Brainscape's Knowledge GenomeTM

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


See full index

GI II > Anti-Ulcer > Flashcards

Anti-Ulcer Flashcards

1
Q

name the five classes of anti-ulcer agents

A
  1. H2 receptor antagonists
  2. PPIs
  3. surface acting agents
  4. PGE1 Analogs
  5. bismuth Compounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

-tidine

A

H2 receptor antagonists

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

-prazole

A

PPIs

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

what are the four H2 receptor antagonists?

A
  1. cimetidine
  2. famotidine
  3. nizatidine
  4. ranitidine

note: some products made with antacids included (calcium, magnesium)

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

name the six PPIs and note isomers

A
  1. lansoprazole
  2. delansoprazole
  3. omeprazole
  4. esomeprazole
  5. pantoprazole
  6. rabeprazole

1+2, 3+4

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

name the one surface acting agent

A

sucralfate

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

name the one PGE1 analog

A

misoprostol

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

name the one bismuth compound

A

bismuth subsalicylate

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

all H2 receptor antagonists are po/iv, except…

A

nizatidine (po)

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

name the drug class–

MOA: reversibly inhibits its receptor on the basolateral membrane of parietal cell

onset: 30 mins. - 2 hours
ulcer healing: 4-8+ weeks

inhibits 20-50% of acid production

A

H2 receptor antagonists / -tidine

note: onset is longer than antacids but shorter than PPIs

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

name the adverse effects of H2 receptor antagonists

rare adverse effect on another card

A
  1. primarily GI related
  2. few CNS related

relatively mild, transient, infrequent

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

which H2 receptor antagonist has a rare adverse effect with long-term, high dosing?

describe the adverse effect

A

cimetidine

decreases testosterone binding to androgen receptor

  • gynecomastia in men
  • galactorrhea in women

blood dyscrasias

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

what are the prototypical inhibitors of several CYP450 enzymes?

A
  1. cimetidine (H2 antagonist)
  2. omeprazole (PPI)

STAR

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

H2 receptor antagonists are relatively contraindicated during pregnancy. if necessary, which is safest?

A

ranitidine (most data)

otherwise, famotidine

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

PPIs are primarily administered po, with the exception of…

A

esomeprazole and pantoprazole (po/iv)

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

name the drug class –

MOA: inhibit gastric acid secretion by irreversibly inhibiting functioning -ase pumps

onset: full symptom effects seen in a few to several days
inhibit: 50-90% of acid
ulcer healing: 4-8+ weeks

A

PPIs

note: covalently bind to sulfhydryl groups of H/K-ATPase at parietal cells secretory sites

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

which drug class has CDAD as a risk?

A

PPIs – c. diff-associated diarrhea
standard GI and CNS related adverse effects as well

associations: increased risk AKI, osteoporosis/bone fractures and MI

STAR

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

PPIs are relatively contraindicated during pregnancy. which is safest if necessary?

A

lansoprazole (common) or pantoprazole

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

name the drug class –

MOA: cross-linking from interactions w/ stomach acid, creating a viscous, sticky polymer which adheres to epithelial cells around ulcer’s crater

…and…

stimulates local PG and mucous production, and EDGF

A

sucralfate

prevents acid access to ulcer sites

…and…

cytoprotection; does not affect pH

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

is it safe to use sucralfate for longer than one year?

A

no

21
Q

which drug is indicated for duodenal ulcer?

A

sucralfate

also used for:

  • aphthous ulcer
  • mucositis/stomatitis
  • more…
22
Q

what is the adverse effect of sucralfate?

A

constipation

23
Q

what is the relative contraindication of sucralfate?

A

severe renal failure (d/t aluminum)

24
Q

when should sucralfate be taken?

A

2 hours after other medications to avoid potential DDIs

dosed at QID for active ulcers so dose other medications accordingly, if possible

25
Q

name the drug class –

MOA: provides protective prostaglandin to gastric mucosa and reduces gastric acid release from parietal cell

…and…

provides cytoprotection by increasing mucosal defenses

A

misoprostol / cytotec
(w/ NSAID, diclofenac)

PGE1 analog; stimulates bicarb, mucous production, and mucosal blood flow

standard doses reduce basal and nocturnal acid output (less than H2 antagonists and PPIs)

26
Q

what is the primary indication for misoprostol?

