33.Reteta: Ulcer duodenal in puseu acut, Helicobacter Pylori prezent

Question 1

Rp 1 / 2 / 3

Answer 1

Rp1/Omeprazol cpr 20 mg
AO nr I (unu)
DS oral, 2x1 cpr/zi, 14 zile
#
Rp2/Amoxicilina cps 1g
AO nr I (unu)
DS oral, 2x1 cps/zi, 10 zile
#
Rp3/Claritromicina cpr 500 mg
AO nr I (unu)
DS oral, 2x1 cpr/zi, 14 zile

Question 2

1.Clasificare

Answer 2

Omeprazol- antiulceros antiagresiv, antisecretor, blocant al pompei de protoni
Amoxicilina – antibiotic bactericid de tip degenerative, Betalactamine, Peniciline cu spectru largit
Claritromicina- antibiotic bacteriostatic, macrolid de generatia ll

Question 3

2. Forma farmaceutica + doza

Answer 3

Omeprazol - cpr 10, 20, 40 mg (p.o)
Amoxicilina - cps. 250 mg, 500 mg, 1.000 mg (p.o)
Claritromicina - cpr. 250 mg, 500 mg (p.o)

Question 4

3.Actiune FD

Answer 4

Omeprazol:
actiune antisecretorie ft puternica -> 20 mg Omeprazol/zi scade secretia gastrica cu 90%.
-sunt prodroguri, se activeaza in mediul acid

Amoxicilina:
-creste fragilitatea peretelui celular bacterian
-liza și moartea celulei bacteriene

Claritromicina:
-inhiba sinteza proteica bacteriana
-in principal claritromicina este bacteriostatică

Question 5

4.Indicatii terapeutice

Answer 5

Omeprazol:
 esofagita de reflux
 ulcer duodenal si gastric
 sindromul Zollinger- Ellison (de electie)  obligatoriu de stiut !!
 tratament de eradicare Helicobacter pylori
 gastropatie iatrogena

Amoxicilina: inf cu HPy

Claritromicina: inf resp/ gastrice

Question 6

5.Efecte adverse

Answer 6

Omeprazol:
 eruptii, greturi, varsaturi, diaree, ameteli, ginecomastie
 Administrarea pe perioade lungi a Omeprazolului -> hiperplazia cel enterocromafine cu aparitia tumorilor de tip carcinoid

Amoxicilina si Claritromicina;
-sunt bine tolerate
-pot cauza tulburari gastrointestinale

Question 7

6.Contraindicatii

Answer 7

Omeprazol:
-sarcina si alaptare, copii, insuficienta hepatica

Amoxicilina si Claritromicina:
-alergii la peniciline, beta-lactamine si alergii la macrolide