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04. GI > Comprehensive Pharm (Segars) > Flashcards

Comprehensive Pharm (Segars) Flashcards

1
Q

Indications antacid salts

A

short term temporary relief of pain and other symptoms associated with PUD/GERD

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2
Q

Adverse reactions antacids

A

do not decrease acid secretion and can have rebound

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3
Q

instructions for taking antacids with other medications

A

take all antacids 1-2 hours before other meds or 2-4 hours after to avoid interactions

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4
Q

class Cimetidine

A

histamine 2 receptor anatgonist

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5
Q

interactions cimetidine

A

prototypical inhibitor of CYP450

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6
Q

class omeprazole

A

proton pump inhibitor

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7
Q

adverse reaction omeprazole

A

CDAD –> C. Diff associated diarrhea

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8
Q

interactions omeprazole

A

prototype CYP inhibitor

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9
Q

bismuth adverse reactions

A

causes constipation and black stools

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10
Q

treat H. pylori

A
  • combination therapy
    1) acid reducer
    2) clarithromycin
    3) amoxicillin or metronidazole
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11
Q

Treat H. pylori with PCN allergy (amoxicillin allergy)

A

1) acid reducer
2) clarithromycin
3) metronidazole

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12
Q

treat H. pylori with metronidazole resistance

A

1) acid reducer
2) clarithromycin
3) tetracycline

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13
Q

treat H. pylori with clarithromycin resistance

A

1) acid reducer

2) amoxicillin or tetracycline

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14
Q

Adverse reactions associated with Serotonin (5HT3) antagonists

A
  • serotonin syndrome

- Torsades – QT prolongation

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15
Q

interactions Serotonin (5HT3) antagonists

A

anti arrhythmics

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16
Q

given for prophylaxis of post-op N/V and timing

A

aprepitant (given 3 hours prior)

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17
Q

suffix serotonin antagonists

A

-setron

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18
Q

class aprepitant

A

neurokinin antagonist

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19
Q

First line N/V in pregnancy

A

doxylamine with vitamin B6

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20
Q

class doxylamine

A

Histamine (H1) antagonist

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21
Q

adverse reactions histamine (H1) antagonists

A

ANTICHOLINERGIC EFFECTS

  • drowsiness
  • dry mouth
  • constipation
  • urinary retention
  • blurred vision
  • lower BP
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22
Q

dopamine (D2) antagonist adverse reactions

A

ANTICHOLINERGIC EFFECTS

  • drowsiness
  • dry mouth
  • constipation
  • urinary retention
  • blurred vision
  • lower BP
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23
Q

class metoclopramide

A

dopamine (D2) antagonist

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24
Q

indication metoclopramide

A

gastroparesis/intestinal dysmotility w/o obstruction

*works by stimulating ACh

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25
Q

scopalamine adverse effects

A

ANTICHOLINERGIC EFFECTS

  • drowsiness
  • dry mouth
  • constipation
  • urinary retention
  • blurred vision
  • lower BP
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26
Q

scopalamine class

A

M1 antagonist

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27
Q

cannabinoid agonists

A
  • dronabinol

- nabilone

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28
Q

Use cannabinoid agonists

A

reserved for treatment resistance cancer induced N/V

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29
Q

how long is high emetic CINV regimen given

A

given for 3 days post chemo

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30
Q

how long is moderate emetic CINV regimen given

A

given for 2 days post chemo

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31
Q

how long is low emetic CINV regimen given

A

given day of chemo

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32
Q

drugs high emetic CINV regimen

A

1) NK1 antagonist
2) 5HT3 serotonin antagonist
3) corticosteroid

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33
Q

drugs moderate emetic CINV regimen

A

1) 5HT3 serotonin antagonist

2) corticosteroid

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34
Q

drugs low emetic CINV regimen

A

corticosteroid or 5HT3 antagonist or metoclopramide or prochlorperazine

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35
Q

minimal emetic regimen

A

0 drugs, but provide breakthrough treatment

36
Q

contraindications 5-ASA agents (end in -zine)

A

patients allergic to ASA

37
Q

IBD drugs utilized as first line treatment, but not officially indicated

A
  • steroids
  • immune modulators
  • antibiotics
38
Q

class tofacitinib

A

JAK inhibitor

39
Q

interactions tofacitinib

A

don’t give with other immunosuppressants

40
Q

class Golimumab

A

TNF-alpha inhibitors

41
Q

Adverse reactions golimumab

A

TB infection (must have testing before taking)

42
Q

When is Golimumab used?

