Benzodiazepinas pdf..

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Benzodiazepinas pdf..

  1. 1. BENZODIAZEPINAS KAREM A. MARTINEZ F.R1 ANESTESIOLOGIA Y REANIMACION HSB
  2. 2. Aumentan actividad Modulan actividad en la Anillo heterociclico neurotransmisora membrana pots sinaptica inhibitoria 2 atomos de N estan Entrada de cloruro Receptor GABA tipo A localizados en 1-4 hiperpolarizacion Desordenes desuegno, ansiedad, estatus Acciones terapeuticas epileptico y tension mediada muscular Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  3. 3. Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483- 493. 2011
  4. 4. • Heteropentamero• Sitios de union para:- Barbituricos- Benzodiazepinas (Subunidad alpha y gamma 2)- GABAEvers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  5. 5. Propiedades farmacologicas dependeran de la subunidad (Histidina) • Alpha 1-2-3-5 combinada con • Betha 1-2-3 subunidades • Gamma 2 (Brain-modulacion a BZN) Insensibles a BZN • Alpha 4-6 • Delta • Aumentan o modulan afinidad por el neutotransmisor fisiologico GABAEvers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  6. 6. Cerebro y corteza Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-
  7. 7. Miller s. anesthesia. 7thedition. Chapter 16.2011
  8. 8. • Los efectos tranquilizantes son asociados a bajas dosis• Lorazepam 2-3 veces mas sedante que Midazolam• Midazolam 5-6 veces mas potente que Diazepam• Lorazepam 4 veces mas amnesico que Midazolam- Cuidado en pacientes ancianos Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  9. 9. Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  10. 10. • Lorazepam, midazolam y diazepam, los mas utilizados en la practica clinica• Difieren en inicio de accion, duracion y terminacion de efectos- Afinidad a los receptores y sus subunidades (potencia)- Liposolubilidad (redistribucion)- Farmacocinetica (Absorcion, distribucion, eliminacion) Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  11. 11. • 99% Diazepam Union a proteinas plasmaticas• 95% Midazolam• 85% Lorazepam Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  12. 12. MIDAZOLAM DIAZEPAM HEPATICO HEPATICO- HIDROXILACION OXIDATIVO N- Enzimas microsomales DESMETILACION Enzimas microsomales HIDROXIMIDAZOLAM 20- DESMETILDIAZEPAM 30% OXAZEPAM Es conjugado y eliminado Conjugacion glucuronizacion renal Eliminacion renalEvers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  13. 13. Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  14. 14. EFECTOS ADVERSOS• Depresion respiratoria• Incremento con opioides• Depresion cardiovascular- Reversion con antagonista benzodiazepinas FLUMAZENIL-1-2 minutos inicio de accion- 45-90 minutos duracion de accion (0.2, 1.0 mg bolo o 3mg /H)Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011
  15. 15. 1. Evers, A, Maze M, Anesthetic Pharmacology. Basic principles and clinical practice. 2nd Edition. Chapter 29 Pag 483-493. 2011BIBLIOGRAFIA

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