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Farmacologie > Tratamentul constipatiei > Flashcards

Tratamentul constipatiei Flashcards

1
Q

Constipatia

A

> 3 scaune/saptamana

disconfort abdominal, pierderea apetitului, defecatie dificila sau dureroasa

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2
Q

Constipatia cronica

A

> 3 luni

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3
Q

Constipatie secundara

A 
Cancer colo-rectal sau ovarian
Obstructii mecanice
hTir, DZ
Neuro: lez MS, Parkinson
colagenoze
anxietate, stres emotional
sarcina
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4
Q

Medicamente care induc constipatie

A 
opioide
m-colinolitice
antiacide - saruri de Al si Ca
X canale de Ca (verapamil)
saruri de Fe
antidepresive triciclice
fenotiazine
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5
Q

Tratamentul constipatiei

A

Masuri igieno-dietetice - aoirt de fibre (legume, fructe, paine integrala), hidratare suficienta, exercitii fizice
Tratament simptomatic - laxative

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6
Q

Laxative si purgative - mecanism de actiune

A

Grabesc tranzitul +/- cresc cant de apa din scaun

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7
Q

Laxative - efect

A

inmuierea scaunului

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8
Q

Purgative - efect

A

elim de scaune lichide

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9
Q

Laxative si purgative - indicatii

A

Constipatie cronica idiopatica
Evitare ef de defecatie - boli CV, AVC, hernie, fisuri ano-rectale, hemoroizi
pregatirea interventiilor chirurgicale, ex Rx

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10
Q

Boala laxativelor

A

manifestari de colita severa cu pierdere de apa si electroliti si vitamine datorita abuzului de laxative

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11
Q

Laxative si purgative - CI

A

abdomen acut de etiologie necunoscuta
obstacole intestinale, ileus mecanis
suspiciune de perforatie sau abces abd
CUH

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12
Q

Laxativele de volum - mecanism de actiune

A

fibre alimentare nedigerabile si coloizi hidrofili
- fibre fermentate de flora intest - 2 efecte: prod AG cu lant scurt (rol trofic pt epit colic) si creste masa bact
- fibre nefermentate - atrag apa in intest, cresc vol cont si + peristaltismul
Nu au toxicitate sistemica

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13
Q

Laxative de volum - reprezentanti

A 
metilceluloza, carboximetilceluloza
triticum (tarate de grau)
psyllum
seminte de in
agar
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14
Q

Laxative de volum - RA

A

balonare, flatulenta

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15
Q

Laxative de volum - CI

A

obstructii mecanice
megacolon, megarect
! admin cu o cant suficienta de apa

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16
Q

Purgative osmotice

A

retin apa in intestin prin mec osmotic si + peristaltismul

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17
Q

Sulfatul de Mg

A

Purgativ salin

RA: greturi, varsaturi, deshidratare, intox cu Mg - deprimare centrala (copii mici, IR, BAV, diuretice)

18
Q

Lactuloza

A

dizaharida sintetica (gal+fru) -> scindata de flora microbiana in gal si fru, greu absorbabile -> fermentate la ac acetic si lactic

19
Q

Lactuloza - indicatii

A

constipatie cronica idiopatica
contipatia prod de opioide si vincristina
encefalopatie hepatica

20
Q

Lactuloza - RA

A

greata, flatulenta, colici, diaree, tul h-e

21
Q

Macrogolul

A

polietilenglicol cu lant lung
nu se absoarbe
laxativ osmotic care nu modif ech h-e

22
Q

Macrogol - indicatii

A

constipatie cr idiopatica

pregatirea pt Rx, endoscopie, interv chirurgicale (Fortrans - 4 L sol timp de 3 h cu cel putin 4 h inaintea procedurii)

23
Q

Macrogol - RA

A

diaree, colici intest

24
Q

Surfactantii

A 
Inmoaie scaunul (emulsionarea grasimilor)
I: varstnici in stare terminala, afect anale acute, combaterea efortului de defecatie
Repr: docusat sodic, ulei de parafina
25
Q

Purgative iritante

A

Ulei de ricin
Purgative antrachinonice - crusin, senna. suc de aloe
Bisacodil - deriv de difenilmetan

26
Q

Purgative antrachinonice - mecanism de actiune

A

hidroliz de flora microbiana -> deriv antrachinonici -> abs -> + plex mienteric

27
Q

Purgative antrachinonice - RA

A 
Colici, 2-3 zile de contipatie post purgatie, obisnuinta, dependenta, leziuni intestinale, melanosis coli
Diaree grava (sugari)
28
Q

Purgative antrachinonice - CI

A

Abdomen acut
Rectoragii
Sarcina, lactatie

29
Q

Bisacodil - indicatie

A

Constipatia cronica idiopatica

30
Q

Bisacodil - RA

A

leziuni inflamatorii ale mucoasei colonului

31
Q

Prucaloprid - clasa si mecanism

A

Prokinetic
agonist selectiv R 5-HT4, faciliteaza transmiterea colinergica - scurteaza timpul de tranzit intest si creste frecventa scaunelor

32
Q

Metilnaltrexona, almivopan - clasa si mecanism de actiune

A

Antagonisti ai R opioizi (R miu periferici) -> nu limiteaza actiunea analgezica a opioidelor

33
Q

Antagonisti ai R opioizi - indicatii

A

Constipatia produsa de opioide la pacientii oncologici

Ileus post-operator

34
Q

Lubiprostona - clasa si mecanism de actiune

A

Secretagog colic, analog de PGE1 -> + canalele de Cl => creste secretia de H2O in lumenul intestinal -> acceleareaza tranzitul, inmoaie scaunul

35
Q

Lubiprostona - indicatii

A

Constipatia idiopatica

SII

36
Q

Lubiprostona - RA

A

Diaree tranzitorie, greata

37
Q

Linaclotida - clasa si mecanism

A

Agonist al guanilatciclazei C -> + secretia si motilitatea intestinala

38
Q

Linaclotida - indicatii

A

Constipatie cronica idiopatica

SII cu constipatie (reduce durerea abdominala)

39
Q

Glicerina intrarectal

A

Lubrifiant si agent higroscopic -> prod scaun in mai putin de o ora
RA: iritatii si discomfort local

40
Q

Clismele

A

Ant interventiilor chirugicale sau proc dg
Cu solutii saline, solutii osmotic active, iritante
Distensia colonului ii declanseaza reflex evacuarea
RA: hiponatremie la clisme repetate cu solutii hipotone

Farmacologie (8 decks)

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