Samenvatting van "partim II" als onderdeel van het vak 'Farmacologie' gegeven door prof. De Meyer G. in de 2e Bachelor Geneeskunde aan de UA. Samenvatting gebaseerd op slides, lesnotities én cursus.
Inhoudstafel
Hypolipemiërende farmaca........................................................................................................................... 7
Lipoproteïnetransport in het bloed........................................................................................................7
Stoornissen in het lipidenmetabolisme = dyslipidemie............................................................. 7
Atherogenese (slagaderverkalking) en atherotrombose...................................................................... 7
Stabiele atherosclerose............................................................................................................ 8
Instabiele atherosclerose..........................................................................................................9
Hypolipemiërende farmaca.................................................................................................................. 9
Statines (bv. simvastatine)........................................................................................................9
Fibraten (bv. fenofibraat).........................................................................................................11
Inhibitie van cholesterol (her)opname in de darm...................................................................11
Visoliederivaten = omega-3 vetzuren ethylesters...................................................................12
PCSK9-inhibitoren.................................................................................................................. 12
Bempedoïnezuur.................................................................................................................... 13
Farmacologie van het hart.......................................................................................................................... 15
Farmaca die de hartfunctie beïnvloeden............................................................................................ 15
Antiaritmica.........................................................................................................................................15
Ritmestoornissen....................................................................................................................15
Vaughan-Williams classificatie van anti-aritmica.................................................................... 17
Nevenwerkingen.....................................................................................................................19
Klinische toepassingen...........................................................................................................19
Inotrope stoffen (oa. hartglycosiden).................................................................................................. 20
Hartcontractie......................................................................................................................... 20
Inotropica................................................................................................................................23
Hartglycosiden........................................................................................................................23
Inhibitoren van PDE-III (bv. milrinon)...................................................................................... 25
Autonome neurotransmitters en verwante stoffen..............................................................................25
1-receptoren in het hart.......................................................................................................... 25
M2-receptoren in het hart....................................................................................................... 25
Anti-anginosa..................................................................................................................................... 26
Zuurstofverbruik door het myocard en coronaire flow............................................................ 26
Classificatie van ischemische hartziekten.............................................................................. 26
Anti-anginosa farmaca............................................................................................................27
NO-donoren............................................................................................................................27
-blokkers................................................................................................................................. 29
Calcium-antagonisten.........................................................................................................................29
Voltage-gated Ca2+-kanalen.................................................................................................. 29
Effecten.................................................................................................................................. 29
Klinische indicaties................................................................................................................. 30
Neveneffecten........................................................................................................................ 30
Farmacologie van het vasculair systeem.................................................................................................. 32
Regulatie van gladde spiercellen....................................................................................................... 32
Contractie van GSC................................................................................................................32
Relaxatie van GSC................................................................................................................. 32
Rol van endotheel in regulatie van de tonus van vasculaire GSC..........................................33
, Vasoconstrictoren............................................................................................................................... 33
Endothelinen (ET-1, ET-2, ET-3)............................................................................................ 33
Angiotensine II........................................................................................................................34
Vasopressine = antidiuretisch hormoon (ADH).......................................................................35
Klinische toepassingen van vasoconstrictoren.......................................................................35
Vasodilatoren: directe......................................................................................................................... 35
Toename van cAMP............................................................................................................... 36
Toename van cGMP............................................................................................................... 36
Hydralazine.............................................................................................................................36
Vasodilatoren: indirecte...................................................................................................................... 37
Clonidine.................................................................................................................................37
Moxonidine............................................................................................................................. 37
Inhibitie van RAAS..................................................................................................................38
Ziektebeelden waarbij vasoactieve geneesmiddelen worden gebruikt.............................................. 38
Hypertensie............................................................................................................................ 38
Hartfalen (HFrEF)................................................................................................................... 39
Hartfalen................................................................................................................................. 41
Angina pectoris.......................................................................................................................41
Ziekte van Raynaud................................................................................................................42
Pulmonaire hypertensie..........................................................................................................42
Farmacologie van de nier............................................................................................................................43
Functie van niertubuli......................................................................................................................... 43
Transport in de proximale tubulus.......................................................................................... 43
Transport in lus van Henle......................................................................................................43
