Robyn Thomas
2VV
2023- 2024
Klinische farmacologie - Inne Hendrickx
Klinische farmacologie - Inne Hendrickx .................................................................................... 1
Deel 1: Algemene principes van de farmacologie ...................................................................... 5
Het geneesmiddel............................................................................................................... 5
Naamgeving .................................................................................................................... 5
Indicaties ........................................................................................................................ 5
Toedieningsvormen ........................................................................................................ 6
Toedieningswijzen .......................................................................................................... 7
Farmacokinetiek ................................................................................................................. 8
Absorptie ........................................................................................................................ 9
Distributie ....................................................................................................................... 9
Metabolisme................................................................................................................... 9
Excretie ......................................................................................................................... 10
Enkele termen .............................................................................................................. 10
Farmacodynamiek ............................................................................................................ 11
Interacties ..................................................................................................................... 12
Absorptiefase............................................................................................................ 12
Distributiefase .......................................................................................................... 13
Metabolisatiefase ..................................................................................................... 13
Excretiefase............................................................................................................... 13
Overgevoeligheid .......................................................................................................... 13
Behandeling .................................................................................................................. 14
Bijwerkingen ................................................................................................................. 15
Ernstige bijwerkingen ................................................................................................... 15
QT-verlenging............................................................................................................ 15
Anticholinerg syndroom ........................................................................................... 16
Serotonine syndroom ............................................................................................... 16
Maligne antipsychotica syndroom ........................................................................... 17
DRESS syndroom....................................................................................................... 17
Hyperkaliëmie........................................................................................................... 18
Medicatie die convulsies uitlokken .................................................................................. 18
Aandachtspunten bij de zwangere ................................................................................... 18
Deel 2: Medicatie ................................................................................................................. 21
Cardiovasculair stelsel ...................................................................................................... 21
1
,Robyn Thomas
2VV
2023- 2024
Betablokkers ................................................................................................................. 22
ACE-inhibitoren of ACE-I ............................................................................................... 22
Angiotensine-II-inhibitoren of sartanen ....................................................................... 23
Calciumantagonisten .................................................................................................... 23
Diuretica ....................................................................................................................... 24
Centraal werkende antihypertensiva ........................................................................... 24
Nitraten ........................................................................................................................ 25
Hypolipemierende middelen ........................................................................................ 25
Statines ......................................................................................................................... 25
Acetylsalicylzuur of aspirine ......................................................................................... 26
Veno- en capillarotropica ............................................................................................. 26
Cardiovasculaire medicatie en zwangerschap .................................................................. 26
Cardiovasculaire medicatie en borstvoeding ................................................................... 27
Afwijkingen van het bloed ................................................................................................ 27
Antithrombotica ........................................................................................................... 28
Antithrombolytica ........................................................................................................ 31
Thrombolytica .............................................................................................................. 31
Ademhalingsstelsel ........................................................................................................... 31
Corticosteroïden ........................................................................................................... 33
Middelen bij hoesten ................................................................................................... 33
Spijsverteringsstelsel = gastro- intestinale stelsel ............................................................ 34
Maagzuurmiddelen ...................................................................................................... 34
Spasmolytica................................................................................................................. 35
Anti-emetica ................................................................................................................. 35
Laxativa ......................................................................................................................... 36
Anti-diarreica ................................................................................................................ 37
Middelen tegen hemorroiden ...................................................................................... 37
Zwangerschap en gastro-intestinale middelen ............................................................ 37
Schildklierlijden ................................................................................................................ 38
Hypothyroidie ............................................................................................................... 38
Hyperthyroidie.............................................................................................................. 38
Schildklierlijden en zwangerschap ............................................................................... 39
Diabetes ............................................................................................................................ 39
Insulinetherapie............................................................................................................ 39
Orale antidiabetische middelen ................................................................................... 40
2
,Robyn Thomas
2VV
2023- 2024
Middelen bij hypoglycemie .......................................................................................... 41
Zwangerschap en diabetes ........................................................................................... 42
Pijnmedicatie .................................................................................................................... 42
Niet-opoide analgetica ................................................................................................. 43
Niet-steroidale anti-inflammatoire middelen .............................................................. 43
Zwangerschap en NSAID’s ............................................................................................ 44
Opoide analgetica ......................................................................................................... 44
Zwangerschap en opiaten ............................................................................................ 45
Middelen bij neuropatische pijn ...................................................................................... 45
Middelen tegen epilepsie ................................................................................................. 45
Epilepsie en zwangerschap ........................................................................................... 46
Middelen tegen migraine ................................................................................................. 46
Preventieve middelen................................................................................................... 47
Zwangerschap en migraine ........................................................................................... 47
Corticosteroïden ............................................................................................................... 47
Corticosteroïden en zwangerschap .............................................................................. 48
Middelen bij infecties ....................................................................................................... 48
Antibiotica .................................................................................................................... 48
Zwangerschap en antibiotica ........................................................................................ 51
Zwangerschap en antimycotica .................................................................................... 52
Antivirale middelen en zwangerschap ......................................................................... 52
Mineralen en vitaminen ................................................................................................... 53
Mineralen ..................................................................................................................... 53
Vitaminen ..................................................................................................................... 53
