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Farmacologie > Tratamentul diareei > Flashcards

Tratamentul diareei Flashcards

1
Q

Diareea

A

cresterea anormala a frecventei, volumului sau lichiditatii scaunelor

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2
Q

Diareea acuta

A

Scaune de consistenta scazuta si pierdere de apa si electroliti <14 zile

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3
Q

Diaree cronica

A

scaune moi > 30 zile + scadere in greutate, slabiciune musculara, deshidratare, tulb h-e

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4
Q

Cauze de diaree

A 
Infectioasa
Medicamentoasa
Datorata SB
Gastroenterocolita cronica
SII, B Crohn
stres emotional
cresterea osm cont intestinal
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5
Q

Diareea acuta simpla

A

Tratament simptomatic

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6
Q

Semne de alarma - diaree acuta infectioasa

A 
Temp > 38,5
stare generala alterata
scaune cu produse patologice
deshidratare accentuata
tara subtropicala/ focar endemic de holera
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7
Q

Obiectivele tratamentului in diaree

A

Mentinerea ech h-e
Tratament antiinfectios
Tratament antidiareic simptomatic

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8
Q

Reechilibrare h-e

A

Oral - saruri de rehidratare

Perfuzie

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9
Q

Clase de medicamente pentru tratamentul simptomatic al diareei

A

Antispastice - opioide, anticolinergice

Adsorbante

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10
Q

Opioidele - mecanism de actiune

A

R opioizi miu si delta -> scad activ propulsiva a intestinului, cresc tonusul sfincterului ileocecal si anal, cresc tonusul IG si scad secr digestive

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11
Q

Opioide - RA

A

Potential de dependenta

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12
Q

Opioide - CI

A

Colita ulcerativa -> megacolon toxic
Abdomen acut
Boli diareice cu germeni enteroinvazivi

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13
Q

Loperamid - efecte

A

Scade motil intest, ef antidiareic intens si de lunga durata, creste tonusul sfincterului anal
Actiune antisecretorie pe tox holerei si ETEC

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14
Q

Loperamid - indicatii

A

Diaree acuta nespecifica
Diaree cronica
Diareea calatorilor +/- antimicrobiene
Ileostomie

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15
Q

Loperamid - RA

A

Greata, varsaturi
Deprimarea SNC
Ileus paralitic
Megacolon toxic (BII)

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16
Q

Loperamid - CI

A 
Ileus paralitic
Copii < 2 ani
Sarcina, alaptare
Diaree febrila
Scaune cu sg
17
Q

Difenoxilat

A

Opioid cu potential adictiv > loperamid
Asoc cu atropina
RA: ef atropinice, SNC, constipatie, megacolon toxic

18
Q

Racecadotril

A

Inhibitor de enkefalinaza -> previne degradare enkefalinelor (opioide endogene) cu rol de inhibitie a secretiei intestinale

19
Q

Adsorbante - mecanism de actiune

A

formeaza complexe cu subst iritante pe care le elimina prin fecale
formeaza complexe cu vitamine si minerale, medicamente -> previn abs

20
Q

Adsorbante - reprezentanti

A 
argile (caolin)
disilicat de Al si Mg
Diosmectita
Subcitratul de Bi
Carbune medicinal
21
Q

Clonidina - mecanism de actiune

A

Agonist alfa2 adrenergic -> + reabs H20 si electroliti

22
Q

Clonidina - indicatii

A

Diaree cronica DZ, sdr de abstinenta la opioide, SII

23
Q

Clonidina - RA

A

hTA, depresie, oboseala

24
Q

Octreotid

A

Analog de somatostatina

I: tu carcinoide pancreatice si GI, sdr dumping, chimioterapie, DZ, SIDA

25
Q

Colestiramina si colestipol

A

Rasini schimbatoare de ioni - leaga SB si unele toxine bact
! in rezectii ileale extinse pot agrava diareea
! NU in diareea infectioasa

26
Q

Alosetron

A

Antagonist specific al R 5HT3 -> scade peristaltismul, creste absorbtia apei, amelioreaza durerea
I: SII

27
Q

Probioticele

A

suplimente alimentare - stimuleaza tranzitul, cresterea florei saprofite impiedica popularea colonului cu flora patogena, favorizeaza rasp imun, efect antiinflamator

28
Q

Prebioticele

A

alimente nedigestibile care stimuleaza dezv spp saprofite ale gazdei (oligozaharide din ceapa, praz, usturoi, banane, inulina)

29
Q

Simbioticele

A

amestecuri de probiotice si prebiotice

30
Q

Tratamentul antiinfectios in diaree (empiric)

A

Ciprofloxacina (sau alte quinolone)

Co-trimoxazol

31
Q

Tratamentul infectiei cu C diff

A

Vancomicina/metronidazol

32
Q

Tratamentul diareei acute necomplicate

A 
Mentinerea balantei h-e
Rehidratare orala/pe
Regim alimentar
Adsorbante (carbune, diosmectita)
Crampe accentuate - butilscopolamina
33
Q

Tratament diaree acuta severa

A

ATB - quinolone, rifamixina, co-trimoxazol
!coprocultura
Rehidratare pe + monitoriz - Ht, ech h-e si AB

34
Q

Tratament diaree cronica

A

Tratarea cauzei
Dieta, lq si electroliti
Smecta, Loperamid, Butilscopolamina

35
Q

Tratamentul diareei calatorilor

A

(ag etiologic EPEC) Co-trimoxazol 2x2 cpr/zi

36
Q

Profilaxia diareei calatorilor

A

Alimente pregatite termic, apa imbuteliata

Farmacologie (8 decks)

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