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Farmacologie > CURS 4 PARASIMPATICOLITICE > Flashcards

CURS 4 PARASIMPATICOLITICE Flashcards

1
Q

Exemple alcaloizi naturali

ANTIMUSCARINICE

A

Atropina si Scopolamina

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2
Q

Amine cuaternare indicate in terapia bolilor gastro-intestinale, exemple
(ANTIMUSCARINICE)

A 
Butilscopolamina
Propantelina
Metantelina
Cidinium
Isopropamida
Mepenzolat
Metscopolamina
Oxifenonium
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3
Q

Amine cuaternare indicate in incontinenta urinara

ANTIMUSCARINICE

A

Trospium si Emepronium

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4
Q

Amine tertiare antispastice

ANTIMUSCARINICE

A

Pirenzepina(M1 M3)
Telenzepine(M1 M3)
Diciclomin
Oxifeniciclimin

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5
Q

Antimuscarinice tertiare neselective pentru incontinenta urinara
(ANTIMUSCARINICE)

A

Oxibutinin
Tolterodin
Propiverin

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6
Q

Antimuscarinice tertiare selective pentru incontinenta urinara
(ANTIMUSCARINICE)

A

Darifenacin (M3)

Solifenacin (M1 M3)

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7
Q

Amine cuaternare indicate in astm bronsic

ANTIMUSCARINICE

A

Scurta durata: Ipratropium si Oxitropium

Lunga durata: Tiotropium

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8
Q

Amine tertiare indicate pt Parkinson si pseudoparkinson

ANTIMUSCARINICE

A 
Benztropina
Trihexifenidil
Orfenadrina
Biperiden
Prociclidina
Difenciclimin
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9
Q

Anticolinergice centrale indicate ca miorelaxante

ANTIMUSCARINICE

A 
Clorzoxazona
Ciclobenzaprina
Carisoprodol
Clorfenezina
Metaxalone
Orfenedrina
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10
Q

In oftalmologie? (ANTIMUSCARINICE)

A

Homatropina
Ciclopentolat
Tropicamida

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11
Q

Efecte atropina asupra aparatului cardiovascular

A

Cord: Cresterea frecventei ( e de obicei precedata de o bradicardie + tulburari de ritm)
Vascular: vasodilatatie + hipotensiune

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12
Q

Efecte atropina glob ocular

A
  • Midriaza = paralizia sfincterului irian(7-10 zile in administrare locala) + reducerea scurgerii umorii apoase prin canalul lui Schlemm
  • Cicloplegie - impiedica acomodarea
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13
Q

Efecte atropina muschi neted

A

Reducerea tonusului muscular (favorizeaza retentia urinara deoarece contracta sfincterul simultan deci pot fi folosita in incontinenta urinara)

  • dupa 3 zile nu mai are efect la nivelul motilitatii digestive din cauza plexului auerbach
  • bronhodilatatie (doar la pers cu astm bronsic )
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14
Q

Efecte atropina glande exocrine

A

inhiba puternic glandele salivare si sudoripare si secretia apoasa a glandelor bronsice, avand ca efect advers cresterea vascozitatii secretiei

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15
Q

Efecte atropina asupra SNC

A

Antiemetic
Amelioreaza simptomele parkinsonului
Miorelaxare

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16
Q

Pe ce cai are absorbtie buna atropina?

A

Orala
Parenterala
Conjunctivala

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17
Q

Traverseaza atropina BHE ?

Cine nu?

A

Da

Derivatii cuaternari NU.

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18
Q

Care e T1/2

A

2 ore

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19
Q

INDICATII Atropina

A
  • intravenos : asistolie, bradiaritmii, antidot, antispastic, premedicatie
  • topic : midriaza terapeutica
  • antiemetic
  • adjuvant
  • diagnostic WPW
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20
Q

CONTRAINDICATII Atropina

A 
Glaucom
Hiperplazie benigna de prostata
Leziuni ateromatoase coronariene/insuf cardiaca/tulburari de ritm
Nou-nascuti/copii mici/varstnici
Boala ulceroasa
\+ trebuie evitata expunerea la soare
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21
Q

Atropina EFECTE ADVERSE

A
  • tulburari de vedere, fotofobie
  • reducerea motilitatii gastro-int
  • reducerea secretiei salivare, sudoripare, lacrimale
  • retentie de urina daca este hiperplazie benigna de prostata
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22
Q

Antidot pentru intoxicatia cu atropina?

A

Pilocarpina sau Neostigmina iv.

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23
Q

Efecte Scopolamina

A

Ca la atropina DAR efecte mai puternice pe globii oculari si secretia salivara si mai slabe pe cord si abdomen,
DIFERENTA : pe SNC determina sedare, efect hipnotic si amnezie retrograda

24
Q

Indicatii scopolamina

A

antispastic
antiemetic
agitatie psihomotorie
premedicatie in anestezie

25
Q

Contraindicatii/Efecte adverse?

