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Farmacologie > CURS 7 INFLUENTA M. NETEDE > Flashcards

CURS 7 INFLUENTA M. NETEDE Flashcards

1
Q

CLASIFICARE- substante care stimuleaza m. neteda viscerala

A
  • tract uro-genital: Neselective (histamina) si selective ( oxitocina si deriv din prostaglandine ( Dinoprostone,Carbaprost, Gemeprost, Mifepristone) si derivati din Ergot ( Ergometrina si Metilergometrina )
  • tract gastro-intestinal: purgative de volum si de iritatie
  • colecist:colecistokinina
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2
Q

Oxitocina - Mecanism de actiune

A

Agonist al receptorilor pentru oxitocina => creste influxul si concentratia de Ca2+

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3
Q

Oxitocina - Efecte farmacodinamice

A
  • induce si mentine travaliul
  • slab vasoconstrictor => creste TA
  • ejectia laptelui
  • slab antidiuretic
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4
Q

Oxitocina - Farmacocinetica

A

Administrare:i.v. sau prin mucoasa bucala/nazala
Absorbtie: buna prin mucoasa, rapid inactivata de enzimele gastrice
Transport: Nu e legata de proteine
T1/2: 5 minute

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5
Q

Particularitati oxitocina

A

Stimulata de estrogeni/inhibata de progesteron
Contractiile pot fi antagonizate de: beta2-stimulante, anestezice generale lichide volatile inhalatorii, sulfat de Mg i.v.

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6
Q

Oxitocina: Indicatii

A
  • inducerea travaliului
  • ejectia laptelui (spray nazal)
  • profilaxia mastitei
  • profilaxia/tratamentul hemoragiilor postpartum
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7
Q

Oxitocina: efecte adverse

A
  • rupturi uterine
  • morti materne si fetale (HTA)
  • intoxicatie cu apa si hiponatremie
  • hipo sau afibrinogenemie
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8
Q

Oxitocina: contraindicatii

A
  • travaliu e prematur
  • HTA
  • placenta praevia
  • bazin chirurgical
  • insuf renala
  • suferinta fetala
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9
Q

Ergometrina si Metilergometrina - Mecanism

A
  • agonist pe alfa-adrenergici
  • agonist pe dopaminergici
  • antagonist partial pe 5HT2
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10
Q

Ergometrina si Metilergometrina - Farmacodinamie

A
  • contractii uterina
  • prokinetic
  • slab vasopresor
  • potential halucinogen
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11
Q

Ergometrina si Metilergometrina - Indicatii

A
  • realizarea globului de siguranta (postpartum)
  • accelerarea delivrarii placentei
  • hemoragii postpartum
  • test la ergometrina - detectarea spasmului coronarian in angina Prinzmetal
  • involutie incompleta a uterului in periaoda puerperala
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12
Q

Ergometrina si Metilergometrina - Efecte adverse

A
  • greata varsaturi diaree
  • cresteri tensionale
  • toxicitate endoteliala - 7 exemple
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13
Q

Ergometrina si Metilergometrina - Contraindicatii

A

Absolute: Sarcina, inertie uterina, IC severa, HTA
Relativa: Boli vasculare obliterante, insuf hepatica/renala, psihoze, colagenoze

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14
Q

Ergotamina - Mecanism

A
  • antagonist partial alfa-adrenergici pre si post
  • antagonist partial 5-HT2
  • stimularea fibrelor m. netede vasculare
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15
Q

Ergotamina - Farmacodinamie

A

-vasoconstrictie a vaselor mari si cerebrale

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16
Q

Ergotamina - Indicatii

A
  • migrena

- cafeina ii potenteaza efectul

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17
Q

Ergotamina - efecte adverse

A
  • greata varsaturi diaree
  • toxicitate endoteliala
  • parestezii a musculaturii membrelor
  • cresteri tensionale
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18
Q

Ergotamina - contraindicatii

A
  • HTA, leziuni vasculare
  • sarcina
  • insuf hepatica/renala
  • boli psihice
  • septicemie
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19
Q

Dihidroergotamina - mecanism si farmacodinamie

A
  • antagonist alfa1,2-adrenergici

- vasoconstrictie + cresterea tonusului venos

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20
Q

Dihidroergotamina - indicatii + efecte adverse + contraindicatii

A 
Indicatii:
-profilaxie migrena
-tratament criza migrena
-hipotensiune arteriala
Efecte adv + contraindicatii: IDEM ERGOTAMINA
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21
Q

Methysergid - Mecanism

A
  • agonist slab pe alfa 1,2 - adrenergici
  • agonist slab dopaminergici
  • antagonist partial pe 5-HT2
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22
Q

