Brainscape's Knowledge GenomeTM

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


See full index

Gastrointestinal II Exam #1 > Antacids and Anti-ulcer Drugs > Flashcards

Antacids and Anti-ulcer Drugs Flashcards

1
Q

Which salts are considered to be low-systemic agents? (3)

A

Aluminum salts
Calcium salts
Magnesium salts

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

Which salt is considered to be a high-systemic agent?

A

Sodium salts

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

What is Simethicone?

A

A supplemental agent

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

What is the MOA of antacids?

What byproducts are produced as a result? (3)

A

They combine with H+ ions.

Water, CO2, Cl-

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

What are antacids capable of doing at higher doses?

A

Increase LES tone

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

Antacids do NOT…

What might be possible as a result?

A

Do NOT reduce acid secretion or production.

Rebound acid production is possible.

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

Calcium

Onset:
DOA:
ANC:

A

Onset: rapid
DOA: long
ANC: very good

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

Aluminum

Onset:
DOA:
ANC:

A

Onset: slow
DOA: short
ANC: fair/weak

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

Magnesium

Onset:
DOA:
ANC:

A

Onset: rapid
DOA: long
ANC: good

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

Sodium

Onset:
DOA:
ANC:

A

Onset: rapid
DOA:short
ANC: fair/good

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

Simethicone is a…

What does it aid in?

A

A surfactant - reduces surface tension.

Aids in expulsion of gas.

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

Adverse effects of Aluminum (4)

A

Constipation

Hypophosphatemia (can be used acutely for hyperphosphatemia)

Renal osteodystrophy (ESRD)

Encephalopathy

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

Adverse effects of Magnesium (2)

A

Diarrhea

Hypermagnesemia

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

Adverse effects of Calcium (4)

A

Constipation

Hypercalcemia

Hypophosphatemia (can be used for hyperphosphatemia)

Calcium-based kidney stones

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

What causes “Milk-Alkali Syndrome”?

A

Occurs due to hypercalcemia and results in nephropathy and metabolic alkalosis.

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

Adverse effects of Sodium (3)

A

Gas

Hypernatremia

Metabolic alkalosis

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

What are “common, important patient factors” in determining an antacid for a patient? (4)

A

Dosage form/paliability

Presence of renal or CVD

Electrolyte status

Diseases associated with diarrhea and constipation

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

Antacids should never be taken…

A

With another med at the same time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When should antacids be taken?

A

1-2 hrs. prior to other meds or 2-4 hrs. after.

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

MOA of -tidines

A

H2 receptor antagonists

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

MOA of -prazoles

A

Proton pump inhibitors

22
Q

MOA of Sucralfate

A

Surface acting agents

23
Q

MOA of Misoprostol

A

PGE1 analogs

24
Q

5 anti-ulcer agent classes

A

H2 receptor antagonists

PPIs

Surface acting agents

PGE1 analog

Bismuth compounds

25
Q

All H2 receptor antagonists can be given IV/PO, except _______, which is given only PO.

A

Nizatidine

26
Q

MOA of Histamine type-2 blockers

A

Reversibly inhibit H2-Rs on basolateral membrane of parietal cells

27
Q

What is the onset of H2-R blockers?

What is the dosing?

When does ulcer healing occur?

What are the adverse effects?

A

0.5-2 hrs. (longer than antacids, quicker than PPIs)

QD to BID dosing

4-8+ wks.

GI-related (N/D/C) and some CNS related (HA)

28
Q

What unique adverse effect can occur from Cimetidine?

A

Decreased testosterone binding to androgen (weak anti-androgen effects)

29
Q

What is the major drug interaction of Cimetidine?

What is the major drug interaction of Ranitidine?

A

Prototypical inhibitor of several CYP450 enzymes.

Same, but occurs at approx. 10% of the rate.

30
Q

What is relative contraindication of H2-R blockers and PPIs?

A

Pregnancy (if a must, give Ranitidine (H2R antagonist), Lansoprazole (PPI))

31
Q

All of the PPIs are given PO, except __________, which can be given PO or IV.

A

Esomeprazole

32
Q

MOA of PPIs

A

Covalently bind to SH- groups of H+/K+ ATPase at parietal cell secretory sites, thereby inhibiting gastric acid secretion. After a few days, a new steady-state of pump activity is created.

