Brainscape's Knowledge GenomeTM

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


See full index

GI II > Anti Ulcer drugs > Flashcards

Anti Ulcer drugs Flashcards

1
Q

What are all the H2 Receptor Antagonists? and what are their suffix

A

Cimetidine
Famotidine
Nizatidine
Ranitidine

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

what are all the Proton Pump Inhibitors and what are their suffix

A 
Lansoprazole
Dexlansoprazole*
Omeprazole
Esomeprazole*
Pantoprazole
Rabeprazole

star means they are an Isomer

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

What is the drug in the surface acting agent?

A

Sucralfate

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

What is the drug in the PGE1 analog

A

Misoprostol

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

What is the Bismuth Compound drug

A

Bismuth subsalicylate

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

what are the adverse effects of histamine Type 2 blockers

A

Primarily GI-related

Some CNS-related

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

What Rare side effect does Cimetidine have

A

Cimetidine decreases testosterone binding to androgen receptor (weak anti-androgen effects)
–Gynecomastiain men
–Galactorrheain women

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

What Histamine Type two Blocker inhibit CYP450

A

Cimitidine

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

What Histamine Type 2 Blocker is given in Pregnancy

A

ranitidine

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

Mechanism of action of the PPIs

A

PPI’s 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

inhibits pump-induced egress of gastric acid

Takes several days to create new steady-state of pump activity

Full symptom effects seen in a few-several days
longer than H2’s

•Inhibit 50%-90+% of acid
Depending on dose, frequency, duration

•Ulcerations healed in 4-8+ weeks*

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

What is the major adverse effects of PPIs

A

GI-related

Additional Risk –CDAD
–Clostridium Difficile-Associated Diarrhea

CNS-related

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

what PPI inhibits CYP450

A

Omeprazole

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

What PPI is given in Pregnancy

A

lansoprazole most Common

or

Pantoprazole

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

Mechanism of action of Sucralfate

A

Undergoes cross-linking from interaction with stomach acid, creating a viscous, sticky polymer which adheres to epithelial cells around ulcer’s crater

Prevents acid access to ulcer sites

•May also:
Stimulate local prostaglandin and mucous production and epidermal growth factor

Cytoprotection

Does not affect pH

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

What are the indications of Sucralfate

A

Duodenal Ulcer

also:
Aphthous ulcers
Mucositis/Stomatitis
Radiation proctitis/ulcers (enema)
Bile reflux gastropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the relative contraindications of Sucralfate

A

Severe renal failure die to the presence of Aluminum making it difficult to be excreted by the kidneys

17
Q

what are drug interactions pf Sucralfate

A

Possible; due to other drugs getting stuck in the barrier therefore, take 2-hours after other medications

Dosed QID for active ulcers so plan dosing other meds accordingly, if possible

also can cause constipation

18
Q

Mechanism of action for Misoprostol and when should it be given

A

A prostaglandin E1analog

Provides protective prostaglandin to gastric mucosa & reduces gastric acid release from parietal cell

Provides cytoprotectionby increasing mucosal defenses
–Stimulates bicarbonate and mucous production
–Increases mucosal blood flow

Standard doses reduce basal & nocturnal acid output (less than H2-antagonists and PPI’s)

given when NSAIDs must be given to a patient
-Primary Prophylaxis

19
Q

Off label uses of Misoprostol

A

With/Without mifepristone (pregnancy termination)

Alone for cervical ripening

Post-partum hemorrhaging (high dose)

20
Q

what are the two contradictions of Misoprostol

A

Pregnancy, unless needed for off label issues

IBD

21
Q

Mechanism of action pf Bismuth Compounds

A

PeptoBismol/Kaopectated

Originally developed as anti diarrheal agent

well known for its antimicrobial actions

22
Q

What is Bismuth Compounds used for

A

OTC: reflux hearburn, indigestion, and diarrhea

Rx used in combination with antibiotics and PPI for suppressant of H Pylori

23
Q

Adverse effects and Drug interactions of Bismuth Compounds

A

(dose related)
Constipation (anti-diarrheal actions)
Black/Dark (regularly-formed) stools

Drug Interactions:
Lots, take 2 hours after other medications

24
Q

Relative and absolute Contradictions of Bismuth Compounds

A

Relative Contraindications
Antiplatelets and anticoagulants
since Bismuth subsalicylate has aspirin modalities
Severe Renal failure

Absolute Contraindications
GI bleeding
Salicylate hypersensitivity

25
Q

How to approach the treatment of H.Pylori?

A

Combination therapy a must

-at least 2 antibiotics and an acid reducer (PPI or H2 blocker) for 10-14 days

26
Q

What is consisted in the typical triple therapy for H Pylori

A 
Triple Therapy (14 days)
All at B.I.D.dosing
A PPI
Clarithromycin
Amoxicillin or Metronidazole
27
Q

what is consisted in the typical quadruple therapy?

A 
Quadruple Therapy (10-14 days)
PPI at B.I.D.,all others at Q.I.D.dosing
A PPI
Metronidazole
Tetracycline
Bismuth subsalicylate
28
Q

what happens if their is a failure of eradication with metronidazole containing triple therapy?

A

should be followed with a non-metronidazole containing quadruple therapy

29
Q

What to do in Clinical management of H Pylori if the patient is allergic to penicillen?

A

no amoxicillin

Substitute Metronidazole (consider Bismuth quad.)

30
Q

what to do in a CLinical management of H Pylori with Metronidazole resistance

A

Substitute Tetracycline

Consider Quadruple therapy (w/ Clarithromycin & Amoxicillin)

31
Q

what to do in a clinical management of H Pylori in a scenario with Clarithromycin resistance

A

Substitute either Amoxicillin or Tetracycline

Consider Bismuth quadruple therapy

32
Q

What to do if patient has Peptic Ulcer disease and presents without H. Pylori

A

Consider short course of antacids or Sucralfate (topical)
–moderate symptoms, consider ranitidine
–severe symptoms, consider lansoprazole

GI II (5 decks)

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