A

Ca la atropina. zi-leeeeeee

26
Q

Butilscopolamina: mecanism si indicatii

A

Antagonist neselectiv pe RM

indicat ca antispastic la niv digestiv si genito-urinar, premedicatie si antiemetic (de electie)

27
Q

Pirenzepina/Telenzepina: mecanism, efecte, indicatii

A

Antagonist selectiv pe M1
Inhiba secretia acida gastrica si de pepsina
Indicat ca antispastic

28
Q

Propantelina: indicatii

A

Antispastic digestiv

29
Q

Trospium: indicatii

A

Incontinenta urinara

30
Q

Diciclomin:efect si indicatii

A

Antispastic

indicat in tratamentul colonului iritabil

31
Q

Oxibutinin efecte si indicatii

A

Contractia sfincterului vezical, relaxarea m. neted al peretelui vezical
Indicat in incontinenta uriara

32
Q

Darifenacin/Solifenacin: mecanism, indicatii

A

Antagonisti selectivi pe M3/M1M3

Indicate in incontinenta urinara, vezica neurologica

33
Q

Ipratropium/Oxitropium/Tiotropium: indicatii, dezavantaj

A

Astm bronsic / determina o crestere a vascozitatii.

34
Q 
Benztropina
Trihexifenidil
Orfenadrina
Biperiden
Prociclidina
Difenciclimin. Mecanism si indicatii
A 
Antagonisti pe M ai neuronilor intercalari medulari
Indicate in (pseudo)parkinson
35
Q 
Clorzoxazona
Ciclobenzaprina
Carisoprodol
Clorfenezina
Metaxalone
Orfenedrina. Mecanism si indicatii
A

Antagonisti pe M ai neuronilor intercalari medulari

Indicate in spasm al m. striate

36
Q

Homatropina/Tropicamida/Ciclopentolat. Indicatii

A

midriaza in scop terapeutic, prolaps irian

37
Q

Toxina botulinica: Cine o produce si care e mecanismul?

A

Clostridium botulinum/ inhibarea eliberarii de Ach

38
Q

Toxina botulinica: indicatii

A
  • spasm m globilor oculari
  • analgezic
  • cosmetica
39
Q

Toxina botulinica efecte adverse si contraindicatii

A
  • disfagie, uscarea gurii, ptoza palpebrala, reactii imunologice
  • sarcina, alaptare, miastenia gravis, tratament cu chimioterapice
40
Q

Derivati cu amoniu cuaternar (GANGLIOPLEGIC)

A

Hexametoniu, Tetraetilamoniu
Pentolinium
Decametoniu

41
Q

Structuri cu functii amidice secundare

GANGLIOPLEGIC

A

Mecamilamina

42
Q

Structuri cu functii amidice tertiare (GANGLIOPLEGIC)

43
Q

Derivati sulfonici

GANGLIOPLEGIC

A

Camsilat de Trimetafan

44
Q

Camsilat de trimetafan indicatii

A
  • crize acute de HTA

- realizarea unei hipotensiuni controlate

45
Q

Camsilat de Trimetafan. Efecte adverse

A
  • simpatoplegie
  • parasimpatoplegie
  • reactii alergice
46
Q

Exemple curarizante nedepolarizante

A

D-Tubocurarina, Atracurium, Cisatracurium, Pipecuronium, Pancuronium, Galamina

47
Q

Exemplu curarizant depolarizant

A

Succinilcolina

48
Q

Pahicurare- mecanism/ traverseaza BHE?

A

antagonisti competitivi pe Nm la poarta canalelor de Na/K -> blocheaza canalele in pozitie deschisa
NU traverseaza BHE

49
Q

Pahicurare indicatii

A
  • miorelaxare in interventii chirurgicale
  • laringoscopii /esofagoscopii /bronhoscopii
  • manevre ortopedice
50
Q

D-Tubocurarina - efecte adverse

A
  • Nu produce buna relaxare a glotei
  • Elibereaza histamina
  • Hipotensiune
  • Scade coagulabilitatea
51
Q

Atracurium particularitate

A
  • metabolizare de tip hoffman

- det eliberare redusa de histamina

52
Q

Cisatracurium/Doxacurium

A
  • Nu au efecte pe Nn si M2

- Nu elib histamina

53
Q

Mivacurium

A
  • Nu actioneaza pe Nn sau M2

- Elibereaza putin histamina

54
Q

Pancuronium

A

blocheaza moderat M2

55
Q

Rocuronium

A

Blocheaza redus M2

56
Q

Galamina

A

Antagonist alosteric pe M2 => tahicardie

  • Nu elibereaza histamina si nu actioneaza pe Nn
  • Nu produce buna relaxare a glotei
57
Q

Avantaje/Dezavantaje Succinilcolina

A
  • instalare si incetare rapida + buna relaxare a glotei

- lipsa antidot + dureri musculare

Farmacologie (10 decks)

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