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farmaco > lp 5 > Flashcards

lp 5 Flashcards

1
Q

efecte produse de sedativ hipnotice

A

IN FUNCTIE DE DOZA:
-sedativ
-hipnotic
-somn anestezic
-moarte

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2
Q

efect sedativ. ce inseamna si la ce doze apare

A

-deprimare psihomotorie cu linistire
-scadere performante psiho-motorii
-uneori somnolenta
- doze mici

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3
Q

efect hipnotic. ce inseamna

A

instalare somn asemanator fiziologic
-pac poate fi trezit prin stimuli obisnuiti

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4
Q

somn anestezic. ce inseamna?

A

=narcoză
- somn asem celui produs de anestezice generale
-pac nu poate fi trezit prin stimuli obisnuiti

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5
Q

cum se produce moartea din sedativ hipnotice

A

stop respirator/ colaps

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6
Q

categorii hipnotice

A

-barbiturice
-benzodiazepinice
-alte hipnotice

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7
Q

ce alt efect pot avea hipnoticele barbiturice

A

anticonvulsivante

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8
Q

ce efecte pot avea benzodiazepinicele

A

-hipnotic
-anxiolitic ( majoritatea)
- anestezie generala IV
anticonvulsivante

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9
Q

benzodiazepine folosite ca anestezice generale IV

A

-midazolam
-diazepam

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10
Q

benzodiazepine cu efect anticonvulsivant

A

-clonazepam
-diazepam
-lorazepam

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11
Q

benzodiazepine cu efect hipnotic

A
  • nitrazepam
    -flurazepam
    -flunitrazepam
    -triazolam
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12
Q

alte hipnotice

A

-zopiclona (Imovane)
zolpidem ( stilnox)
-zaleplon
-cloralhidrat
-ramelteon

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13
Q

tipuri de insomnii

A

-prin deficit de adormire (de inductie)
-de mentinere

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14
Q

medicamente insomnia prin deficit de adormire

A

-pac nu poate sa adoarma
- barbiturice cu durata scurta de actiune

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15
Q

medicamente insomnie de mentinere

A

-hipnotice benzodiazepinice
-hipnotice cu alta structura
sau mai putin eficiente barbiturice cu efect lunga durata

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16
Q

cum modifica barbituricele modelul fiziologic al somnului

A

scad proportia somn REM (ala cu vise)
cresc somn cu unde lente

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17
Q

consecinte privare de somn REM

A

tulburari de comportament
stari de nevroza

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18
Q

ce produc barbituricele

A

inductie enzimatica
autoinductie enzimatica

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19
Q

mecanism actiune barbiturice

A

-agonisti fata de reveptori GABA A

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20
Q

efect fenobarbital descriere

A

instalare lenta
durata lunga- peste 8 ore

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21
Q

pt ce se utilizeaza fenobarbitalul

A

-hipnotic- rar- produce sedare diurna
-sedativ
-anticonvulsivant
-injectabil im

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22
Q

doza fenobarbital sedativ

A

doze mici 15-30 mg

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23
Q

doze fenobarbital hipnotic

A

100 mg/zi
seara

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24
Q

fenobarbital ca anticonvulsivant

A

doze medii
adm oral
tratament cronic epilepsie

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25
Q

fenobarbital injectabil im

A

in crize convulsive

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26
Q

efect+ actiune hipnotice benzodiazepinice

A

efect rapid, durata medie de actiune
-nu scad REM
-nu produc inducție enzimatica

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27
Q

medicamente sedative cu efect intwnsitate mica, posibil placebo

A

-extract Crataegus
-extract Passiflora
-bromuri- nu se mai fol

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28
Q

enumerare sedative blocante receptori histaminergici H1 de prima generatie

A

-hidroxizina
-prometazina
-difenhidramina
-clorfeniramina

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29
Q

efect sedative blocante receptori histaminergici H1 de prima generatie

A

antialergic
antiemetic
sedativ

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30
Q

enumerare anxiolitice

A

diazepam
oxazepam
medazepam
lorazepam - Anxiar
alprazolam - Xanax - pt depresie nevrotica
bromazepam
clordiazepoxid

