Summary

Samenvatting Farmacologie partim II

0 purchase

Course
Farmacologie (1028GENGE2)

Institution
Universiteit Antwerpen (UA)

Samenvatting van het volledige 2e (& 3e) deel van farmacologie. Dit deel wordt gegeven samen met de studierichting farmacie. Op de eerste 3 pagina's is de inhoudstafel terug te vinden. Op het einde van het document zitten zowel de voorbeeldvragen als antwoorden die klassikaal beantwoord werden. Ik...

[Show more]

Preview 5 out of 94 pages

View example

Uploaded on August 30, 2024
Number of pages 94
Written in 2023/2024
Type Summary

farmacologie
partim ii
hypolipemiërende farmaca
farmacologie hart
farmacologie gi stelsel
farmacologie nier
farmacologie czs
opioiden
farmacologie vasculair systeem
farmacologie respiratoir stelsel
an

Institution
Universiteit Antwerpen (UA)
Education
Geneeskunde
Course
Farmacologie (1028GENGE2)

lorree

Member since 1 year 15 documents sold

$19.76

Add to cart

Save

100% satisfaction guarantee
Immediately available after payment
Both online and in PDF
No strings attached

Inhoudstafel
Inhoudstafel ............................................................................................................................................................................. 1

1) Hypolipemiërende farmaca ................................................................................................................................................... 4
Lipoproteïnetransport in het bloed................................................................................................................................................. 4
Stoornissen in het lipidenmetabolisme (dyslipidemie) ................................................................................................................... 4
Atherosclerose .......................................................................................................................................................................... 4
Hypolipemierende farmaca ............................................................................................................................................................ 7
Statines ...................................................................................................................................................................................... 7
Fibraten ..................................................................................................................................................................................... 8
Harsen die galzuren binden ....................................................................................................................................................... 8
Remmer van de cholesterolopname in de darm ....................................................................................................................... 9
Visoliederivaten ......................................................................................................................................................................... 9
PCSK9-inhibitoren ...................................................................................................................................................................... 9
Bempedoïnezuur ..................................................................................................................................................................... 10

2) Farmacologie van het hart .................................................................................................................................................. 11
Effecten van GM op het hart ........................................................................................................................................................ 11
Farmaca die de hartfunctie beïnvloeden ...................................................................................................................................... 11
Anti-artimica ............................................................................................................................................................................ 11
Hartglycosiden ......................................................................................................................................................................... 14
Autonome neurotransmitters en verwante stoffen ................................................................................................................ 17
Anti-anginosa........................................................................................................................................................................... 18
Calciumantagonisten ............................................................................................................................................................... 20

3) Farmacologie van het vasculair systeem ............................................................................................................................. 23
Gladde spiercellen ........................................................................................................................................................................ 23
Vasoconstrictoren ........................................................................................................................................................................ 24
Endotheline ............................................................................................................................................................................. 24
Angiotensine II ......................................................................................................................................................................... 24
Vasopressine = ADH ................................................................................................................................................................ 25
Klinische toepassingen ............................................................................................................................................................ 25
Vasodilatoren ............................................................................................................................................................................... 26
Directe vasodilatoren .............................................................................................................................................................. 26
Indirecte vasodilatoren ........................................................................................................................................................... 27
Geneesmiddelen ........................................................................................................................................................................... 28
GM bij hypertensie .................................................................................................................................................................. 28
GM bij hartfalen met een gereduceerde ejectiefractie ........................................................................................................... 29
GM bij angina pectoris............................................................................................................................................................. 31
GM bij de ziekte van Raynaud ................................................................................................................................................. 32
GM bij pulmonale hypertensie ................................................................................................................................................ 32

4) Farmacologie van de nier .................................................................................................................................................... 33
Inleiding ........................................................................................................................................................................................ 33
Transportprocessen ...................................................................................................................................................................... 33
Diuretica ....................................................................................................................................................................................... 34
Aangrijpingspunten diuretica .................................................................................................................................................. 34
Lisdiuretica .............................................................................................................................................................................. 35
Thiazidediuretica ..................................................................................................................................................................... 35
Kaliumsparende diuretica........................................................................................................................................................ 36
Osmotische diuretica ............................................................................................................................................................... 36
Koolzuuranhydrase remmers .................................................................................................................................................. 36
Werking ACE-remmers bij nier problematiek in context van diabetes ......................................................................................... 37

,5) Farmacologie van het respiratoir en GI stelsel ..................................................................................................................... 38
Farmacologie van het ademhalingsstelsel ................................................................................................................................... 38
Regulatie van de luchtwegen .................................................................................................................................................. 38
Astma ........................................................................................................................................................................................... 38
Geneesmiddelen...................................................................................................................................................................... 39
Farmacologie van het maagdarmstelsel ...................................................................................................................................... 42
Secretie van maagzuur, mucus en bicarbonaat....................................................................................................................... 42
Anti - ulcerosa.......................................................................................................................................................................... 42
Braken ..................................................................................................................................................................................... 44
Obstipatie / constipatie ........................................................................................................................................................... 46
Diarree: anti-diarreïca ............................................................................................................................................................. 47
Spasmolytica............................................................................................................................................................................ 48

