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FA-MA202 Klinische Farmacie, uitgebreide samenvatting

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In deze samenvatting is alle leerstof per thema samengevat. De stof is afkomstig uit de hoorcolleges, werkcolleges en bijbehorende richtlijnen. Voor deze samenvatting heb ik de Thema's van het vak aangehouden en daarbinnen overzichtelijke subkoppen gemaakt: Thema 1: Bioanalyse & Medicatiebew...

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  • June 21, 2022
  • 87
  • 2021/2022
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FA-MA202
Klinische Farmacie
Samenvatting

,FA-MA202 Klinische Farmacie, Samenvatting M. de Leeuw



Inhoud
Leerdoelen ..........................................................................................................................................5
Thema 1; Bioanalyse & Medicatiebewaking .......................................................................................... 6
Clinical Rules................................................................................................................................................ 6
Nierfunctie............................................................................................................................................... 6
Kalium...................................................................................................................................................... 6
Natrium ................................................................................................................................................... 7
INR ........................................................................................................................................................... 7
QTc-verlenging ........................................................................................................................................ 7
Antistolling .................................................................................................................................................. 8
Pathofysiologie trombose ....................................................................................................................... 8
Groepen antistolling .............................................................................................................................. 11
Antitrombotische therapie .................................................................................................................... 16
Casussen uit HC-antistolling & operatie ................................................................................................ 17
Farmacogenetica ....................................................................................................................................... 20
Begrippen .............................................................................................................................................. 20
Naamgeving allelen ............................................................................................................................... 21
Type metabolisers ................................................................................................................................. 21
Farmacogenetische test ........................................................................................................................ 23
Casus clopidogrel................................................................................................................................... 23
Thema 2; TDM & Toxicologie ............................................................................................................. 25
Farmacokinetiek ........................................................................................................................................ 25
Therapeutic Drug Monitoring.................................................................................................................... 26
TDM anti-epileptica: Valproïnezuur ...................................................................................................... 27
TDM Antibiotica .................................................................................................................................... 28
TDM Voriconazol ................................................................................................................................... 30
TDM immunosuppressiva...................................................................................................................... 30
Toxicologie ................................................................................................................................................ 31
Voorbeelden intoxicaties ...................................................................................................................... 31
Intoxicaties algemeen ........................................................................................................................... 31
Toxidromen ........................................................................................................................................... 32
Screening ............................................................................................................................................... 34
Behandeling van intoxicaties................................................................................................................. 34
Paracetamol intoxicatie......................................................................................................................... 35
Benzodiazepinen intoxicatie ................................................................................................................. 36
Tricyclische antidepressiva intoxicatie .................................................................................................. 37
Alcoholen intoxicatie ............................................................................................................................. 37
Thema 3; Medicatieoverdracht in de keten......................................................................................... 40
Medicatieverificatie vs. Medicatiebeoordeling......................................................................................... 40

Pagina 2 van 87

,FA-MA202 Klinische Farmacie, Samenvatting M. de Leeuw


Medicatieoverdracht ................................................................................................................................. 41
Risico-inschatting ...................................................................................................................................... 41
LSP ............................................................................................................................................................. 42
Opname en ontslag gesprek...................................................................................................................... 42
Conclusie ................................................................................................................................................... 42
Thema 4; Infectieziekten.................................................................................................................... 43
Bacteriën ................................................................................................................................................... 43
Antibiotica ................................................................................................................................................. 43
Beta-lactam antibiotica ......................................................................................................................... 45
Aminoglycosiden ................................................................................................................................... 47
Tetracyclines.......................................................................................................................................... 47
Macroliden ............................................................................................................................................ 47
Sulfonamiden (+trimethoprim) ............................................................................................................. 48
Chinolonen ............................................................................................................................................ 48
Glycopeptiden ....................................................................................................................................... 48
Metronidazol ......................................................................................................................................... 48
Tubercolose-middelen (tuberculostatica) ............................................................................................. 48
Antimycotica ............................................................................................................................................. 49
Indeling en toepassing........................................................................................................................... 49
Virussen & antivirale middelen ................................................................................................................. 49
Resistentie ................................................................................................................................................. 50
Mechanismen van resistentie ............................................................................................................... 51
Algemene strategie antibioticumbeleid .................................................................................................... 52
Reserve antibiotica .................................................................................................................................... 53
Pneumonie beleid SWAB........................................................................................................................... 53
Definitie ................................................................................................................................................. 53
Oorzaak ................................................................................................................................................. 53
Classificatie ............................................................................................................................................ 53
Diagnostiek ............................................................................................................................................ 53
Behandeling........................................................................................................................................... 54
Urineweginfectie beleid NHG .................................................................................................................... 59
Thema 5; Radiofarmacie & Cytostatica ............................................................................................... 61
Radiofarmaca ............................................................................................................................................ 61
Radioactiviteit basics ................................................................................................................................. 61
Radiofarmaca bij onderzoeken ................................................................................................................. 61
Single photon emission CT (SPECT) ....................................................................................................... 62
Positron emissive tomografie (PET ) ..................................................................................................... 63
Therapeutische radiofarmaca ................................................................................................................... 63
Verantwoordelijkheden radiofarmaceut .................................................................................................. 64


Pagina 3 van 87

, FA-MA202 Klinische Farmacie, Samenvatting M. de Leeuw


Radiochemie .............................................................................................................................................. 64
Radiochemie technetium ...................................................................................................................... 64
Tc-99m generator en labeling farmacon ............................................................................................... 64
Cyclotron ............................................................................................................................................... 65
Fluor-18 / FDG ....................................................................................................................................... 66
Gallium-68 (Ga-68) ................................................................................................................................ 66
Bereiding radiofarmaca vs. Cytostatica ..................................................................................................... 67
Radiofarmaca ........................................................................................................................................ 67
Cytostatica ........................................................................................ Fout! Bladwijzer niet gedefinieerd.
Thema 6; Voeding en geneesmiddelen + toediening-systemen ............................................................ 68
Soorten sondes.......................................................................................................................................... 69
Sondevoeding ............................................................................................................................................ 69
Geneesmiddelen over de sonde................................................................................................................ 70
Medicatiereview bij een patiënt met een sonde ...................................................................................... 71
Totaal parenterale voeding ....................................................................................................................... 75
Koolhydraten ......................................................................................................................................... 75
Eiwitten ................................................................................................................................................. 75
Vetten .................................................................................................................................................... 76
Wie, Wanneer, Welke TPV ........................................................................................................................ 77
Refeeding syndrome ............................................................................................................................. 77
Perifere lijnen en lokale complicaties ....................................................................................................... 78
Extravasatie ........................................................................................................................................... 78
Centrale-veneuze lijnen (CVC) ................................................................................................................... 80
Soorten centrale lijnen .......................................................................................................................... 81
Complicaties centrale lijnen .................................................................................................................. 81
Thema 7; Klinische Geneesmiddelenonderzoek & ethiek .................................................................... 82
Historie ...................................................................................................................................................... 82
Toetsing medisch-wetenschappelijk onderzoek ....................................................................................... 82
De organisatie van toetsing ....................................................................................................................... 83
Definitie geneesmiddelenonderzoek ........................................................................................................ 84
IMP vs non-IMP ......................................................................................................................................... 84
Regelgeving KGO ....................................................................................................................................... 84
Medicatiebewaking ................................................................................................................................... 85
Drug accountability ................................................................................................................................... 85
Vragen werkcollege ................................................................................................................................... 85




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