11. Reteta: HTA, stadiul ll, 30 ani – identic ca la 12

Question 1

Rp 1/ 2/ 3

Answer 1

Rp1/ Betaxolol cpr 20 mg
AO nr I (unu)
DS oral 1 cpr/zi, 30 zile
#
Rp2/Indapamid cpr 1,5mg
AO nr I (unu)
DS oral 1cpr/zi, dimineata, 30 zile
#
Rp3/Spironolactona dj 25mg
AO nr I (unu)
DS oral 1 cpr/zi, dimineata, 30 zile

Question 2

1.Clasificare

Answer 2

Betaxolol - antihipertensiv, beta blocant neselectiv fara ASI (liposolubil)

Indapamid – antihipertensiv, diuretice tiazidice (tiazid-like) – hipopotasemiante

Spironolactona – antiHTA, diuretic economisitor de potasiu (antialdosteronice)

Question 3

2. Forma farmaceutica + doza + mod de adm

Answer 3

Betaxolol cpr 20 mg (oral)

Indapamid (Tertensif SR) – cpr 1,5mg (oral)

Spironolactona – dj. 25mg, 50mg, cps. 100mg (oral)

Question 4

3. Actiune FD

Answer 4

Betaxolol:
-efect inotrop, cronotrop, dromotrop, batmotrop NEGATIV
-antiaritmica, antianginoasa si coronarodilatatoare
-antihipertensiva prin blocarea Rec β1-cardiaci
-antiglaucomatoasa

Indapamid:
-eliminare f crescuta H2O, K+, Na+, Cl-
-inhiba reabs de Na+ si Cl- in TCD
-act. la nivelul TCD (segm de dilutie) => efect antiHTA slab comparativ cu diureticele de ansa

Question 5

4. Indicatii terapeutice

Answer 5

Betaxolol:
 HTA
 aritmii
 glaucom, prin scaderea presiunii intraoculare prin scaderea secretiei apoase
 cardiopatie ischemica, angina pectorala, angina cronica stabila
 insuficienta cardiaca
 betablocantele neselective pot determina bronhoconstrictie, fiind contraindicate la bolnavii cu astm bronsic, BPOC.

Indapamid: HTA, Insuficienta Cardiaca, edeme usoare de origine
cardiaca, hepatica sau alergica

Spironolactona: Insuf Cardiaca, HiperALDO primar si secundar, Hipopotasemie (aritmii, ileus, miastenia gravis); edeme, in asociere cu Furosemid (diuretic de ansa)

Question 6

5.Efecte adverse

Answer 6

Betaxolol:
 bronhospasm cu agravarea astmului bronsic
 deprimare cord cu scadere contractilitate miocard
 bradicardie
 ischemie periferica
 hipoglicemie la diabetici
 fenomene de rebound la intreruperea brusca a tratamentului
 disfunctie sexuala – impotenta la barbate, infertilitate la femei
 insomnie, vise bizare, fatigabilitate

Indapamid: scade K+, Mg2+ si Cl-, creste Glicemia, Acid Uric, Colesterol, Ca2+

Spironolactona: creste K+
tulburari endocrine: impotenta sexuala, ginecomastie la B si hirsutism si amenoree la F.

Question 7

6.Contraindicatii

Answer 7

Betaxolol:
Absolute: BAV, bradicardie severa, astm bronsic sever, depresii psihice severe

Relative: BPOC, Sd. Raynaud, HTA in sarcina,

Spironolactona: Hiperpotasemie, IRA si Insuf Hepatica grava; prudenta in IRC.