A

prevention (primary prophylaxis) of NSAID-induced gastric ulceration in pts at high risk of ulcerations d/t complications

27
Q

what are the off-label uses of misoprostol?

A
  1. w/ or w/o mifepristone – pregnancy termination
  2. cervical ripening
  3. post-partum hemorrhaging (high dose)
28
Q

name the contraindications of misoprostol

A
  1. pregnancy

2. IBD (avoid, if possible)

29
Q

name the adverse effects of misoprostol

A

GI related (primarily) and CNS related

30
Q

name the drug class –

MOA: antimicrobial actions prevent microbial attachment to mucosa, possible inactivation of enterotoxins, and disruption of bacterial cell wall

A

bismuth compounds

31
Q

what are the OTC indications of bismuth compunds?

A

reflux, indigestion, diarrhea

32
Q

what are the Rx indications for bismuth compunds?

A

used in combination with antibiotics and acid suppressant for H. pylori

33
Q

what are the adverse effects of bismuth compounds?

A
  1. constipation
  2. black/dark (regularly formed) stools

STAR

34
Q

when should a patient take bismuth compounds?

A

two hours after other medications d/t DDIs

35
Q

what are the relative contraindications of bismuth compounds?

A
  1. antiplatelets and anticoagulants

2. severe renal failure

36
Q

what are the absolute contraindications of bismuth compounds?

A
  1. GI bleeding

2. salicylate hypersensitivity

37
Q

describe the general treatment process for H. pylori

A

combination therapy!!

TRIPLE THERAPY
- at least 2 antibiotics and an acid reducer (PPI* or H2-blocker)

  • BID for 14 days
  • the antibiotics: clarithromycin + amoxicillin OR metronidazole

STAR

38
Q

which products must be avoided four weeks prior to performing gastric urease or urea breath-test d/t potential cause of false-negative results?

A
  1. bismuth preparations
  2. some antimicrobials
  3. some PPIs

b/c they suppress H. pylori

39
Q

describe quadruple therapy for H. pylori

A

for 10-14 days

  1. PPI (BID)
  2. metronidzaole (QID)
  3. tetracycline (QID)
  4. bismuth subsalicylate (QID)
40
Q

which antibiotic is a safe replacement in the treatment of H. pylori when a patient has a penicillin allergy?

A

metronidazole

41
Q

what are prevpac and omeclamox-pak?

A

BID packs for H. pylori

prevpac – ACL
amoxicillin (1,000 mg)
clarithromycin (500 mg)
lansoprazole (30 mg)

omeclamox – ACO
amoxicillin (1,000 mg)
clarithromycin (500 mg)
omeprazole (20 mg)

42
Q

what is helidac?

A

QID pack for H. pylori – BMT

bismuth subsalicylate (525 mg)
metronidzaole (250 mg)
tetracycline (500 mg)

add PPI b/c not in pack

STAR

43
Q

what is pylera?

A

QID pack for H. pylori – BMT

bismuth subsalicylate (140 mg)
metronidazole (125 mg)
tetracycline (125 mg)

add PPI / omperazole

STAR

44
Q

failure of eradication with metronidazole-containing triple therapy should be followed with…

A

non-metronidzaole containing quadruple therapy

clarithromycin and amoxicillin
OR
clarithromycin and tetracycline

STAR

45
Q

H. pylori w/ PCN allergy…

A

sub in metronidazole

consider bismuth quadruple therapy

STAR

46
Q

H. pylori w/ metronidazole resistance…

A

sub in tetracycline

consider quadruple therapy w/ clarithromycin and amoxicillin

STAR

47
Q

H. pylori w/ clarithromycin resistance…

A

sub in amoxicillin or tetracycline

consider bismuth quadruple therapy

STAR

48
Q

describe the treatments for a pregnant patient w/o H. pylori

A

moderate - ranitidine

severe - lansoprazole

STAR

49
Q

describe the treatment course for NSAID-at risk

A
  1. if NSAID not required – acetaminophen and D/C NSAID

2. if NSAID required – COX-2 NSAID and/or PPI or misoprostol

GI II (5 decks)

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