Methysergid - indicatii

A
  • tratament de FOND al migrenei
  • alternativa in profilaxia migrenei
  • alternativa tratament tumori carcinoide producatoare de serotonina
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23
Q

Methysergid- Efecte adverse

A
  • modif fibrotice ale venelor
  • fibroze retroperitoneale, miocardice, pleurale
  • cresteri tensionale
  • aritmii
  • toxicitate endoteliala
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24
Q

Methysergid - contraindicatii

A

IDEM ERGOTAMINA

25
Q

CLASIFICARE

Blocante de canale de Ca vasculare si pe cord

A
  • Dihidropiridine: Nifedipina, Amlodipina, Nitrendipina, Nicardipina
  • Fenilalchilamine:Verapamil
  • Benzotiazepine:Diltiazem
26
Q

CLASIFICARE

Blocante de canale de Ca relativ selectiv vascular

A

Dihidropiridine:Felodipina, Isradipina, Nisoldipina, Lacidipina, Lercanidipine

27
Q

CLASIFICARE

Blocante de canale de Ca relativ selectiv cerebral

A
  • Dihidropiridine: Nimodipina

- Deriv piperazinici: piperazina

28
Q

CLASIFICARE

Blocante de canale de Ca relativ selectiv cord

A

Bepridil

29
Q

CLASIFICARE

Deriv izocinoleinici din opiu

A

Papaverina, Eupaverina, Ethaverina, Proxifyline, Diproxiphyline, Enprofyline

30
Q

CLASIFICARE

Metilxantine

A
  • Naturale: Teofilina, Teobromine, Cafeina

- De sinteza: Pentoxifilina, Propentofilina, Pentifiline, Dyphyline

31
Q

Blocante de canale de calciu - mecanism

A

Blocarea canalelor de Ca de tip L prin:

  • cresterea efluxului de Ca din celula
  • inhibarea Ca-calmodulina
  • stimularea inactivarii miozin-kinazei cu lanturi usoare
32
Q

Blocante de canale de calciu - Farmacodinamie

A
  • vascular: scaderea TA sistolice si diastolice
  • bronsic: bronho dilatator pt Verapamil si Diltiazem
  • cord inotrop cronotrop dromotrop negative: sunt antiaritmice de clasa IV
  • efect analgezic pt Verapamil Diltiazem si Nifedipina
33
Q

Verapamil- farmacodinamie

A
  • inhibarea eliberarii de insulina
  • inhibarea glicoproteinei P
  • creste HDL
  • reduce depozitarea de Ca
  • reduce hipertrofia ventriculara
34
Q

Blocante de canale de calciu - farmacocinetica

A
  • peste 90% se leaga de proteine plasmatice
  • traverseaza BHE si ajunge in lapte
  • Efectul primului pasaj hepatic la Verapamil si Diltiazem (acesta se elimina prin fecale)
35
Q

Blocante de canale de calciu - Indicatii

A
  • HTA care?
  • tahiaritmii care?
  • angina pectorala
  • cardiomiopatie hipertrofica obstructiva
  • tulburari de irigatie cerebrala care?
  • sdr Raynaud
  • mgirena
  • prevenirea rezistentei la chimioterapice
36
Q

Blocante de canale de calciu - contraindicatii

A
  • bradicardie sinusala
  • bloc AV
  • sarcina
  • insuf cardiaca severa
37
Q

Blocante de canale de calciu - efecte adverse

A
  • edeme ale fetei/mb inf
  • hipotensiune
  • bloc AV/agravarea insuf cardiace
  • hiperglicemii
  • sedare
  • tahiaritmii
  • r. imunologice de tip I
  • torsada varfurilor
  • constipatie, varsaturi, disconfort abdominal
38
Q

Derivati izochinoleinici din opiu: Papaverina, Eupaverina, Ethaverina, Proxyfilina, Diproxiphyline, Enprofylline:

  • mecanism
  • farmacodinamie
  • farmacocinetica
A
  • inhibarea neselectiva a fosfodiesterazelor, nu actioneaza pe R opiacei, nu det adictie, nu au efecte analgezice/euforizante
  • relaxarea musculaturii netede
  • papaverina t1/2 = 1-2, 90% legata de prot plasmatice
39
Q

Derivati izochinoleinici din opiu: Papaverina, Eupaverina, Ethaverina, Proxyfilina, Diproxiphyline, Enprofylline:
-indicatii

A
  • antispatic
  • preeclampsie, eclampsie, vasospasm
  • disfunctie sexuala masculina
40
Q

Derivati izochinoleinici din opiu: Papaverina, Eupaverina, Ethaverina, Proxyfilina, Diproxiphyline, Enprofylline:
-efecte adverse