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31
Q

mecanism actiune anxiolitice benzodiazepine

A

agonisti receptori GABA ergici
se fixeaza pe situsuri BZ1 si BZ2

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32
Q

efecte diazepam

A

anxiolitic
anestezic general IV
criza convulsiva inj IM sau intrarectal
miorelaxant central- tetanos/ afect cerebrale

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33
Q

etape metabolizare benzodiazepine

A
  1. oxidare microzomiala
  2. glucuronoconjugare

exceptie- Lorazepam+ oxazepam metabolizate doar prin glucuronoconjugare

34
Q

contraindicatii benzodiazepine si dc

A
  • varstnici
  • alcoolici
    -prematuri
    -hepatici
    pt ca proces oxidare este mai lent

EXCEPTIE- LORAZEPAM+ OXAZEPAM

35
Q

tipuri de crize epileptice

A

-majore= mare rau epileptic / grand mal
-minore= crize de absenta/ mic rau epileptic/ petit mal
- status epilepticus

36
Q

criza epileptica majora descriere

A
  • pierderea cunoștinței
  • cadere bolnav
  • aparitie contractii tonice, apoi clonice, apoi tonico-clonice generalizate
37
Q

descriere criza epileptica minora

A

-nu se manif prin cadere/ convulsii
- intrerupere brusca activitate obisnuita
-pierderea contactului cu mediu exterior perioada timp scurta

38
Q

status epilepticus descriere

A

= criza epileptica lunga durata
sau
= succesiune rapida de crize convulsive subintrante

39
Q

focar epileptogen

A

focar cerebral care contribuie la aparitie comvulsii - descarca impulsuri cu frecv mare ce se transmit la niv cerebral

40
Q

exemple crize convulsive in afara epilepsiei

A

-convulsii febrile copil mic
- convulsii meningite
- convulsii in tulb metabolice grave
-convulsii produse de unele subst chimice

41
Q

medicamente mare rau epileptic

A

carbamazepina
fenitoina
fenobarbital

42
Q

medicamente micul rau epileptic

A

etosuximida

43
Q

medicamente care se adm in ambele epilepsii

A

acid valproic
Lamotrigina

44
Q

tratament epilepsie

A

-lunga durata
- se opreste dupa 2-5 ani de la ultima criza, doar la indicatie neurolog

45
Q

medicament status epilepticus/ alte situatii urgenta

A

anticonvulsivant inj
DIAZEPAM
fenobarbital

46
Q

medicamente convulsii neepileptice

A

diazepam inj sau intrarectal
fenobarbital

47
Q

mecanism actiune anticonvulsivante

A

oprire aparitie focar epileptogen
oprire extindere excitatie focar spre restul creier

48
Q

mecanisme prin care actioneaza anticonvulsivantele

A

-blocare canale ionice Na
-potentare efect tip GABA ergic
scadere eliberare glutamat

49
Q

alternativa diazepam pt crize convulsive

A

FENOBARBITAL inj im
o fiola are 200 mg in 2 ml de solutie
se adm 1/4 sau 1/2 din fiola, repetand daca e cazul dupa 6 ore

50
Q

alte anticonvulsivante criza

A

Midazolam- iv sau sublingual
Lorazepam iv

51
Q

sindrom neuroleptic ce inseamna

A

tablou caracteristic celor 4 tipuri de efecte ale antipsihoticelor

52
Q

cum se mai numesc antipsihoticele

A

neuroleptice

53
Q

cele 4 tipuri de efecte antipsihotice

A

-antipsihotic
sedativ
-sindrom extrapiramidal
-fenomene vegetativo-litice si endocrine

54
Q

efect antipsihotic neuroleptice

A

diminuare progresiva manifestari psihotice
-apare la 3 sapt
-este maxim la 2-6 luni

55
Q

efect sedativ neuroleptice

A

scadere activ psiho-motorii in sensul de stare de indiferenta la stimuli exteriori
- scadere agresivitate

