Summary
Samenvatting TAB 3.2 Farmacologie Merckx
- Course
- Institution
Samenvatting van het deel gegeven door mevrouw Merckx (farmacologie). Wat in het rood staat aangeduid is belangrijk voor het examen.
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TAB 3.2 GESPECIALISEERDE VERPLEEGKUNDIGEZORGVERLENING
APOTHEKER (MERCKX)
Inhoud
1 Geneesmiddelen distributie................................................................................................................3
Ziekenhuisapotheek............................................................................................................................3
Medicatieveiligheid............................................................................................................................3
Voorschrift..........................................................................................................................................5
Centrale en decentrale voorraad geneesmiddelen.............................................................................7
Logistiek..............................................................................................................................................7
Accreditatie........................................................................................................................................8
Ziekenhuisnetwerken..........................................................................................................................9
5 rechten............................................................................................................................................9
2 Medicatiefouten................................................................................................................................12
Omgang met fouten..........................................................................................................................12
Analyse.............................................................................................................................................12
Verbeteringen...................................................................................................................................12
Technieken om HRM zichtbaar te maken..........................................................................................13
International Patient Safety Goals (IPSG)..........................................................................................15
Vimmen............................................................................................................................................15
Medicatiefouten thuis......................................................................................................................16
Voornaamste oorzaken van medicatiefouten...................................................................................16
3 Interacties: farmacokinetiek en dynamiek.........................................................................................17
Farmacokinetiek...............................................................................................................................17
Belangrijke begrippen in de farmacokinetiek...................................................................................17
Geneesmiddelinteracties..................................................................................................................18
Metabolisatie....................................................................................................................................20
Farmacodynamische reacties............................................................................................................21
Besluit interacties.............................................................................................................................22
4 Totale parenterale nutritie (TPN).......................................................................................................24
Screenen van malnutritie..................................................................................................................24
Laatste ontwikkeling in meten van energiebehoefte........................................................................24
Behandeling van malnutritie.............................................................................................................24
1
, Enterale en parenterale voeding.......................................................................................................25
Indicaties voor TPN...........................................................................................................................25
Samenstelling TPN............................................................................................................................26
Soorten PN op basis van samenstelling............................................................................................26
Toediening TPN.................................................................................................................................28
Aandachtspunten voor verpleegkundige..........................................................................................31
5 Chemotherapie..................................................................................................................................33
Toepassingsgebied en verantwoordelijkheden.................................................................................33
Bescherming.....................................................................................................................................33
Systemen voor veilige bereiding van cytostatica...............................................................................34
Voorschrift........................................................................................................................................34
Voorbereiding...................................................................................................................................35
Transport..........................................................................................................................................35
Bewaring...........................................................................................................................................35
Morsprocedure.................................................................................................................................36
Extravasatie bij de patiënt................................................................................................................37
6 Extravasatie.......................................................................................................................................39
2
,1 Geneesmiddelen distributie
Ziekenhuisapotheek
Staat in voor
Opslag van medicatie en medische materialen
Picking van medicatie volgens (elektronisch) voorschrift
Bereiden van medicatie
Verpakken indien nodig
Medicatie bezorgen aan diensten = geneesmiddelendistributie
Opslag volgens bewaarvoorschriften
Koeling (inloopkoelkast + koude keten niet doorbreken !!)
o Insuline (Novomix, Novorapid)
o Epo (Aranesp)
o GM Parkinson (Duodopa)
Andere
o Donker
o Luchtdicht
o Beschermen tegen licht (oranje zak voor instabiele producten)
Medicatieveiligheid
JUISTE GM – JUISTE DOSIS – JUISTE TOEDIENING – JUISTE TIJDSTIP – JUISTE
PATIËNT
Keten met verschillende stappen, verschillende uitvoerders: mogelijkheid tot
fouten ↑
arts
patiënt apotheker
verpleeg-
kundige
3
, 4
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