A
  • furt sanguin (ce e?)
  • efecte de tip chinidinic (care sunt?)
  • hepatotoxicitate
41
Q

Metilxantine - mecanism

A
  • antagonist pe R adenozinici A1 si A2

- inhiba neselectiv fosfodiesterazele

42
Q

Metilxantine - efecte SNC

A
  • vasoconstrictie
  • dependenta
  • irascibilitate, convulsii
  • tremuraturi ale extr
  • efect psihoanaleptic
43
Q

Metilxantine - efecte periferice

A
  • cord: inotrop cronotrop dromotrop pozitiv, creste rezistenta periferica, scade TA (PENTOXIFILINA: efect antiagregant plachetar, scade vascozitatea sangelui, creste capacitatea de deformare a hematiilor)
  • bronsic: bronhodilatator, creste miscarea ciliara
  • antiinflamator, imunosupresor
  • antialergic
  • renal: slab diuretic
  • stimuleaza secretia glandelor gastrice
  • analgezic
44
Q

Teofilina- indicatii

A

Mai mult sub forma teofilina-etilendiamina

  • astm bronsic
  • BPOC
  • apnee la nou-nascut
  • adjuvant in IC
45
Q

pentoxifilina - indicatii

A
  • arteriopatii obstructive
  • ulcere trofice, flebite, tromboflebite
  • mielom multiplu
46
Q

Metilxantine - efecte adverse

A
  • digestive: inapetenta greata varsaturi dureri abominale
  • cardiovasculare: hipotensiune, palpitatii
  • SNC: iritabilitate, cefalee, insomnie, anxietate, tremuraturi
  • imnunosupresie
47
Q

Metilxantine - contraindicatii

A
  • IMA, tahiaritmii
  • epilepsie, insomnie
  • insuf hepatica
  • ulcer peptic
  • imunosupresie
  • asociere cu psihostimulante, chinolone de gen III
48
Q

inhibitori de PDE5

Sildenafil Tadalafil Vardenafil - indicatii

A
  • disfunctii sexuale erectile
  • hipertensiune arteriala pulmonara
  • sdr Raynaud
  • afrodisiac
49
Q

inhibitori de PDE5

Sildenafil Tadalafil Vardenafil - efecte adverse

A

severe: priapism, hTA severa, IM, AVC, moarte subita
moderate: cefalee, roseata, palpitatii, fotofobie, greata si varsaturi

50
Q

inhibitori de PDE5

Sildenafil Tadalafil Vardenafil - contraindicatii

A
  • IM recent, hTA
  • insuf hepatica/renala
  • afectiuni degenerative retiniene
  • asociere cu nitriti, inhibitori de proteaze
51
Q

Hidralazina - farmacodinamie

A
  • vasodilatatia vasculara
  • inotrop cronotrop dromotrop pozitiv
  • creste renina plasmatica
  • creste retentia de apa si Na
52
Q

Hidralazina- efecte adverse

A
  • dupa prima doza: cefalee roseata transpiratii
  • dupa tratament indelungat: polinevrite, fenomene autoimune, edeme, fen de inhibitia a maduvei hematopoietice, lacrimare conjunctivite rinoree, cefalee, vertij, hipersecretie gastro-intestinala, diaree, spasme intestinale
53
Q

Minoxidil - mecanism si farmacodinamie

A
  • deschiderea si activarea canalelor de K+

- dilata selectiv arteriolele, creste renina, retentia de apa si Na, CRESTEREA FIRELOR DE PAR

54
Q

Minooxidil - indicatii si efecte adverse

A
  • HTA severa si alopecie

- retentie hidrosalina si hirsutism

55
Q

Diazoxid - mecanism si farmacodinamie

A

idem Minoxidil +

- inhiba si alti muschi netezi + inhiba eliberarea de insuline

56
Q

Diazoxid- ef adverse + indicatii

A
  • crize acute de HTA

- retentie hidrosalina, hirsutism, hiperglicemie

57
Q

Nitriti si nitrati- mecanism

A

interactioneaza cu gruparile tiol din tesuturi determinand eliberarea de NO care determina:
-activarea guanilat-ciclazei
-stimularea producerii de PGI2
Ambele au ca efect relaxarea musculaturii netede

58
Q

Nitroglicerina + ceilalti nitrati - indicatie + ef adverse

A
  • angina pectorala

- hTA pana la sincopa, cefalee bitemporala pulsatila, tahifilaxie, anemie, methemoglobinemie, criza de glaucom

59
Q

Nitroprusiat de Na- indicatii

A
  • feocromocitom

- hipotensiune dirijata in chirurgie

Farmacologie (10 decks)

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