Brainscape's Knowledge GenomeTM

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


See full index

HLST220: Pharmacology > Chapter 81: Drugs for Peptic Ulcer Disease > Flashcards

Chapter 81: Drugs for Peptic Ulcer Disease Flashcards

1
Q

what is peptic ulcer disease

A

group of upper gastrointestinal disorders
- degrees of erosion of the gut wall

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

peptic ulcer disease cause

A
  • imbalance between mucosal and aggressive factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the defensive factors against peptic ulcer disease

A
  • mucus
  • bicarbonate
  • blood flow
  • prostaglandins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

aggressive factors

A
  • helicobacter pylori
  • NSAIDS
  • gastric acid
  • pepsin
  • smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

H. pylori infection can lead to

A
  • peptic ulcer disease
  • gastric cancer
  • mucosal lymphoma (MALT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what population has higher rates of H. pylori infection

A

indigenous peoples

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

how do NSAIDS contribute to peptic ulcer disease

A
  • inhibit the biosynthesis of prostaglandins
  • reduce blood flow, mucus, and bicarbonate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does gastric acid contribute to peptic ulcer disease

A
  • directly injures cells of the GI mucosa and indirectly by activating pepsin
  • Zollinger-Ellison syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how does smoking contribute to peptic ulcers

A
  • delays ulcer healing and increases risk for recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the most common cause of ulcer development

A

H. pylori

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

what is the second most common cause of ulcer development

A

NSAIDS

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

what are the goals of drug therapy

A
  • alleviate symptoms
  • promote healing
  • prevent complications
  • prevent recurrence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the classes of antiulcer drugs

A
  • antibiotics
  • antisecretory agents
  • mucosal protectants
  • antisecretory agents that enhance mucosal defences
  • antacids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

drugs that reduce gastric acidity

A

antisecretory agents, misoprostol

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

drugs that enhance mucosal defenses

A

secralfate, misoprostol

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

NSAID induced ulcers treatment

A
  • histamine blockers and PPIs (eg. omeprazole)
  • discontinue use of NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what drugs can cause peptic activity to increase

A

antacids, histamine 2 antagonists, PPIs

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

gastric Ph should be rasied above

A

5

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

Non-drug therapy

A
  • Diet: 5-6 small meals a day
  • smoking cessation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how to test for H pylori

A
  • breath test
  • serologic test
  • stool test
  • Invasive: endoscopic specimen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

H. Pylori treatment

A

minimum of 2 antibiotics prescribed to reduce risk of developing resistance
- amoxicillin
- clarithromycin
- bismuth compounds
- tetracycline
- metromidozole

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

common side effects of antibiotics

A
  • nausea, GI upset
  • diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

bismuth side effects

A
  • black discoloration to the tongue and stool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

antibiotic regimens goal

A
  • minimize emergence of resistance; guidelines recommend using at least 2 antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

treatment regimens

A
  • PPI + amoxicillin + clarithromycin x 10-14 days
  • PPI + metronidazole + clarithromycin x 10-14 days
  • PPI + 3 antibiotics x 10-14 days
  • PPI + bismuth + 2 antibiotics x 10-14 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

clarithromycin [Biaxin]

A

inhibiting protein synthesis
- rate of resistance is high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

clarithromycin [Biaxin] most common side effects

A
  • nausea
  • diarrhea
  • distortion of taste
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

amoxicillin

A
  • rate of resistance is low
  • antibacterial activity is highest at neutral pH and thus can be adhanced by reducing gastric acidity with antisecretory agent (e.g. omeprazole)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the msot common side effect of amoxicillin

A

diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how do bismuth compounds destroy H pylori

A

act topically to disrupt the cell wall casuing lysis and cell death
- also may inhibit urease activity (may prevent from adhering to the gastric surface)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

bismuth compounds long term therapy

A

possible risk of neurologic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

tetracycline

A
  • inhibitor of bacterial protein synthesis
  • resistance is rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

tetracycline should not be used in

A

pregnant patients and young children
- can stain teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

tetracycline side effect

A

can stain teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

metronidazole [Flagyl]

A
  • very effective agianst sensative strains
  • over 40% of strains are now resistant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

metronidazole [Flagyl] most common side effect

A

nausea and headache

37
Q

what should be avoided in patients takin metronidazole [Flagyl]

A

avoid alcohol
- reaction can occur

38
Q

examples of Histamine 2 receptor antagonists

A
  • Cimetidine [Tagamet]
  • Famotidine [pepcid]
  • Nizatidine [Axid]
39
Q

histamine 2 receptor antagonists

A
  • effects drug for treating gastric and duodenal ulcers
  • promote healing by suppressing secretion of gastric acid
  • side effects uncommon
40
Q

therapeutic uses for all H2RA’s

A
  • gastric doudenal ulcers
  • GERD
  • zollinger-ellison syndrome
  • aspiration pneumonits
  • heartburn, acid indigestion, sour stomach
41
Q

therapeutic uses for cimetidine only

A
  • molluscum contagiosum
  • warts
42
Q

Cimetidine [Tagamet] adverse effects

A
  • antiandrogenic effects
  • elevation of gastric pH may increase risk of pneumonia
  • CNS effects: confusion, hallucinations
43
Q

H2RAs should be taken

A

without meals

44
Q

what is the msot effective drug for suppressing secretion of gastric acid

A

Proton Pump Inhbitors (PPIs)