6) Farmacologie van het CZS ................................................................................................................................................... 49
Geneesmiddelen ........................................................................................................................................................................... 49
Neurotransmitters ........................................................................................................................................................................ 49
Aminozuren ............................................................................................................................................................................. 49
Noradrenaline in het CZS ......................................................................................................................................................... 51
Dopamine in het CZS ............................................................................................................................................................... 51
5-HT (serotonine) in het CZS.................................................................................................................................................... 52
Acetylcholine in het CZS .......................................................................................................................................................... 53
Histamine ................................................................................................................................................................................ 53
Purines ..................................................................................................................................................................................... 53
Melatonine .............................................................................................................................................................................. 53
NO............................................................................................................................................................................................ 54
Neurodegeneratieve aandoeningen ............................................................................................................................................. 54
Oorzaken ................................................................................................................................................................................. 54
Ziekte van Alzheimer ............................................................................................................................................................... 55
Ziekte van Parkinson................................................................................................................................................................ 55
Antipsychotica .............................................................................................................................................................................. 57
Schizofrenie ............................................................................................................................................................................. 58
Werkingsmechanisme ............................................................................................................................................................. 58
Typische antipsychotica........................................................................................................................................................... 59
Atypische antipsychotica ......................................................................................................................................................... 60
Ziekte van Parkinson................................................................................................................................................................ 61
Antidepressiva .............................................................................................................................................................................. 61
Affectieve stoornissen ............................................................................................................................................................. 61
Monoamine-theorie van depressie ......................................................................................................................................... 61
Pathofysiologie van depressie ................................................................................................................................................. 62
Werkingsmechanismen ........................................................................................................................................................... 62
Stemmingsstabilisatoren ......................................................................................................................................................... 65
Anxiolytica en hypno-sedativa...................................................................................................................................................... 66
Benzodiazepines ...................................................................................................................................................................... 66
Barbituraten ............................................................................................................................................................................ 67
Andere ..................................................................................................................................................................................... 68
Anti-epileptica .............................................................................................................................................................................. 68
Epilepsie .................................................................................................................................................................................. 68
Anti-epileptica ......................................................................................................................................................................... 69

7) Opioïden ............................................................................................................................................................................. 71
Definitie van pijn .......................................................................................................................................................................... 71
Soorten pijn .................................................................................................................................................................................. 71
Nociceptieve pijn ..................................................................................................................................................................... 71
Analgetica: opioïden..................................................................................................................................................................... 73
Werkingsmechanisme ............................................................................................................................................................. 74
Opioïde receptoren ................................................................................................................................................................. 75

,8) Lokale anesthetica .............................................................................................................................................................. 79
Werkingsmechanisme .................................................................................................................................................................. 79
Gebruik ......................................................................................................................................................................................... 80

Farmacologie van diabetes ..................................................................................................................................................... 81
Symptomen ............................................................................................................................................................................. 81
Screening ................................................................................................................................................................................. 81
Classificatie van diabetes: 4 klinische klassen .............................................................................................................................. 81
Type 1-diabetes mellitus ......................................................................................................................................................... 81
Type 2-diabetes mellitus ......................................................................................................................................................... 82
Andere specifieke types diabetes ............................................................................................................................................ 82
Zwangerschapsdiabetes .......................................................................................................................................................... 82
Complicaties ................................................................................................................................................................................. 82
Geneesmiddelen: anti-diabetica................................................................................................................................................... 83
Insuline .................................................................................................................................................................................... 83
Metformine ............................................................................................................................................................................. 85
Sulfonylurea............................................................................................................................................................................. 86
Gliniden ................................................................................................................................................................................... 87
Incretines ................................................................................................................................................................................. 87
Gliflozinen................................................................................................................................................................................ 89
Glitazonen (TZDS) .................................................................................................................................................................... 89
Glucagon .................................................................................................................................................................................. 90

Voorbeeldvragen .................................................................................................................................................................... 93

, 1) Hypolipemiërende farmaca

Lipoproteïnetransport in het bloed
Chylomicronen
- Bevatten triglyceriden en cholesterolesters: brengen het vd GI-tractus naar de weefsels
- LPL (lipoproteinelipase) zet triglyceriden om naar glycerol en vrije vetzuren --> brengen naar de spieren &
vetweefsel
- Het gene dat overblijft = chylomicronen remnants kan opgestapeld w, gescrecreteerd w tot gal, geoxideerd w
of gebruiken voor VLDL-partikels

VLDL
- Bevat cholesterol met nieuw gesynthetiseerde
triglyceriden --> transport naar weefsels
- Via LPL omzetting tot vrije vetzuren --> LDL partikel met
cholesterolester blijft over (= oorzakelijke
factoratherosclerose)

