Summary
Samenvatting Punten bij FT en FZ
- Course
- Institution
Puntjes die ik belangrijk vond bij het vak FZ en FT
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Algemene principesEUB
1. Intake
2. Indicatie
3. Werking
4. Gebruiksinstructies
5. Bijwerkingen
6. Extra informatie
7. Feedback
8. Registratie in patiëntdossier
HUB
1. Patiëntervaringen
2. Problemen aanpakken
3. Informatie verduidelijken
4. Feedback
5. Registratie in patiëntdossier
Voorschrijfcascade
NSAID -> hypertensie -> antihypertensiva
Thiazide diuretica -> jicht -> allopurinol
ACE-inhibitor -> hoest -> hoestonderdrukker/AB
Anti-epileptica -> misselijkheid -> metoclopramide
Zelfzorg
Wie
Hoe
Anders
Medicatie
OTC
1. Werking
2. Hoe, wanneer en hoe lang
3. Eventuele bijzonderheden betreffende gebruik of medicatie
4. Eventuele bijwerkingen
5. Wanneer arts contacteren
1
,Mogelijke mechanismen bij FK-interactie thv absorptie
1. Complexvorming met metaalionen (antacida, melk (Ca2+))
a. Slachtoffers: tetracyclinen, chinolonen, levothyroxine, bisfosfonaten
i. Bisfosfonaten ook scheiden van voedsel/drank/GM
ii. Antacida: GGR raadt interval van 1-2u aan, maar niet altijd voldoende!
2. Binding
3. Veranderingen in GI pH (antacida, PPI)
a. Slachtoffer: itraconazole
4. Veranderingen in darmflora
5. Veranderingen in GI motiliteit
Renine-Angiotensine-Aldosteron-Systeem
Opletten met combinaties voor hyperkaliëmie
- ACE-inhib/ sartanen/ renine-inhib (=RAAS-remmers)
- Kaliumsparende diuretica (spironolacton, eplerenon)
- Kaliumsupplementen (kaliumzouten)
- NSAID
- Trimethoprim
2
, Bloedingsrisico (hemorragie)
Opletten met combinaties van NSAID/ anti-aggregans/ anticoagulans +
- 2e NSAID/ anti-aggregans/ anticoagulans
- SSRI/ SNRI
- Glucocorticoïden
SSRI SNRI
- Citalopram - Venlafaxine
- Escitalopram - Duloxetine
- Fluoxetine
- Fluvoxamine
- Paroxetine
- Sertraline
Serotoninesyndroom
Opletten met combinaties van
- Antidepressiva
o MAO-inhib: fenelzine, moclobemide
o SSRI: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
o AD van eerste en tweede groep: amitriptyline, clomipramine, desipramine,
dosulepine, doxepine, duloxetine, imipramine, mirtazepine, trazodon,
venlafaxine
o Lithiumzouten
o Sint-Janskruid
- Anti-migrainemiddelen
o Dihydro-ergotamine
o Triptanen
- MAO-B-inhib
o Selegiline, rasagiline
- Narcotische analgetica
o Hydromorfon, pethidine, tramadol
- Varia
o Bupropion, buspiron, dextromethorfan (ANTI-HOEST), drugs, linezolide,
methadon, fentanyl, oxycodon
QT-interval
QT-verlengende GM uit hoogste risicocategorie
- Citalopram, escitalopram, domperidon, clarithromycine, erythromycine,
azithromycine, moxifloxacine
- Anti-aritmica: amiodaron, disopyramide, flecaïnide, sotalol
- Antipsychotica: haloperidol, droperidol, pimozide, sertindol
Foliumzuursuppletie
0,4mg/dag vanaf 8 weken voor de conceptie t/m de 2e – 3e maand van de zwangerschap
3
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