45
Q

Proton Pump Inhbitors (PPIs) therapeutic uses

A

Short term
- gastric/duodenal ulcers
- GERD

46
Q

Proton Pump Inhibitors (PPIs) negatives

A
  • cost and prescribers preference, DI’s swallowing abilities
  • can increase risk of serious adverse events, including fracture, pneumonia, acid rebound, and possibly intestinal infection with Clostridium difficile
47
Q

examples of PPI

A

omepazole [Losec]

48
Q

omepazole [Losec]

A

prodrug converted in parietal cells

49
Q

omepazole [Losec] side effects

A
  • usually inconsequential with short term use
  • headache
  • GI: nausea, diarrhea, abdominal pain, flatulence
50
Q

omepazole [Losec] adverse effects

A
  • pneumonia (initial use)
  • fractures
  • hypomagnesemia
  • rebound acid hyperssecretion
  • c. difficile infection
51
Q

Esomeprazole [Nexium] should be administered

A
  • before meal
  • in combination with naproxen [vimovo]
  • daily dosing
52
Q

Esomeprazole [Nexium] can be given

A

to children > 1 yr

53
Q

Esomeprazole [Nexium] has better _____ than omeprazole

A

bioavailability

54
Q

Lansoprazole [Prevacid]

A
  • delayed release capsules and FasTabs
  • NG tube, swallowing difficulties
  • dose: 30mg daily
55
Q

Dexlansoprazole [Dexilant]

A
  • formulated as dual release capsule
  • doses: 30-60 mg daily
  • lower dose if moderate-severe hepatic impairment
56
Q

omeprazole dose

A
  • compunded suspension or delayed release tablet
  • 20-40mg daily
57
Q

Pantoprazole [Pantoloc]

A
  • basically no drug interactions
  • dose 40mg daily
  • available in 2 salts
  • avaliable IV
58
Q

adverse effects when Pantoprazole [Pantoloc] is administered via IV

A

diarrhea, headache, nausea, dyspepsia, injection site reactions, including thrombophlebitis and abcess)

59
Q

Rabeprazole [Pariet]

A
    • fewer Di because less effect on CYP450
  • dose 20mg daily (entric coated tab)
60
Q

Sucralfate [Sulcrate] MOA

A

creates a protective barrier for up to 6 hours

61
Q

Sucralfate [Sulcrate] therapeutic uses

A
  • acute ulcers and maintence therapy
62
Q

Sucralfate [Sulcrate] adverse effects

A
  • constipations
63
Q

Misoprostol [Cytotec] MOA

A

replaces andogenous prostiglandins

64
Q

Misoprostol [Cytotec] therapeutic effects

A
  • only approved for Gi indication is prevention of gastric ulcers cause by long term NSAID therapy
65
Q

Misoprostol [Cytotec] adverse effects

A
  • Most common; dose related diarrhea and abdominal pain
66
Q

Misoprostol [Cytotec] is contradicted during

A

pregnancy
- category X

67
Q

antacids MOA

A

react with gastric acid to produce neutral salts or salts of low acidity

68
Q

what is the only antiacid that alters the systemic pH

A

sodium bicarbonate

69
Q

antacids should be used with caution is patients with

A

renal impairment

70
Q

Antacids adverse effects

A
  • Constipation: aluminum hydroxide
  • Diarrhea: magnesium hydroxide
  • sodium loading
71
Q

antacid drug interactions

A
  • Cimetidine
  • Sucralfate
72
Q

antacid administration

A

seperate administration of antacid and other drugs by at least ONE HOUR

73
Q

antacid families

A
  • aluminum compounds
  • magnesium compounds
  • calcium compounds
  • sodium compounds
74
Q

Magnesium hydroxide [Milk of magnesium]

A

rapid acting, high acid-neutralizing capacity, produces long lasting effects

75
Q

Magnesium hydroxide [Milk of magnesium] most prominent adverse effect is

A

diarrhea

76
Q

Magnesium hydroxide [Milk of magnesium] is usually taken in combination with

A

aluminum hydroxide (antacid that promotes constipation)

77
Q

Magnesium hydroxide [Milk of magnesium] is avoided in patients with

A

undiagnoised abdominal pain

78
Q

Magnesium hydroxide [Milk of magnesium] is frequently used as a

A

laxative

79
Q

Magnesium hydroxide [Milk of magnesium] is used with caution in patients with

A

renal failure

80
Q

Aluminum Hydroxide [Amphogel]

A
  • low acid neutralizing capacity
  • slow acting; effects have long duration
  • rarely used alone (combination with magnesium hydroxide)
81
Q

Aluminum Hydroxide [Amphogel] caution

A

significant amounts of sodium

82
Q

Aluminum Hydroxide [Amphogel] adverse effects

A

constipation

83
Q

Calcium carbonate (tums)

A
  • rapid acting, high acid neutralizing capacity, effects have long duration
  • acid rebound
  • low palatability
84
Q

Calcium carbonate (tums) principle adverse effect

A

constipation
-eructation (belching) and flatulence

85
Q

Sodium Bicarbonate (Eno)

A
  • useful for treating acidosis and elevating urinary pH to promote excretion of acidic drugs after overdose
86
Q

can Sodium Bicarbonate (Eno) be used to treat PUD

A

no
- can cause alkalosis

87
Q

Sodium Bicarbonate (Eno)adverse effects

A
  • can cause alkalosis (patients with renal failure)
  • eructation and flatulence
  • can exacerbate hypertension and heart failure
88
Q

Simethicone (Ovol)

A
  • used to reduce gas bubbles
  • often an add-on in antacids
  • also used for babies

HLST220: Pharmacology (46 decks)

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