LDL
- W deels opgenomen door de weefsels maar ook door de
lever via endocytose mbv specifieke LDL-receptoren
- Bevat hoog gehalte cholesterol
- Oorzakelijke factor van atherosclerose

HDL
- Neemt cholesterol op vanuit weefsels (celturnover), ook
uit arteriën! --> VLDL en LDL
- = goede cholesterol

Stoornissen in het lipidenmetabolisme (dyslipidemie)
Primair
- Genetisch bepaald
- 6 fenotypes afhankelijk van welk type lipoproteïnepartikel is gestegen

Secundair
- In aansluiting op een veralgemeende aandoening: bv tgv overgewicht, diabetes mellitus, hypothyroïdie
ð Hoe hoger de plasmaspiegel van het LDL-cholesterol en hoe lager de concentratie van het HDL-cholesterol, hoe
groter het risico is op het tot stand komen van ischemische hartziekte

Frederickson / WHO classificatie hyperlipoproteïnemie
- Type 1: geen behandeling voor
- Type 2A: LDL toegenomen
o Hoog risico voor atherosclerose
- Type 2B: LDL en VDL toegenomen --> cholesterol &
triglyceriden gestegen
o Hoog risico voor atherosclerose

Atherosclerose
Cholesterol
- Hoog triglyceridengehalte is gecombineerd met laag HDL-C (cholesterol)
- LDL-C ↑ en/of HDL-C ↓ --> atherosclerose

, = slagaderverkalking = atherotrombose (want kan trombus bij betrokken zijn)
- Is focale aandoening van de intima van grote en middelgrote arterien
- Thv coronaire arterien: hartkramp (angina pectoris), hartinfarct
- Cerebrovasculaire ziekten: TIA (transient ischemic attack: nog geen volledige verstopping, maar O2 toevoer is
verminderd), beroerte (herseninfarct: volledige occlusie)
- Perifeer arterieel vaatlijden: claudicatio intermittens (etalagebenen: mensen hebben veel pijn bij stappen -->
zullen stilstaan om pijn te verminderen)
ð Heel groot aandeel van het aantal sterfgevallen

Atherogenese
= ontstaan van atherosclerose
- Is aandoening vd binnenwand (intima) van grote en middelgrote arteriën
- Pathogenese duurt enkele decennia: tijdens weinig klinische symptomen
- Na tijd wel ziekteverschijnselen: wijst op vergevorderd stadia
- O2 tekort thv coronairen --> angina pectoris
- O2 tekort thv perifere bloedvaten --> claudicatie intermittens
- Foto:
o Links: doorsneden bloedvat bij geboorte: endotheel is enige
laag cellen vd intima
o 2e: rond 20 jaar: plakkenvorming, maar nog relatief klein en
bloedvat vrij doorgankelijk
§ !! het is niet omdat plak klein is dat het niet gevaarlijk
kan zijn: als die onstabiel is bv
o 3e: rond 40 jaar: plak groeit en komen plakken bij, kunnen al
symptomen zijn
o Rechts: heel weinig doorgankelijk: symptomen zichtbaar

Pathogenese:
- Vooral bij patienten met hypercholesterolemie dringt het LDL door tot in de subendotheliale structuren -->
geoxideerd tot oxLDL
o Is immunogeen, wordt door het lichaam als vreemd ervaren
o Trekt T lymfocyten aan
o Zendt signalen uit naar het endotheel dat adhesiemoleculen tot expressie brengt (oa VCAM) waaraan
monocyten blijven kleven die de bloedbaan verlaten en worden omgevormd tot geactiveerde macrofagen
- Hypercholesterolemie (teveel LDL) --> LDL wordt
opgenomen in de intima --> wordt geoxideerd naar
oxLDL --> endotheelcellen worden geactiveerd -->
adhesiemoleculen tot expressie --> monocyten
blijven kleven aan adhesiemoleculen --> eens in
intima w ze omgevormd tot macrofagen -->
macrofagen willen geoxideerde LDL opruimen:
fagocyteren het via scavenger receptor op een
ongecontroleerde wijze ==> vormen zich om tot
‘foamcels’ (schuimcellen)
g Ondertussen zullen ook T lymfocyten in intima binnenkomen, IFN𝛾 produceren ->
macrofaag geactiveerd
o Schuimcellen tesamen met T lymfocyten vormen “vetstrepen’ of fatty streaks (->)
die de 1ste stadia vh atheroomletsel uitmaken
g Ook GSC migreren en prolifereren vanuit media naar intima --> produceren extracellulaire matrix: oa
collageen --> vormt soort van kap op de plak: lipide,
necrotische kern afschermen van het lumen
o Fibroatheromateus letsel = atheroom,
atheroomplaque, plaque
g Bloedplaatjes zullen cytokines en groeifactoren
vrijstellen --> vorming BW, proliferatie & migratie GSC
g = stabiele plak

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller lorree. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $19.76. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

69569 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 15 years now

Start selling

Summary

Samenvatting Farmacologie partim II

Document information

Subjects

Written for

Seller

Reviews received

Content preview