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GI 2 > antacid and ulcer drugs > Flashcards

antacid and ulcer drugs Flashcards

1
Q

Low systemic antacids

A
  • Aluminum
  • Calcium
  • Magnesium
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2
Q

High systemic antacids

A

-sodium salts

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3
Q

the one supplemental antacid agent

A

simethicone

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4
Q

Do antacids reduce acid production and secretion?

A

NOOOO

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5
Q

What are the two antacids that have rapid onset and long duration of action and have good acid neutralizing capacity

A
  • calcium

- Magnesium

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6
Q

MOA of simethicone antacid

A
  • surfactant: decreases surface tension

- Aids in expulsion of gas (PRO FART)

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7
Q

Adverse effect of Aluminum antacid

A

constipation

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8
Q

adverse effect of magnesium antacid

A

Diarrhea (stool-softening/laxative-like activity)

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9
Q

adverse effect of calcium antacid

A

constipation

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10
Q

Adverse effect of sodium antacid

A
  • Gas/Flatulence (“bicarb. burp)

- be cautious with HTN .. . hypernatremia

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11
Q

Drug interactions with antacids

A

TONS!!!!!!!!!!

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12
Q

Advice on when to take antacids

A

*****take all antacids 1-2 hours before other medications OR 2-4 hours after other meds

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13
Q

What are the 5 CATEGORIES of anti-ulcer agents

A
  • H2 receptor antagonist
  • Proton Pump inhibitor
  • Surface Acting Agents
  • PGE1 analog
  • Bismuth compounds
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14
Q

H2 receptor antagonists have what ending

A

Tidine

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15
Q

Proton pump inhibitors have what ending

A

Prazole

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16
Q

If you give enough H2 antagonist, can you completely shut down acid production?

A

NO, multiple paths lead to acid production

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17
Q

Onset of action with H2 antagonist

A

.5-2 hours

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18
Q

How long until ulcer healing occurs after H2 antagonist given

A

4-8 weeks

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19
Q

Adverse effects of H2 antagonist

A

relatively mild and infrequent . . . GI related or CNS like drowsiness or headache

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20
Q

Adverse effect of Cimetidine with Long term, high dosage

A
  • gynecomastia in men

- Galactorrhea in women

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21
Q

Drug interaction of cimetidine

A

PROTOTYPICAL inhibitor of CYP450 isoenzymes

22
Q

which H2 antagonist would you use in pregnancy

A

Ranitidine

23
Q

Proton pump inhibitor MOA

A

covalently bind to sulfhydryl groups of H+/K+ ATPase at parietal cell secretory sites, thereby inhibiting gastric acid secretion by IRREVERSIBLY inhbiting ase pumps

24
Q

time takes for PPIs to start working

A

several days

25
Q

when given a PPI, how long does it take ulcers to heal

A

4-8 weeks

26
Q

Adverse effect of PPI

A

CDAD

-Clostridium Difficile Associated Diarrhea

27
Q

Drug interactions for Omeprazole

A

PROTOTYPICAL CYP450 inhibitor

28
Q

which PPI do you use for pregnancy

A

Iansoprazole

29
Q

What is the anti ulcer drug that is a sulfated polysaccharide that creates a viscous, sticky polymer which adhere to epithelial cells around ulcers crater to prevent acid access in ulcer site

A

Sucralfate

30
Q

Does sucralfate affect pH

A

no

31
Q

adverse effect of sucralfate

A

constipation

32
Q

dosing for sucralfate that makes it difficult

A

4 times a day and avoid with other meds

33
Q

Misoprostol is an analog to what

A

prostaglandin E1

34
Q

What type of protection does misoprostol provide

A

Cytoprotection by increasing mucosal defenses

35
Q

Indication for misoprostal use

A

NSAID-induced gastric ulceration

36
Q

Contraindication for misoprostal

A

Pregnancy

37
Q

MOA of Bismuth compounds (pepto-Bismol)

A

anti- diarrheal and antimicrobial

38
Q

Bismuth compounds are used with what in treatment of H. pylori

A

antibiotics

39
Q

Adverse affects of Bismuth compounds

A

Black/Dark stools

40
Q

Drug interactions with Bismuth compounds

A

Lots, take 2 hours after other meds

41
Q

Absolute contraindication for Bismuth

A
  • GI bleeding

- Salicylate hypersensitivity

42
Q

Treatment for H. pylori . .generally

A

Combination . . AT LEAST 2 antibiotics and an acid reducer (PPI or H2 blocker

43
Q

Time frame and number of drugs for H. pylori treatment

A
  • 10-14 days

- Triple drug therapy

44
Q

normal triple drug therapy for H. pylori

A
  • PPI
  • Clarithromycin
  • either amoxicillin OR metronidazole
45
Q

Quadruple therapy for H. pylori

A
  • PPI (or H2 blocker)
  • Metronidazole OR Clarithromycin
  • Amoxicillin OR Tetracycline
  • Bismuth Subsalicylate
46
Q

When is tetracycline useful in quadruple therapy for H. pylori

A

amoxicillin allergy and metronidazole resistance

47
Q

Expain the time frame for continuation of PPI or H2 blocker after the 10-14 day combo therapy for H. pylori

A

consider for several weeks after for complete healing of ulcers

48
Q

H. pylori therapy with PCN allergy

A

substitute metronidazole for amoxicillin

49
Q

H. pylori therapy with metronidazole resistance

A
  • substitute tetracycline

- consider quadruple therapy

50
Q

H. pylori with clarithromycin resistance

A
  • substitute either amoxicillin or tetracycline

- consider quadruple therapy

51
Q

treatment of Pregnant patient with ulcer but without H. pylori

A
  • short course of antacids or sucralfate
  • if moderate consider ranitidine
  • if severe consider Iansoprazole
52
Q

If patient has an ulcer and on NSAIDs

A
  • if it ISN’T required consider switching to Acetaminophen

- If NSAIDS are required then Misoprostol

GI 2 (13 decks)

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