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Compacte samenvatting deel 2 Farmacologie (K04B9A) $8.67   Add to cart

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Compacte samenvatting deel 2 Farmacologie (K04B9A)

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Compacte samenvatting van de essentie van deel 2 van farmacologie.

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  • June 1, 2022
  • 10
  • 2021/2022
  • Summary
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ZENUWSTELSEL
Perifeer zenuwstelsel
- Afferent: sensorische prikkels naar CZS.
- Efferente
o AZS
 PZS
 Pre en postganglionaire vezels met synap in autonome ganglia
o Pre = mesencephalon, medulla oblongata en sacraal
ruggenmerg.
o Post = glad spierweefsel, hart en exocriene klieren.
 Uitsluitend P: m. constrictor pupillae, m. ciliaris, GI-klieren,
traanklieren, bronchiale gladde spieren.
 OZS
 Pre en postganglionaire vezels met synap in autonome ganglia
o Pre = thoracaal ruggenmerg, bezenuwd glas spierweefsel,
hart, exocriene klieren, bijniermerg, eilandjes van
Langerhans, lever, nier, vetweefsel en skeletspier
o Contact post vezels en bezenuwd weefsel =
neuroeffectorjunctie
 Uitsluitend O: zweetklieren, pilomotorspieren, BV, niet, skeletspier
en m. dilatator pupillae.
 EZS
 Parasympatische ganglia
 Intrinsieke neuronen in intramurale plexus van darmwand
 Postganglionaire vezels van OZS + preganglionaire vezels van PZS.
o MZS
 Alfa en gamma motroneuronen: projectie ventrale ruggenmerg naar
skeletspier, met neuromusculaire junctie.
- Denervatiesupersensitiviteit
o Opheffen blokkade = rebound effect
 Proliferatie R
 Verlies mechanisme om NT te verwijderen
 Verhoogde synaptische gevoeligheid

, CHOLINERGE TRANSMISSIE
AZS (PZS, OSZ en EZS) en NMJ van MZS.

Acetylatie choline: acetyl van AcCoA naar choline oiv CAT  ACh in granulen  exocytose 
postsynaptische R stimulatie of hydrolyse tot choline oiv cholinesterase en heropname.

Nicotine R
- Postysynaptisch cellichaam OS- en PS-ganglia + chromaffiene cellen bijniermerg + NMJ + CZS.
- Opent direct-R-gekoppelde kationenkanalen = snelle depolarisatie.
- Ionotroop – LGIC – pentameer – 5 bindingsplaatsen – snelle signaaltransductie.
Muscarine R
- M1 = neuraal gangalia EZS, CZS IP3↑, Ca↑, ↓K Gq = excitatie
- M2 = cardiaal hart: sinus, atrium, AV-knoop cAMp↓, Ca↓, ↑K Gi = inhibitor
Presynaptisch uiteinde perifere
en centrale neuronen
- M3 = klier/GS exocriene klieren, GS, endotheelcel, IP3↑, Ca↑ Gq = excitatie
pariëtale cellen
- Metabotroop – GPCR – 7TL – 1 bindingsplaats – 2° messengers
o R activeert G-EW  α = inhibitor AC, vrij van βγ / αGDP wisselt voor GTP.

Activatie
- Muscarine-R-agonisten
Oog Miosis (M3)
Speekselklier, traanklier, neussslijmvlies Secretie (M3)
Longen Secretie + bronchocontrictie (M3)
Hart Sinusknoop: (-)chromotroop (M2)
Atriale spier: contractiekracht daalt
AV-knoop: (-)dromotroop evt AV-blok
GI Secretie, motiliteit (M3) en relaxatie sfincter
Blaas Contractie fundus + relaxatie sfincter (M3)
Genitaal Erectie
BV VD (NO vrij via endotheelcellen)
CZS Afhankelijk doorgang BHB
o ACh: lokaal mioticum.
o Pilocarpine = 3° amine (BHB = centrale effecten): lokaal mioticum, po monddroogte.
o Carbachol = 4° amine (M- en N-agonist): lokaal peroperatief mioticum.
o Betanechol = 4° amine: postoperatieve urineretentie of blaasatonie.
- Nicotine-R-agonisten
o Ganglia AZS
 CZS: overheerst OS-effecten
 Hoge dosis: depolarisatieblok  BD-val, shock en spierverlamming
o NMJ
 Normaal: geen effect enkel bij MG
 Hogere dosis: spierfascicultaties of spiertrekkingen
 Hoge dosis: depolarisatie blok met slappe spierverlamming = cholinerge crisis
o Substitutie: kauwgom, inhaler.
o Varenicline = N-agonist of bupropion = AD (niet bij epileps en MAO-inhibitor.

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