Mineralen en vitaminen en zwangerschap .................................................................. 53
Vaccins .............................................................................................................................. 54
Basisvaccinatieschema voor kinderen .......................................................................... 54
Immunoglobulinen ....................................................................................................... 55
Vaccins en zwangerschap ............................................................................................. 55
Vaccins en borstvoeding ............................................................................................... 55
Deel 3: Teratologie................................................................................................................ 56
Inleiding ............................................................................................................................ 56
.......................................................................................................................................... 59
.......................................................................................................................................... 59
Genetica en het geslacht .............................................................................................. 59
3
, Robyn Thomas
2VV
2023- 2024
Basisbegrippen ............................................................................................................. 60
Mutaties ........................................................................................................................... 60
Genmutaties ................................................................................................................. 62
Chromosoommutaties .................................................................................................. 62
Chromosoomafwijkingen ................................................................................................. 63
Numerieke afwijkingen................................................................................................. 63
Genoommutaties.......................................................................................................... 63
Structurele afwijkingen ................................................................................................ 65
Monogeen overervende aandoeningen ........................................................................... 66
Autosomaal dominant ................................................................................................. 68
Geslachtsgebonden dominant .................................................................................... 68
Autosomaal recessief ................................................................................................... 69
Geslachtsgebonden recessief ....................................................................................... 70
Multifactorieel overervende aandoeningen .................................................................... 71
Neuraalbuisdefecten .................................................................................................... 71
Gentica van kanker ....................................................................................................... 72
Samenvatting genetica ..................................................................................................... 73
Oefeningen ....................................................................................................................... 74
Deel teratologie – Dr. Cha’ban.............................................................................................. 77
Algemeen.......................................................................................................................... 77
Definities........................................................................................................................... 77
Epidemiologie ................................................................................................................... 78
Oorzaken........................................................................................................................... 78
Genetische factoren ..................................................................................................... 78
Teratogene factoren – Teratogenen ............................................................................. 78
.......................................................................................................................................... 79
Teratogenen ...................................................................................................................... 79
Infecties ........................................................................................................................ 79
Maternale ziektebeelden ............................................................................................. 79
Medicatie ...................................................................................................................... 79
Omgevingsfactoren ...................................................................................................... 82
Deel 4: Toxicologie ................................................................................................................ 85
Intoxicaties algemeen ....................................................................................................... 85
Problemen bij de opvang ............................................................................................. 85
Intoxicatie ......................................................................................................................... 86
4
2VV
2023- 2024
Klinische farmacologie - Inne Hendrickx
Klinische farmacologie - Inne Hendrickx .................................................................................... 1
Deel 1: Algemene principes van de farmacologie ...................................................................... 5
Het geneesmiddel............................................................................................................... 5
Naamgeving .................................................................................................................... 5
Indicaties ........................................................................................................................ 5
Toedieningsvormen ........................................................................................................ 6
Toedieningswijzen .......................................................................................................... 7
Farmacokinetiek ................................................................................................................. 8
Absorptie ........................................................................................................................ 9
Distributie ....................................................................................................................... 9
Metabolisme................................................................................................................... 9
Excretie ......................................................................................................................... 10
Enkele termen .............................................................................................................. 10
Farmacodynamiek ............................................................................................................ 11
Interacties ..................................................................................................................... 12
Absorptiefase............................................................................................................ 12
Distributiefase .......................................................................................................... 13
Metabolisatiefase ..................................................................................................... 13
Excretiefase............................................................................................................... 13
Overgevoeligheid .......................................................................................................... 13
Behandeling .................................................................................................................. 14
Bijwerkingen ................................................................................................................. 15
Ernstige bijwerkingen ................................................................................................... 15
QT-verlenging............................................................................................................ 15
Anticholinerg syndroom ........................................................................................... 16
Serotonine syndroom ............................................................................................... 16
Maligne antipsychotica syndroom ........................................................................... 17
DRESS syndroom....................................................................................................... 17
Hyperkaliëmie........................................................................................................... 18
Medicatie die convulsies uitlokken .................................................................................. 18
Aandachtspunten bij de zwangere ................................................................................... 18
Deel 2: Medicatie ................................................................................................................. 21
Cardiovasculair stelsel ...................................................................................................... 21
1
,Robyn Thomas
2VV
2023- 2024
Betablokkers ................................................................................................................. 22
ACE-inhibitoren of ACE-I ............................................................................................... 22
Angiotensine-II-inhibitoren of sartanen ....................................................................... 23
Calciumantagonisten .................................................................................................... 23
Diuretica ....................................................................................................................... 24
Centraal werkende antihypertensiva ........................................................................... 24
Nitraten ........................................................................................................................ 25
Hypolipemierende middelen ........................................................................................ 25
Statines ......................................................................................................................... 25
Acetylsalicylzuur of aspirine ......................................................................................... 26
Veno- en capillarotropica ............................................................................................. 26
Cardiovasculaire medicatie en zwangerschap .................................................................. 26
Cardiovasculaire medicatie en borstvoeding ................................................................... 27
