sau = succesiune rapida de crize convulsive subintrante
39
focar epileptogen
focar cerebral care contribuie la aparitie comvulsii - descarca impulsuri cu frecv mare ce se transmit la niv cerebral
40
exemple crize convulsive in afara epilepsiei
-convulsii febrile copil mic - convulsii meningite - convulsii in tulb metabolice grave -convulsii produse de unele subst chimice
41
medicamente mare rau epileptic
carbamazepina fenitoina fenobarbital
42
medicamente micul rau epileptic
etosuximida
43
medicamente care se adm in ambele epilepsii
acid valproic Lamotrigina
44
tratament epilepsie
-lunga durata - se opreste dupa 2-5 ani de la ultima criza, doar la indicatie neurolog
45
medicament status epilepticus/ alte situatii urgenta
anticonvulsivant inj DIAZEPAM fenobarbital
46
medicamente convulsii neepileptice
diazepam inj sau intrarectal fenobarbital
47
mecanism actiune anticonvulsivante
oprire aparitie focar epileptogen oprire extindere excitatie focar spre restul creier
48
mecanisme prin care actioneaza anticonvulsivantele
-blocare canale ionice Na -potentare efect tip GABA ergic scadere eliberare glutamat
49
alternativa diazepam pt crize convulsive
FENOBARBITAL inj im o fiola are 200 mg in 2 ml de solutie se adm 1/4 sau 1/2 din fiola, repetand daca e cazul dupa 6 ore
50
alte anticonvulsivante criza
Midazolam- iv sau sublingual Lorazepam iv
51
sindrom neuroleptic ce inseamna
tablou caracteristic celor 4 tipuri de efecte ale antipsihoticelor
52
cum se mai numesc antipsihoticele
neuroleptice
53
cele 4 tipuri de efecte antipsihotice
-antipsihotic sedativ -sindrom extrapiramidal -fenomene vegetativo-litice si endocrine
54
efect antipsihotic neuroleptice
diminuare progresiva manifestari psihotice -apare la 3 sapt -este maxim la 2-6 luni
55
efect sedativ neuroleptice
scadere activ psiho-motorii in sensul de stare de indiferenta la stimuli exteriori - scadere agresivitate
56
manifestari sindrom extrapiramidal neuroleptice
-fenomene parkinsoniene -neliniste si agitatie motorie = acatisie -reactii distonice acute -diskinezii tardive
57
cand apar diskinezii tardive
tratamente indelungate -pot fi ireversibile
58
ce inseamna acatisie
neliniste si agitatie motorie
59
fenomene vegetativo-litice si endocrine neuroliptice
* efecte prod de blocare R alfa adrenergici perifeci/ inhibare simpatica la niv central * efecte parasimpatolitice * inhibare formatiuni vegetative centrale * inhibare centru termo-reglator * influentare activ endocrina
60
efecte neuroleptice produse de blocare receptori alfa adrenergici perif si inhibare simpatica centrala
* hipotensiune- m ales ortostatica * congestie nazala
61
efecte parasimpatolitice neuroleptice
* uscaciune gura * cicloplegie cu tulburari de vedere * agravare eventual glaucom * constipatie * mictiune dificila * tahicardie * uscaciune piele * tulburare fct sexuala ## Footnote intre timp- toleranta=> intensitate efecte scade
62
la ce se foloseste efectul inhibare centru termo-reglator neuroleptice
chirurgie- hipotermia controlata =metoda adjuvanta interventii unde e necesara scadere metabolism si consum tisular de oxigen
63
efecte neuroleptice pe sist endocrin
* crestere secretie prolactina * diminuare secretie STH * deprimare functie corticosuprarenala in stres
64
categorii antipsihotice
* tipice= clasice * atipice- nu produc r. adverse extrapiramidale semnificative si sunt antidepresive+ anxiolitice
65
mecanism actiune antipsihotice clasice
**blocheaza receptori dopaminergici**- m ales D2 * blocare D2=> ef. antipsihotic * blocare nigro-striati=>ef. extrapiramidale * blocare sist hipotalamo-hipofizari=> ef. vegetativo-litice
66
mecanism actiune antipsihotice atipice
blocheaza receptori dopaminergici+ pentru serotonina ( 5HT 2A)
67
exemple antipsihotice atipice
* ziprasidona * risperidona * olanzapina
68
alte utilizari neuroleptice
* antivomitive * preanestezie
69
reactii adverse importante neuroleptice
* hipotensiune ortostatica * crestere secretie prolactina * tulburari extrapiramidale * efecte anticolinergice periferice si centrale * diskinezia tardiva
70
medicament contracarare tulburari extrapiramidale neuroleptice
trihexifenidil (romparkin) =antiparkinsonian * actiune anticolinergica, blocheaza R muscarinici
71
efecte anticolinergice periferice si centrale neuroleptice imp pt stoma
* xerostomie * crestere frecv CD * roseata difuza muc bucala * stomatita * pierdere progresiva dantura * limba neagra paroasa
72
ce medicamente neuroleptice produc hipersalivatie
* clozapina * olanzepina
73
tipuri neuroleptice tipice
* fenotiazinice * tioxantenice * butirofenonice
74
categorii neuroleptice fenotiazinice
* sedative cu potenta mica * sedative cu potenta medie * tip incisiv
75
neuroleptice fenotiazinice sedative potenta mica
* clorpromazina * levomepromazina
76
neuroleptice fenotiazinice sedative potenta mare
tioridazina
77
neuroleptice fenotiazinice tip incisiv
* trifluoperazina * fluflenazina- exista si pp retard
78
neuroleptice tioxantenice
* clorprotixen * flupentixol
79
neuroleptice butirofenonice
haloperidol
80
neuroleptice atipice
* risperidona * olanzapina * ziprasidona * aripiprazol

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