Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI 2 Final > Antacids and anti-ulcer > Flashcards

Antacids and anti-ulcer Flashcards

1
Q

indication for antacids

A

short-term, temporary relief of mild pain and symptoms associated with PUD/GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

categories of antacids

A

low-systemic agents (aluminum, calcium, magnesium)
high systemic agents (sodium)
supplemental agents (simethicone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

low systemic antacids

A

aluminum
calcium
magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

high systemic antacids

A

sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MoA of antacids

A

combine chemically with hydrogen ions resulting in the generation of by-products - water, CO2, Cl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

at higher doses of antacids, what happens to LES tone?

A

increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F - antacids reduce acid secretion and production

A

no, dont reduce secretion or production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

rapid onset antacids include

A

calcium and magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

slow onset antacids include

A

aluminum and sodium

S(low) A(ntacids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

long lasting antacids include

A

calcium and magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

best acid neutralizing capacity

A

calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

surfactant that decreases surface tension and aids in the expulsion of gas

A

simethicone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

aluminum adverse effects

A

constipation
hypophosphatemia ***
rare –> renal osteodystrophy, encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

magnesium adverse effects

A

diarrhea (stool-softening/laxative like activity)

hypermagnesemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

calcium adverse effects

A

contipation
hypercalcemia (milk-alkali syndrome resutling in nephrop)
hypophosphatemia (effective treatment for hyeprphosphatemia)
calcium based kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

sodium adverse effects

A

gas/flatulence
hypernatremia
metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when prescribing antacids, what important information about TIMING should you educate them on

A

patients should take all antacids 1-2 hours BEFORE other medications or 2-4 hours AFTER
AVOID ANTACID AND MEDICATION CO-ADMINISTRATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

anti-ulcer drug families

A 
h2 receptor antagonists (-tidine) 
PPI (-prazole)
surface acting agent (sucralfate) 
PGE1 analog (misoprostol) 
bismuth compounds (bismuth subsalicylate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

nizatidine is unique of all the h2 blockers because

A

PO only

all others are IV/PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MoA of H2 blockers

A

REVERSIBLY inhibit h2 recpetors on baso-lateral membrane of parietal cell
30min-2 hour onset (longer than antacids, shorter than PPIs)
ulcer healing occursin 4-8 weeks
inhibit 20-50% of acid production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

H2 adverse effects

A

gi - nausea/diarrhea/constipatino
cns - headache
RARE - CEMETIDINE DECREASES TESTOSTERONE BINDING TO ANDROGEN RECPETOR – GYNECOMASTIA IN MEN AND GALACTORRHEA IN WOMEN
blood dyscrasias such as neutropenia and thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

H2 drug interactions

A

primarily with cemetidine
CEMETIDINE INHIBITS CYP450 AND INTERACTS WITH A SHIT TON OF DRUGS
Ranitidine ~10% CYP450 inhibition and other in the family have no inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

CI for H2 blockers

A

pregnancy

if you have to - use ranitidine or famotidine

24
Q

PPIs include

A 
omeprazole
esomeprazole
lansoprazole
dexlansoprazole 
pantoprazole
rabeprazole
25
Q

PO ONLY PPIs

A

omeprazole
lansoprazole
dexlansoprazole
rabeprazole

26
Q

PO/IV PPIs

A

esomeprazole

pantoprazole

27
Q

MoA of PPIs

A

covalently bind to sulfhydryl groups of H+/K+ ATPase at parietal cell secretory sites, thereby inhibiting gastric acid secretion by IRREVERSIBLY INHIBITING functioning -ase pumps
takes several days to reach new steady state

28
Q

PPIs are more effective than H2 blockers, reducing acid secretion by

A

50-90%, whereas H2 vblockers only reach 20-50%

however, H2 blockers have a more rapid onset than PPIs

29
Q

PPIs adverse effects

A 
GI- diarrhea/dyspepsia/nausea 
*****CDAD - clostridium difficile-associated diarrhea *****
CNS - HA/dizziness
rare - generalized myalgias, fatigue, myopathies 
increased risk for 
kidney disease (AKI)
bone fractures 
cardiovascular disease
30
Q

