205
Anästhesie (Fach) / Pharmakologie (Lektion)
FMH
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- Ropivacain (Naropin) S-Enantiomer im Vgl mit Bupivacain ähnlich potent, aber weniger lipidlöslich und weniger NW im ZNS und Cardiovaskulär. pKa 8,1 0,2-1% Konzentrationen vasokonstriktorisch Proteinbindung 94% hepatischer Metabolismus max. 3,5 mg/kg
- Makrolid (Erythromycin) hemmt Translokation der Proteinbiosynthese grampositiv (Streptokokken,Staphylokokken) anaerob (Propionibakterien,Corynebakterien) Mykoplasmen Legionellen
- Co-trimoxazol sulphamethoxazole and trimethoprim Pneumocystis pneumonia
- Propranolol Propranolol is a non-selective beta adrenoceptor antagonist (both beta 1 and 2) with no intrinsic sympathomimetic action (ISA). It has a large volume of distribution. It is lipid soluble and therefore readily crosses the blood brain barrier, leading to sedation, nightmares and depression. Its elimination half life is relatively short at four hours.
- Alpha-Blocker Alpha adrenergic receptor antagonists are used as antihypertensive agents by causing vasodilatation which reduces afterload. Selective alpha 1 blockers include: Prazosin Phenoxybenzamine and Indoramin, etc. Yohimbine is an alpha 2 blocker, and phentolamine is non-selective alpha blocker. There is a 'first dose' effect with selective alpha 1 blockers, characterised by marked postural hypotension and tachycardia. Alpha 1 blockers do not, or at least are less likely to, cause reflex tachycardia in the long term, whereas alpha 2 blockers exaggerate the reflex tachycardia. Alpha 1 blockers cause less of a tachycardia because they do not affect the negative feedback at alpha 2 receptors. Tachyphylaxis may occur. Low density lipoprotein (LDL), triglycerides and total cholesterol is reduced with prolonged therapy, but it improves insulin sensitivity and glucose control in diabetics. Prostatic symptoms may improve with alpha blockers, but priapism may occur.
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