ls, primenyaemie pribronxoobstruktsii

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sredstva, vliyayushie na funktsiyu organov dixaniya po teme: agenti, vliyayushie na organi dixaniya 1 ls, vliyayushie na funktsiyu dixaniya : ls, primenyaemie pri bronxoobstruktsii protivokashlevie sredstva otxarkivayushie sredstva stimulyatori dixaniya ls, primenyaemie pri oteke legkix sredstva dlya lecheniya bronxialnoy astmi v osnove patogeneza bronxialnoy astmi lejat sleduyushie izmeneniya dixatelnix putey: spazm gladkoy muskulaturi, otek slizistoy, kletochnaya infiltratsiya i narushenie proxodimosti probkami iz plotnoy slizi. dlya preduprejdeniya i snyatiya bronxospazma ispolzuyut bronxodilyatatori. dlya snyatiya oteka i infiltratsii -protivovospalitelnie sredstva 3 4 sredstva, primenyaemie pri bronxialnoy astme bronxorasshiryayushie sredstva 1. adrenergicheskie agonisti a) 2 –adrenomimetiki: korotkogo deystviya dlitelnogo deystviya salbutamol* salmeterol* fenoterol formoterol sverxdlitelnogo deystviya: indakaterol (onbriz brizxaler), vilanterol , olodaterol, 2. m-xolinoblokatori: ipratropiya bromid (atrovent)* tiotropiya bromid (spiriva) glikopirroniy (sibri brizxaler) aklidiniya bromid (bretaris djenueyr) umikledoniy (inkruz elipta) 3. ingibitori fosfodiesterazi: teofillin dlya kupirovaniya pristupov aminofillin (eufillin) prolongirovannogo deystviya teotard (ne primenyaetsya!!) 5 sredstva, primenyaemie pri bronxialnoy astme (prodoljenie) bronxorasshiryayushie sredstva …

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ok: kromoglitsievaya kislota (kromolin natriya, intal) nedokromil (tayled) ketotifen (zaditen) 3.antagonisti leykotrienov: a)ingibitori sinteza leykotrienov zileuton b)blokatori leykotrienovix retseptorov zafirlukast (akolat) 7 sredstva, primenyaemie pri bronxialnoy astme drugie sredstva dlya lecheniya astmi •antigistaminnie sredstva •blokatori kaltsievix kanalov • -adrenoblokatori • donori okisi azota • preparati, otkrivayushie kalievie kanali 8 adrenomimetiki 1. adrenergicheskie agonisti v) 2 –adrenomimetiki: korotkogo deystviya dlitelnogo deystviya salbutamol* salmeterol* fenoterol formoterol terbutalin klenbuterol ne primenyayutsya! a) - i -adrenomimetiki: adrenalina gidroxlorid* efedrina gidroxlorid b) 1- 2 –adrenomimetiki: izoprenalin (izadrin) ortsiprenalin (alupent) mexanizm deystviya adrenomimetikov stimulyatsiya--adrenoretseptorov bronxov  aktivatsiya adenilattsiklazi  uvelichenie obrazovaniya tsamf  snijenie obrazovaniya sa v kletkax gladkix mishts bronxov  rasslablenie gladkix mishts bronxov. tsamf sa tonus gladkix mishts 10 farmakodinamicheskie effekti adrenomimetikov legkie bronxoliticheskiy effekt: - rasshirenie bronxov, - ingibirovanie visvobojdeniya veshestv, vizivayushix bronxospazm (gistamina, medlenno reagiruyushey substantsii anafilaksii), - snijenie bronxospasticheskix effektov (atsetilxolina, gistamina, serotonina), - povishenie mukotsiliarnogo transporta formoterol >salmeterol >izoprenalin …

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zmu) nekotorie metaboliti obladayut farmakologicheskoy aktivnostyu: - 3-metoksiizoprenalin (metabolit izoprenalina) – okazivaet 2–adrenoblokiruyushee deystvie - sulfatirovanniy efir salbutamola - 2–adrenostimuliruyushee deystvie ekskretsiya: s jelchyu i cherez pochki pronikayut cherez platsentu-izoprenalin, salbutamol, terbutalin sekretiruyutsya s grudnim molokom –izoprenalin, salbutamol, terbutalin 12 vremennie pokazateli deystviya ingalyatsionnix 2-adrenomimetikov ls doza, mg bronxoliticheskiy effekt nach, min maks., min dlit, korotkogo deystviya ortsiprenalin (alupent) 0,75 6 2 8-10 salmeterol 0,05 >30 2-4 12 indakaterol* (onbrez brizxaler) vilanterol (umeklidiniy) olodaterol* (striverdi) abediterol karmoterol 13 indakaterol (onbrez® brizxaler) kapsuli s poroshkom dlya ingalyatsiy, 150 mkg, 300 mkg. po 10 kaps. v blistere. doza 150 mkg 1 raz/sut. pobochnie deystviya adrenomimetikov pri ingalyatsii terapevticheskix doz 2-adrenomimetikov – prakticheski otsutstvuyut pri prieme neselektivnix preparatov: - taxikardiya - tremor reje - aritmii - uchashenie pristupov stenokardii - gipokaliemiya vozmojno -  kontsentratsii svobodnix jirnix kislot -  sekretsii insulina razvitie tolerantnosti - pri dlitelnom prieme 2-adrenomimetikov ili ix peredozirovke (vremenno …

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sredstva, vliyayushie na funktsiyu organov dixaniya po teme: agenti, vliyayushie na organi dixaniya 1 ls, vliyayushie na funktsiyu dixaniya : ls, primenyaemie pri bronxoobstruktsii protivokashlevie sredstva otxarkivayushie sredstva stimulyatori dixaniya ls, primenyaemie pri oteke legkix sredstva dlya lecheniya bronxialnoy astmi v osnove patogeneza bronxialnoy astmi lejat sleduyushie izmeneniya dixatelnix putey: spazm gladkoy muskulaturi, otek slizistoy, kletochnaya infiltratsiya i narushenie proxodimosti probkami iz plotnoy slizi. dlya preduprejdeniya i snyatiya bronxospazma ispolzuyut bronxodilyatatori. dlya snyatiya oteka i infiltratsii -protivovospalitelnie sredstva 3 4 sredstva, primenyaemie pri bronxialnoy astme bronxorasshiryayushie sredstva 1. adrenergicheskie agonisti a) 2 –adreno...

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