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Samenvatting Medische Tandheelkundige Interactie (MTI) - maag- en darmziekten en medicatie BA3 ACTA tandheelkunde $6.43
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Samenvatting Medische Tandheelkundige Interactie (MTI) - maag- en darmziekten en medicatie BA3 ACTA tandheelkunde

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Medische tandheelkundige interactie samenvatting/ overzicht maag- en darmziekten - collegejaar 2020/2021 T_MTI BA3 MTI Tandheelkunde ACTA

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  • December 15, 2020
  • December 17, 2020
  • 21
  • 2020/2021
  • Summary
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Medische Tandheelkundige Interactie
Overzicht maag- en darmziekten en bijbehorende medicatie

Inhoudsopgave
Vertering .............................................................................................................................................................3

Organen ..........................................................................................................................................................4
Speekselklieren....................................................................................................................................................4
Slokdarm .............................................................................................................................................................5
Maag...................................................................................................................................................................5
Lever....................................................................................................................................................................6
Gal ..................................................................................................................................................................6
Alvleesklier (pancreas) ........................................................................................................................................7

Maag- en darmziekten ....................................................................................................................................8
Colorectaal carcinoom – darmkanker .................................................................................................................8
Pancreas carcinoom ............................................................................................................................................8
Colitis ulcerosa ....................................................................................................................................................9
Ziekte van Crohn .................................................................................................................................................9
Pancreatitis .......................................................................................................................................................10
Acuut ............................................................................................................................................................10
Chronisch .....................................................................................................................................................10
Zuur gerelateerde aandoeningen .....................................................................................................................11
Ulcus pepticum – maagzweer ......................................................................................................................11
Gastro-oesophagele reflux ziekte (GERZ).....................................................................................................12
Prikkelbare darmsyndroom – irritable bowel syndrome (IBS)...........................................................................12
Obstipatie .........................................................................................................................................................13
Misselijkheid en braken ....................................................................................................................................13

Medicatie......................................................................................................................................................15
Maagklachten ...................................................................................................................................................15
Antacida .......................................................................................................................................................15
H2 receptor antagonisten ............................................................................................................................15
Cimetidine ...............................................................................................................................................15
Ranitidine ................................................................................................................................................15
Proton Pump Inhibitors ................................................................................................................................16
Omeprazol ...............................................................................................................................................16
Prostaglandine analoga ................................................................................................................................16
Amoxicilline ..................................................................................................................................................16
Claritromycine ..............................................................................................................................................16
Darmklachten ...................................................................................................................................................17
Antidiarrhoica ..............................................................................................................................................17
Actieve kool .............................................................................................................................................17
Loperamide .............................................................................................................................................17
ORS ..........................................................................................................................................................18
Laxantia ........................................................................................................................................................18
Osmotisch................................................................................................................................................18

, LOTJE GOMMERS BA3 – MEDISCHE TANDHEELKUNDIGE INTERACTIE



Lactulose .............................................................................................................................................18
Stimulantia ..............................................................................................................................................19
Contactlaxans - Bicosadyl en sennosiden (senna thee) ......................................................................19
Natriumlaurylsulfoacetaat en natriumducosaat ................................................................................19
Misselijkheidsklachten: anti-emetica/ pro-kinetica ..........................................................................................19
Dopamine antagonisten ...............................................................................................................................19
Domperidon ............................................................................................................................................20
Metoclopramide......................................................................................................................................20
Metronidazol.....................................................................................................................................................20

Effecten ........................................................................................................................................................21

, LOTJE GOMMERS BA3 – MEDISCHE TANDHEELKUNDIGE INTERACTIE



Vertering
Mondholte
Eerste fase vertering. Tong: kauwen, slikken, reinigen, smaakgewaarwording
Speeksel: voedselbolus à water, slijm, eiwitten, amylase à vertering koolhydraten
Huig (uvula) = uitloper zachte gehemelte, sluit de neuskeelholte af tijdens slikken
Keelamandelen (tonsillen), Keelholte (farynx)
Luchtpijp afgesloten: strottenhoofd (larynx = ademhalingsstelsel) komt omhoog tijdens slikken en
voedsel duwt strottenklepje (epiglottis) omlaag
Slokdarm (oesophagus): vertering suikers, peristaltische bewegingen à maag

Maag
Voedsel tijdelijk opgeslagen
Neurale + hormonale stimulatie maagperistaltiek en maagsapsecretie
Cellen maagbodem: hormoon gastrine à productie maagsap
Maagsap: water, slijm, zoutzuur (doodt bacteriën + eiwitstructuur losser), pepsine (grote eiwitten
verteren), intrinsieke factor (vit. B12 nodig = extrinsieke factor à rode bloedcellen aanmaken)
Spijsbrok/bolus = chymus/maagbrei

12-vingerige darm (duodenum)
Zure chymus van maagportier (pylorus) à 12-v-darm wand aanraken: pylorus gesloten
Alvleessap via papil van Vater: bij zure chymus à geneutraliseerd (bicarbonaat) à opening pylorus:
voedsel in maag.
o.i.v. alvleessap: amylaseà koolhydraten, trypsineà (kleine) eiwitten én lipaseà vetten
Via papil van Vater: gal vanuit galbuis in 12-v-darm à gal emulgeert vet: makkelijker verteerd door
enzymen. Gal wordt geproduceerd door de lever (afvalproduct bij stofwisselingsprocessen
koolhydraten, eiwitten, vetten) opgeslagen in galblaas (ingedikt)

Dunne darm
Voedsel door peristaltische bewegingen dunne darm in à darmsap toegevoegd: eindvertering
eiwitten, koolhydraten, vetten
o.i.v. darmsap: amylaseà koolhydraten, trypsineà (kleine) eiwitten én lipaseà vetten

Kronkeldarm
Verteringsproducten langs darmplooien: vili: microvili: lymfe- en bloedvaten
Bloedvaten: opnemen verteringsproducten: water, mineralen, vitaminen, glucose, enkelv.
Aminozuren, kleine vetdeeltje à poortader (vena portae) à lever
Vetten: vetzuren en glycerol à door darmwand verpakt à lymfebaan: borstbuis
Onverteerde voedselresten en afvalstoffen à klep van Bauhin à blindedarm à dikke darm

Dikke darm
Onverteerde voedselresten: Opstijgende, horizontaal en bochtvormige deel (sigmoïd) à faeces in
rectum à verlaten lichaam
Functies: uitscheiden afvalresten, indikken faeces, uitscheiden cholesterol, productie vit K, rotting,
gisting, primaire immuunsysteem door probiotica

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