33
Q

What is the dosing for PPIs?

How long does it take to achieve full symptom effects?

How long until it heals ulcerations?

A

QD, effects last approx. 24 hrs.

A few to several days (longer than H2-R antagonists).

4-8+ wks.

34
Q

What is the major adverse effect of PPIs?

What is the “additional risk”?

A

GI-related: diarrhea, dyspepsia, nausea.

-C. diff-associated diarrhea

35
Q

Which PPI is the prototypical PPI for CYP450 inhibition?

A

Omeprazole

36
Q

MOA of Sucralfate

What is the major indication for it?

What is the major adverse effect?\

What is the relative contraindication?

How long should they be taken after other meds?

A

Cross-links via interaction with stomach acid and creates a viscous, sticky polymer that adheres to epithelial cells around the ulcer’s crater.
-Prevents acid access to the ulcer site.

Duodenal ulcers

Constipation (Al(OH)3)

Severe RF

2 hrs. after other meds

37
Q

Aside from the the typical MOA of Sucralfate, what might also be stimulated?

A

Local PG and mucous production and EGF (cytoprotection).

38
Q

MOA of Misoprostol

The standard doses reduces…

A

It is a PGE1 analog and provides protection to the gastric mucosa and reduces gastric acid release from parietal cells.

  • Cytoprotection (stimulates bicarb and mucous production)
  • Increases mucosal blood flow

Basal and nocturnal acid output.

39
Q

What is the indication for Misoprostol?

What is the major adverse effect?

Contraindications? (2)

A

Prevention of NSAID-induced gastric ulceration in patients with high risk.

GI-related (diarrhea)

Pregnancy, IBD

40
Q

What is the major action of bismuth compounds?

What was it originally developed as?

A

Antimicrobial action - believed to prevent microbial attachment, inactivation of enterotoxins and disruption of cell walls

Anti-diarrheal agent

41
Q

What is the OTC vs. Rx use of bismuth compounds?

A

OTC - reflux, indigestion and diarrhea

Rx - used in combo with abx and acid suppressant for H. pylori

42
Q

What are the 2 major adverse effects of bismuth compounds?

What are the Rx interactions?

A

Constipation

Black (regularly formed) stools

Lots, take 2 hrs. post other meds.

43
Q

What are the 2 relative contraindications and 2 absolute contraindications for bismuth compounds?

A

Relative

  • antiplatelets and anticoagulants (bismuth subsalicylate)
  • severe RF

Absolute

  • GI bleeding
  • salicylate hypersensitivity
44
Q

What is the treatment for H. pylori?

A

Combination therapy is a must: at least 2 abx and an acid reducer (PPI or H2-R blocker)

45
Q

What is the triple therapy for H. pylori?

What is the dosing and for how long?

A

PPI
Clarithromycin
Amoxicillin or Metronidazole

BID for 14 days

46
Q

What is quadruple therapy for H. pylori?

What is the dosing and for how long?

A

PPI
Metronidazole
Tetracycline
Bismuth subcitrate potassium

PPI at BID, all others at QID for 10-14 days

47
Q

What is in the Prevpac (BID) for PUD?

A

Amoxicillin
Clarithromycin
Lansoprazole

48
Q

What is in the Omeclamox-Pak (BID) for PUD?

A

Amoxicillin
Clarithromycin
Omeprazole

49
Q

What is in the Helidac (QID) for PUD?

A

Bismuth subsalicylate
Metronidazole
Tetracycline
+ PPI

50
Q

What is in the Pylera (3 capsules QID) for PUD?

A

Bismuth subcitrate potassium
Metronidazole
Tetracycline
+ PPI (omeprazole)

51
Q

H. pylori with a PCN allergy, give:

H. pylori with Metronidazole resistance, give:

H. pylori with Clarithromycin resistance, give:

A

Substitute Metronidazole for Amoxicillin

Substitute Tetracycline

Substitute either Amoxicillin or Tetracycline

52
Q

Pregnant patients with PUD, but without H. pylori, give:
If moderate?
If severe?

A

Short courses of antacids or sucralfate

  • if moderate, consider ranitidine
  • if severe, consider lansoprazole

Gastrointestinal II Exam #1 (19 decks)

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