A

Ulcerative colitis. Used after inadequate response to conventional immunosuppressants

43
Q

class ustekinumab

A

IL-12/23 inhibitor

44
Q

adverse reaction ustekinumab

A

TB infection (must have testing before taking)

45
Q

Use of ustekinumab

A

Drug for crohn’s disease. For patients intolerant to TNF-alpha steroids and immune modulators

46
Q

class Certolizumab

A

TNF-alpha inhibitor

47
Q

adverse reaction Certolizumab

A

TB infection (must have testing before taking)

48
Q

use Certolizumab

A

Crohn’s disease only. Used after inadequate response to conventional immunosuppressants

49
Q

class Natalizumab

A

a4 integrin inhibitor

50
Q

adverse reaction Natalizumab

A

infection (PML-progressive mulitfocal leukocephalopathy) associated with Johns cunningham virus (JCV)

51
Q

site(s) inhibited by Natalizumab

A

both a4b1 and a4b7

52
Q

use Natalizumab

A

Crohn’s disease only. Used after inadequate response to TNF-alpha therapy

53
Q

class Vedolizumab

A

a4 integrin inhibitor

54
Q

adverse reaction Vedolizumab

A

infection (PML-progressive mulitfocal leukocephalopathy) associated with Johns cunningham virus (JCV)

55
Q

site(s) inhibited by Vedolizumab

A

a4b7

56
Q

Use Vedolizumab

A

Ulcerative colitis and Crohn’s disease. Used after inadequate response to TNF-alpha therapy

57
Q

Are steroids used for maintenance therapy?

A

NO, unless absolutely required

58
Q

class diphenoxylate

A

opiod agonist

59
Q

Note: diphenoxylate

A

synthetic opiod with atropine added to reduce abuse

60
Q

class Eluxadoline

A

opiod agonist

61
Q

indication eluxadoline

A

IBS-D

62
Q

adverse reaction Eluxadoline

A

hepatic/pancreatic toxicity

- pancreatitis in patients w/o gallbladder

63
Q

Alosetron class

A

5HT3 antagonist

64
Q

indication Alosetron

A

chronic severe IBS-D

65
Q

Adverse reaction Alosetron

A

ischemic colitis (no refills, must enroll in prescribing program)

66
Q

class Crofelemer

A

Cl channel inhibitor

67
Q

indication crofelemer

A

non-infectious diarrhea in HIV-AIDS

68
Q

drugs used for abdominal spasms

A

antimuscarinic agents:

hyoscyamine, dicyclomine, clindium/chlordiazeproxide

69
Q

class lubiprostone

A

C2 activator

70
Q

indication lubiprostone

A

opioid induced constipation

71
Q

class methylnaltrexone

A

opiod antagonist

72
Q

class alvimopan

A

opiod antagonist

73
Q

indication methynaltrexone

A

opioid induced constipation

74
Q

indication alvimopan

A

opioid induced constipation, prevention of post op ileus following bowel resection surgery

75
Q

adverse effects alvimopan

A

risk of MI, REMS program with max 15 doses given in hospital only

76
Q

how long do bulk-forming agents take to work?

A

2-4 days

77
Q

class docusate salts, mineral oil

A

stool softeners

78
Q

MOA docusate salts, mineral oil

A

anionic surfactant to soften stool by increasing secretions, inhibiting H20 absorption in GI

79
Q

class sodium picosulfate

A

stimulant

80
Q

Use sodium picosulfate

A

used precolonoscopy

81
Q

adverse effects stimulants

A

urine discoloration (Senna), melanosis coli

82
Q

Contraindications stimulants

A

do not use with obstruction/impaction (ileus)

83
Q

class lactulose

A

osmotic agent

84
Q

use lactulose

A

constipation and used with severe liver disease to trap ammonia

85
Q

PEG-3350 class

A

osmotic agent

86
Q

Use PEG-3350

A

constipation, AND large doses used for bowel prep prior to scope (take effect 1-3 hours)

04. GI (7 decks)

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