samenvatting en toevoeging lesstof verantwoord diergeneesmiddelen gebruik van de opleiding Diergezondheid en Management Leerjaar 1 aan de Aeres Hogeschool in Dronten
Verantwoord
Diergeneesmiddelen
gebruik
PPRC04
ANNICK DI VIRGILIO
,Inhoud
Antibioticum (AB)...................................................................................................................................6
Bacterie..................................................................................................................................................6
Type bacteriën........................................................................................................................................6
Gramkleurstof........................................................................................................................................7
Werking antibiotica 1.............................................................................................................................7
Werking antibiotica 2.............................................................................................................................7
Cide of statisch.......................................................................................................................................8
Uitwisseling tussen bacteriesoorten.......................................................................................................8
Secundaire resistentie: transductie........................................................................................................8
Bacteriofaag: vriend of vijand?...............................................................................................................9
Bacterie en AB........................................................................................................................................9
Antibiotica indeling.................................................................................................................................9
resistentie.............................................................................................................................................10
Kruisresistentie.....................................................................................................................................10
Effectieve dosis.....................................................................................................................................11
Effectieve dosis bepalen.......................................................................................................................12
Effectief doseren en resistentie............................................................................................................12
Resistentie ontwikkelen na AB contact................................................................................................13
Aantal bacteriën...................................................................................................................................13
Nieuwe ontwikkeling............................................................................................................................14
Keuze van AB........................................................................................................................................14
1: Verwachte werkzaamheid................................................................................................................14
2: Smalspectrum AB vs breedspectrum AB...........................................................................................15
3: kans op resistentie-ontwikkeling......................................................................................................15
4: Kolonisatie-resistentie......................................................................................................................15
Hoge kolonisatie-resistentie bereiken..................................................................................................16
kolonisatie-resistentie en AB................................................................................................................16
1e, 2e en 3e keus AB............................................................................................................................16
1e, 2e en 3e keus bij GD vs LHD............................................................................................................17
Richtlijnen AB bij LHD...........................................................................................................................17
Bedrijfsbehandelplan (BBP)..................................................................................................................17
Mag een boer zelf AB toedienen aan zijn vee?.....................................................................................18
‘Wedloop’ bacterie en mens................................................................................................................18
Staphylococcus aureus.........................................................................................................................18
,Varianten MRSA...................................................................................................................................18
Soorten MRSA (2).................................................................................................................................19
ESBL Extended spectrum beta lactamase enzymes..............................................................................19
Stand van zaken....................................................................................................................................19
Evidence based medicine.....................................................................................................................21
Experiment vs onderzoek.....................................................................................................................21
Zuiver wetenschappelijk onderzoek.....................................................................................................21
RCT.......................................................................................................................................................21
Dubbelblind onderzoek........................................................................................................................22
Overige onderzoeksvormen.................................................................................................................22
Complementaire geneeswijzen wetenschappelijk onderbouwen........................................................22
Wat kan wel?........................................................................................................................................22
Empirie.................................................................................................................................................23
De praktijk............................................................................................................................................23
Placebo-effect.......................................................................................................................................23
Medicinaal effect vs. placebo-effect.....................................................................................................24
Placebo’s en dieren..............................................................................................................................24
nieuwe medicijnen...............................................................................................................................24
Grondbeginsel homeopathie................................................................................................................25
Visie op ziekte in homeopathie............................................................................................................26
De anamnese........................................................................................................................................26
De anamnese in homeopathie..............................................................................................................26
Hoe het juiste middel wordt gevonden I:.............................................................................................27
Hoe het juiste middel word gevonden II:..............................................................................................27
Salicine.................................................................................................................................................28
Fytotherapie in de belangstelling.........................................................................................................29
Zelfmedicatie bij dieren........................................................................................................................29
Zelfregulatie complexiteit.....................................................................................................................30
Criteria zelfmedicatie...........................................................................................................................30
Voorbeelden van zelfmedicatie bij dieren............................................................................................30
Mechanismen van zelfmedicatie..........................................................................................................30
Acupunctuur.........................................................................................................................................31
Reclame................................................................................................................................................31
Reclame DGM.......................................................................................................................................31
Publieksreclame...................................................................................................................................32
CAVP.....................................................................................................................................................32
, De Code................................................................................................................................................32
Uitschrijven recepten...........................................................................................................................33
Wat staat er op het recept...................................................................................................................33
Recept voor ‘voorraad’.........................................................................................................................33
DGM met recept: aanschaf door eigenaar...........................................................................................34
Recept afhalen......................................................................................................................................34
Handmatig recept.................................................................................................................................35
Recept innemen...................................................................................................................................35
Regelgeving m.b.t. dgm........................................................................................................................35
Wetgeving m.b.t. diergeneesmiddelen................................................................................................35
Hoe herken je een dgm?.......................................................................................................................35
Besluit Diergeneesmiddelen.................................................................................................................35
4 pijlers Besluit DGM............................................................................................................................37
Registratie-regeling..............................................................................................................................37
‘Diergeneesmiddel’ volgens Besluit Diergeneesmiddelen....................................................................37
Welke middelen vallen onder het Besluit Diergeneesmiddelen?.........................................................38
Besluit DGM: dgm moet geregistreerd zijn...........................................................................................39
Uitzonderingen op registratieplicht......................................................................................................39
Redenen voor uitzonderingen op registratieplicht...............................................................................39
Vrij van registratieplicht ≠ VRIJ.............................................................................................................39
Oude registratie van homeopathische middelen.................................................................................40
Homeopathie m.i.v. 6 april 2021..........................................................................................................40
1. Registratieprocedure........................................................................................................................40
2. Ontwikkelingsfasen...........................................................................................................................40
Stap 1: Synthese...................................................................................................................................41
Stap 2: Preklinisch onderzoek...............................................................................................................42
Stap 3 t/m 5: klinisch onderzoek (3 fasen)............................................................................................42
Klaar voor registratie?..........................................................................................................................42
Registratie aanvragen...........................................................................................................................42
Registratie-aanvraag beoordelen.........................................................................................................43
Registratieprocedure............................................................................................................................43
3. Criteria voor registratie....................................................................................................................43
1. Veiligheid van dgm...........................................................................................................................44
2. Farmacokinetiek, ADME...................................................................................................................44
A - Absorptie.........................................................................................................................................44
A tegelijk met DME...............................................................................................................................45
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