56
Q

manifestari sindrom extrapiramidal neuroleptice

A

-fenomene parkinsoniene
-neliniste si agitatie motorie = acatisie
-reactii distonice acute
-diskinezii tardive

57
Q

cand apar diskinezii tardive

A

tratamente indelungate
-pot fi ireversibile

58
Q

ce inseamna acatisie

A

neliniste si agitatie motorie

59
Q

fenomene vegetativo-litice si endocrine neuroliptice

A
  • efecte prod de blocare R alfa adrenergici perifeci/ inhibare simpatica la niv central
  • efecte parasimpatolitice
  • inhibare formatiuni vegetative centrale
  • inhibare centru termo-reglator
  • influentare activ endocrina
60
Q

efecte neuroleptice produse de blocare receptori alfa adrenergici perif si inhibare simpatica centrala

A
  • hipotensiune- m ales ortostatica
  • congestie nazala
61
Q

efecte parasimpatolitice neuroleptice

A
  • uscaciune gura
  • cicloplegie cu tulburari de vedere
  • agravare eventual glaucom
  • constipatie
  • mictiune dificila
  • tahicardie
  • uscaciune piele
  • tulburare fct sexuala

intre timp- toleranta=> intensitate efecte scade

62
Q

la ce se foloseste efectul inhibare centru termo-reglator neuroleptice

A

chirurgie- hipotermia controlata
=metoda adjuvanta interventii unde e necesara scadere metabolism si consum tisular de oxigen

63
Q

efecte neuroleptice pe sist endocrin

A
  • crestere secretie prolactina
  • diminuare secretie STH
  • deprimare functie corticosuprarenala in stres
64
Q

categorii antipsihotice

A
  • tipice= clasice
  • atipice- nu produc r. adverse extrapiramidale semnificative si sunt antidepresive+ anxiolitice
65
Q

mecanism actiune antipsihotice clasice

A

blocheaza receptori dopaminergici- m ales D2
* blocare D2=> ef. antipsihotic
* blocare nigro-striati=>ef. extrapiramidale
* blocare sist hipotalamo-hipofizari=> ef. vegetativo-litice

66
Q

mecanism actiune antipsihotice atipice

A

blocheaza receptori dopaminergici+ pentru serotonina ( 5HT 2A)

67
Q

exemple antipsihotice atipice

A
  • ziprasidona
  • risperidona
  • olanzapina
68
Q

alte utilizari neuroleptice

A
  • antivomitive
  • preanestezie
69
Q

reactii adverse importante neuroleptice

A
  • hipotensiune ortostatica
  • crestere secretie prolactina
  • tulburari extrapiramidale
  • efecte anticolinergice periferice si centrale
  • diskinezia tardiva
70
Q

medicament contracarare tulburari extrapiramidale neuroleptice

A

trihexifenidil (romparkin)
=antiparkinsonian
* actiune anticolinergica, blocheaza R muscarinici

71
Q

efecte anticolinergice periferice si centrale neuroleptice imp pt stoma

A
  • xerostomie
  • crestere frecv CD
  • roseata difuza muc bucala
  • stomatita
  • pierdere progresiva dantura
  • limba neagra paroasa
72
Q

ce medicamente neuroleptice produc hipersalivatie

A
  • clozapina
  • olanzepina
73
Q

tipuri neuroleptice tipice

A
  • fenotiazinice
  • tioxantenice
  • butirofenonice
74
Q

categorii neuroleptice fenotiazinice

A
  • sedative cu potenta mica
  • sedative cu potenta medie
  • tip incisiv
75
Q

neuroleptice fenotiazinice sedative potenta mica

A
  • clorpromazina
  • levomepromazina
76
Q

neuroleptice fenotiazinice sedative potenta mare

A

tioridazina

77
Q

neuroleptice fenotiazinice tip incisiv

A
  • trifluoperazina
  • fluflenazina- exista si pp retard
78
Q

neuroleptice tioxantenice

A
  • clorprotixen
  • flupentixol
79
Q

neuroleptice butirofenonice

A

haloperidol

80
Q

neuroleptice atipice

A
  • risperidona
  • olanzapina
  • ziprasidona
  • aripiprazol

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