Afwijkingen van het bloed ................................................................................................ 27
Antithrombotica ........................................................................................................... 28
Antithrombolytica ........................................................................................................ 31
Thrombolytica .............................................................................................................. 31
Ademhalingsstelsel ........................................................................................................... 31
Corticosteroïden ........................................................................................................... 33
Middelen bij hoesten ................................................................................................... 33
Spijsverteringsstelsel = gastro- intestinale stelsel ............................................................ 34
Maagzuurmiddelen ...................................................................................................... 34
Spasmolytica................................................................................................................. 35
Anti-emetica ................................................................................................................. 35
Laxativa ......................................................................................................................... 36
Anti-diarreica ................................................................................................................ 37
Middelen tegen hemorroiden ...................................................................................... 37
Zwangerschap en gastro-intestinale middelen ............................................................ 37
Schildklierlijden ................................................................................................................ 38
Hypothyroidie ............................................................................................................... 38
Hyperthyroidie.............................................................................................................. 38
Schildklierlijden en zwangerschap ............................................................................... 39
Diabetes ............................................................................................................................ 39
Insulinetherapie............................................................................................................ 39
Orale antidiabetische middelen ................................................................................... 40
2
,Robyn Thomas
2VV
2023- 2024
Middelen bij hypoglycemie .......................................................................................... 41
Zwangerschap en diabetes ........................................................................................... 42
Pijnmedicatie .................................................................................................................... 42
Niet-opoide analgetica ................................................................................................. 43
Niet-steroidale anti-inflammatoire middelen .............................................................. 43
Zwangerschap en NSAID’s ............................................................................................ 44
Opoide analgetica ......................................................................................................... 44
Zwangerschap en opiaten ............................................................................................ 45
Middelen bij neuropatische pijn ...................................................................................... 45
Middelen tegen epilepsie ................................................................................................. 45
Epilepsie en zwangerschap ........................................................................................... 46
Middelen tegen migraine ................................................................................................. 46
Preventieve middelen................................................................................................... 47
Zwangerschap en migraine ........................................................................................... 47
Corticosteroïden ............................................................................................................... 47
Corticosteroïden en zwangerschap .............................................................................. 48
Middelen bij infecties ....................................................................................................... 48
Antibiotica .................................................................................................................... 48
Zwangerschap en antibiotica ........................................................................................ 51
Zwangerschap en antimycotica .................................................................................... 52
Antivirale middelen en zwangerschap ......................................................................... 52
Mineralen en vitaminen ................................................................................................... 53
Mineralen ..................................................................................................................... 53
Vitaminen ..................................................................................................................... 53
Mineralen en vitaminen en zwangerschap .................................................................. 53
Vaccins .............................................................................................................................. 54
Basisvaccinatieschema voor kinderen .......................................................................... 54
Immunoglobulinen ....................................................................................................... 55
Vaccins en zwangerschap ............................................................................................. 55
Vaccins en borstvoeding ............................................................................................... 55
Deel 3: Teratologie................................................................................................................ 56
Inleiding ............................................................................................................................ 56
.......................................................................................................................................... 59
.......................................................................................................................................... 59
Genetica en het geslacht .............................................................................................. 59
3
, Robyn Thomas
2VV
2023- 2024
Basisbegrippen ............................................................................................................. 60
Mutaties ........................................................................................................................... 60
Genmutaties ................................................................................................................. 62
Chromosoommutaties .................................................................................................. 62
Chromosoomafwijkingen ................................................................................................. 63
Numerieke afwijkingen................................................................................................. 63
Genoommutaties.......................................................................................................... 63
Structurele afwijkingen ................................................................................................ 65
Monogeen overervende aandoeningen ........................................................................... 66
Autosomaal dominant ................................................................................................. 68
Geslachtsgebonden dominant .................................................................................... 68
Autosomaal recessief ................................................................................................... 69
Geslachtsgebonden recessief ....................................................................................... 70
Multifactorieel overervende aandoeningen .................................................................... 71
Neuraalbuisdefecten .................................................................................................... 71
Gentica van kanker ....................................................................................................... 72
Samenvatting genetica ..................................................................................................... 73
Oefeningen ....................................................................................................................... 74
Deel teratologie – Dr. Cha’ban.............................................................................................. 77
Algemeen.......................................................................................................................... 77
Definities........................................................................................................................... 77
Epidemiologie ................................................................................................................... 78
Oorzaken........................................................................................................................... 78
Genetische factoren ..................................................................................................... 78
Teratogene factoren – Teratogenen ............................................................................. 78
.......................................................................................................................................... 79
Teratogenen ...................................................................................................................... 79
Infecties ........................................................................................................................ 79
Maternale ziektebeelden ............................................................................................. 79
Medicatie ...................................................................................................................... 79
Omgevingsfactoren ...................................................................................................... 82
Deel 4: Toxicologie ................................................................................................................ 85
Intoxicaties algemeen ....................................................................................................... 85
Problemen bij de opvang ............................................................................................. 85
Intoxicatie ......................................................................................................................... 86
4