Transport in de distale tubulus................................................................................................43
Transport in de ductus colligens............................................................................................. 44
Diuretica............................................................................................................................................. 44
Lisdiuretica (bv. furosemide)...................................................................................................45
Thiazidediuretica (bv. hydrochloorthiazide)............................................................................ 46
Kaliumsparende diuretica....................................................................................................... 46
Osmotische diuretica (bv. Mannitol)....................................................................................... 46
Koolzuuranhydraseremmers.............................................................................................................. 46
CASUS: diabetes............................................................................................................................... 47
Farmacologie van het ademhalingsstelsel................................................................................................ 48
Regulatie van de luchtwegen............................................................................................................. 48
Astma................................................................................................................................................. 48
Bronchiale hyperreactiviteit.................................................................................................... 49
Mediatoren..............................................................................................................................49
Geneesmiddelen bij astma.................................................................................................................50
2-receptor agonisten (bv. salbutamol, salmeterol, formoterol)............................................... 50
Theofylline.............................................................................................................................. 50
M-antagonisten.......................................................................................................................51
CysLT-receptor antagonisten..................................................................................................51
Glucocorticoïden.....................................................................................................................52
Natriumcromoglicaat...............................................................................................................52
Farmacologie van het maagdarmstelsel....................................................................................................53
, Secretie van maagzuur, mucus en bicarbonaat................................................................................. 53
Anti-ulcerosa...................................................................................................................................... 54
Antacida..................................................................................................................................54
H2-antihistaminica.................................................................................................................. 54
Protonpompinhibitoren........................................................................................................... 55
Prostaglandine E1-analogen.................................................................................................. 55
Rol van NSAID bij peptische ulcera........................................................................................56
Behandeling van H. pylori.......................................................................................................56
Anti-emetica....................................................................................................................................... 56
Braken.................................................................................................................................... 56
Anticholinergica (bv. scopolamine)......................................................................................... 57
H1-antagonisten..................................................................................................................... 57
Neuroleptica / antipsychotica..................................................................................................58
Gastrokinetica.........................................................................................................................58
5-HT3-antagonisten (bv. Ondansetron).................................................................................. 59
Cannabinoïden....................................................................................................................... 59
Dexamethason....................................................................................................................... 59
Neurokinine-1 antagonisten (bv. aprepitant)...........................................................................59
Laxativa.............................................................................................................................................. 59
Obstipatie............................................................................................................................... 59
Laxativa met lubrifiërende werking......................................................................................... 60
Contactlaxativa....................................................................................................................... 60
Osmotische laxativa............................................................................................................... 61
Zwelmiddelen......................................................................................................................... 62
Antidiarreïca....................................................................................................................................... 62
Orale rehydratiezouten (ORS)................................................................................................62
Secretie- en motiliteitsinhibitoren............................................................................................62
Spasmolytica...................................................................................................................................... 63
Farmacologie van het centraal zenuwstelsel............................................................................................ 64
Chemische transmissie in het CZS.................................................................................................... 64
Aminozuren als transmitters...............................................................................................................64
Exciterende aminozuren (EAA).............................................................................................. 64
Inhiberende aminozuren.........................................................................................................66
Klassieke neurotransmitters............................................................................................................... 67
Noradrenaline......................................................................................................................... 67
Dopamine............................................................................................................................... 67
Serotonine.............................................................................................................................. 68
Acetylcholine.......................................................................................................................... 69
Andere transmitters en modulatoren.................................................................................................. 69
Histamine................................................................................................................................70
Purines................................................................................................................................... 70
Melatonine.............................................................................................................................. 70
NO.......................................................................................................................................... 70
Neurodegeneratieve aandoeningen........................................................................................................... 71
Foutieve opvouwing van proteïnen.................................................................................................... 71
Excitotoxiciteit en oxidatieve stress....................................................................................................71
Dementie en ziekte van Alzheimer.....................................................................................................72
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