Prescrierea AINS

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t014_b
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219942
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Prescrierea AINS
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2013-05-17 01:21:43
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Prescrierea AINS
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Prescrierea AINS
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  1. AINS : Indicatii pe termen scurt (5) si lung (1)
    • artroza
    • microcristale
    • periarticulare
    • rahidiene si radiculare
    • traume sportive
    • -----
    • reumatisme inflamtorii cronice
  2. contraindicatii (7)
    • alergie
    • antecedente de ulcer peptic/ulcer activ
    • astm la aspirina si alergie incrucisata la alte AINS
    • insuf renala, hepatica, cardiaca
    • sarcina (trim 3) si alaptare
    • tulburari hemoragice
    • astm
  3. ketoprofen(3)
    local(artic superficiale degete/genunchi)

    fotosensibilizant

    singurul IV 300 mg/zi max, 2-3 zile
  4. FR AINS(4 + o CI Absoluta)
    • >65
    • ant de ulcer/hemoragie g.i. superioara
    • coprescriptii (aspirina, AVK, corticoizi)
    • AINS in doza mare
    • combinatie de 2 AINS
  5. complicatii renale AINS (4)
    • IR funct
    • nefrita acuta interstitiala imunoalergica(rar)
    • lez glomer minime
    • hiperkaliemie (indometacin)
  6. complicatii alergice AINS(6)
    • eriteme
    • urticarii
    • dermatoze buloase
    • bronhospasm
    • angioedem
    • anafilaxie
  7. Adaugare IPP la AINS (4)
    • >65
    • ant de ulcer gastroduod
    • intoleranta la AINS
    • aspirina microdoza
  8. Indicatii steroizi
    imunosupresoare( 4)
    durere (2)
    • poliart reumatoida
    • colagenoze
    • vasculita(Horton)
    • polimialgie reumatica
    • nevralgie cervicobrahiala
    • lombocruralgie (scurta durata)
  9. doza corticoizi PR /kg/zi
    0,1mg/kg/zi prednison
  10. doza steroizi Horton
    0,5-1mg/ kg/zi
  11. doza steroizi polimialgie reumatica
    0,25-05mg/kg/zi
  12. scadere doza steroizi
    2,5-5mg/zi (sau 10%) la fiecare 3 sapt

    sub 10mg/zi din mg in mg lunar
  13. complicatii terapie scurta durata steroizi(6)
    • infectii
    • diabet zaharat
    • HT
    • complic dig
    • glaucom
    • tulb psihice
  14. complicatii psihice steroizi(5)
    • depresie
    • insomnie
    • delir
    • accese maniacale
    • halucinatii
  15. complicatii cutanate in trat cu corticoizi(7)
    • fragilitatea pielii
    • acnee
    • echimoze
    • hipertricoza
    • vergeturi
    • folicute
    • intarzierea vindecarii plagilor
  16. recomandare trat in osteoporoza indusa de corticoizi, cu bifosfonati
    corticoterapie >7,5 mg/zi 3 luni

    T < -1,5SD ( fara fractura)

    istoric de fractura osteoporoza
  17. indicatii infiltratiilor de corticosteroizi(6)
    • artrita aseptica
    • artrozxa
    • tendinite
    • bursite
    • canal carpian
    • lomboradiculalgii comune
  18. CI infiltrarii de corticoizi
    • infectie activa
    • tulb de coagulare
    • hipersensibilitate

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