PPI drug interactions

A

OMEPRAZOLE INHIBITS CYP450

many drug-drug interactions

31
Q

CI for PPIs

A

pregnancy
only if necessary - lansoprazole or pantoprazole
AVOID OMEPRAZOLE

32
Q

what is sucralfate

A

a suflated polysaccharide

an octasulfate of sucrose with al(OH)3 added

33
Q

MoA of sucralfate

A

cross-links when interacting with stomach acid, creating a viscious sticky polymer which adheres to epithelial cells around an ulcer’s crater
prevents acid access to ulcer sites
stimulates local prostaglandin and mucous productino and epdiermal growth factor - cytoprotective
DOES NOT AFFECT PH

34
Q

indication of sucraflate

A

DUODENAL ULCERS

off-label uses: aphthous ulcers, mucosities/stomatitis, radiation proctitis/ulcers, bile reflux gastropathy, otehrs

35
Q

adverse effects for sucraflate

A

CONSTIPATION

36
Q

CI for sucralfate

A

severe renal failure d/t presence of aluinum

also avoid aluminum antacids

37
Q

drug interactions with sucralfate

A

possible, take 2 hours after other medications

dosed QID for active ulcers so plan other meds accordingly

38
Q

prostaglandin e1 analog

A

misoprostol

39
Q

MoA of misorpostol

A

provides protective prostaglandin to gastric mucosa and reduces gastric acid release from parietal cell
provides cytoprotection by increasing mucosal defenses
stimulates bicarb and mucous production

40
Q

indication for misoprostol

A 
prevention of NSAID induced gastric ulceration in patients iwth high risk of ulceration and complications 
off-label uses 
pregnancy termination 
CERVICAL RIPENING
post-partum hemorrhaging
41
Q

adverse effects of misoprostol

A

GI - diarrhea **

cns - HA/dizziness

42
Q

CI for misoprostol

A

pregnancy - unless for off-label issues

IBD - avoid if possible

43
Q

MoA of bismuth compounds

A

anti-diarrheal agent
antimicrobial actions
exact mechanism for PUD not known, might function similar to aspirin and inhbiit prostaglandin synthesis

44
Q

what agent is used in combiination with antibiotics and acid suppression for h. pylori treatment

A

bismuth compounds

45
Q

adverse effects of bismuth comounds

A

constipation
BLACK/DARK STOOLS
lots of drug interactions, take 2 hours after other medications

46
Q

CI for bismuth

A

antiplatelets and anticoagulates

severe renal failure

47
Q

ABSOLUTE ci for bismuth

A

GI bleeding

salicylate hypersensitivity

48
Q

treatment of h pylori

A

combination treatment
2 ANTIBIOTICS AND AN ACID REDUCER (PPI or H2)
10-14 days
BID

49
Q

antibiotics for h pylori

A

clarithromycin

amoxicillin/metronidazole

50
Q

in order to test for successful h pylori eradication, what hsould the patient discontinue

A

discontinue bismuth, antibiotics and PPIs within 4 weaks prior to breath test

51
Q

triple therapy - 14 days

A

BID
A PPI
clarithromycin
axomycillin/metronidazole

52
Q

quadruple therapy - 10-14 days

A 
PPI - BID, all other QID 
PPI
metronidazole
tetracycline
BISMUTH subsalicyate
53
Q

helidac and pylera contain what

A

all the shit plus a PPI

54
Q

PCN allergy - no amoxicillin

A

substitute metrodiazole (consider bismuth quadruple therapy)

55
Q

h pylor with metronidazole resistance

A

substitute tetracycline

56
Q

h pylori with clarithromycin resistande

A

substitute either amoxicillin or tetracycline

57
Q

managing a pregnant patient with PUD and no h pylori

A

short course of antacids or sucralfate
moderate - ranitidine
severe - lansoprazole

GI 2 Final (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions