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Pharma > drugs for PUD > Flashcards

drugs for PUD Flashcards

1
Q

drugs that reduce intragastric activity

A

antacids
H2-R blocker
PPI

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2
Q

promote mucosal defense

A

sucralfate
prostaglandin analogs
colloidal bismuth compound

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3
Q

antacid drugs

A

sodium bicarbonate
calcium carbonate
Mg/Al hydroxide

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4
Q

antacid MOA

A

weak base

dec. intragastic act.; inc. prostaglandin

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5
Q

antacid dosage

A

single dose 156mEq 1h after meal to neutralize acid for 2hrs; 4x/d

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6
Q

drugs that react with antacid

A

fluroquinolone
itraconazole
iron
tetracycline

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7
Q

sodium bicarbonate AE

A

belching; exacerbate fluid retention;

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8
Q

calcium carbonate AE

A

belching; Milk-alkali syndrome; hyperCa; metab alkalosis

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9
Q

Mg/Al OH AE

A

Mg- osmotic diarrhea

AL- constipation

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10
Q

H2-R blocker drugs

A 
(-tidine)
cimetidine
ranitidine
famotidine
nizatidine
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11
Q

H2-R blocker drugs pharmacodynamic

A

competitive inhibit parietal H2-R; dec. acid secretion
60-70% acid inhb
inhb nocturnal acid sec.
mod. inhb. on meal stim. acid sec.

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12
Q

H2-R blocker drugs pharmacokinetic

A 
h- 1-4hrs
10hrs duration; BID
hepa metab
glomerular filtration
renal tubular secretion
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13
Q

H2-R blocker drugs indication

A

GERD, PUD, dyspepsia, gastritis

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14
Q

H2-R blocker drugs AE

A

mental status change; C- gynecomastia, impotence, galactorrhea; cross placenta; bradycardia & hypotension; blood dyscrasia

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15
Q

H2-R blocker drugs with 100% bioavailability

A

Nizatidine

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16
Q

PPI drugs

A 
(LORDEP) -prazole
lansoprazole
omeprazole
rabeprazole
dexlansoprazole
esomeprazole
pantoprazole
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17
Q

PPI pharmacokinetics

A 
pKa 4-5
h-1.5hrs
suppression for 24hrs
complete acid suppression 2-3days
taken 1hr before meal
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18
Q

hepatic ds reduces clearance of what PPIs?

A

esomeprazole, lansoprazole

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19
Q

first line mgmt for GERD

A

PPI

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20
Q

PPI indication

A

GERD, PUD, non-ulcer dyspepsia, mucosal bleeding, gastrinoma, NSAID-assoc. ulcer, H. pylori

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21
Q

PPI for GERD

A

OLE- omeprazole, lansoprazole, esomeprazole

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22
Q

PPI for NSAID-assoc. ulcer

A

LEP- pantoprazole, esomeprazole, lansoprazole

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23
Q

triple therapy for H. pylori

A

OCA- omeprazole, clarithromycin, amoxicillin

10-14 days

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24
Q

PPI general AE

A

diarrhea, headache, abd pain

25
Q

PPIs with interaction to warfarin

A

ROLE- rabeprazole, omeprazole, lansoprazole, esomeprazole

26
Q

PPIs with interaction to cyclosporine

A

OR- omeprazole, rabeprazole

27
Q

px with asthma should avoid what PPI?

A

omeprazole

28
Q

PPIs with interaction to phenytoin & theophylline

A

omeprazole

29
Q

sucralfate pharma

A
  • charged sucrose binds to + charged proteins in base of ulcer
    stimulate prostaglandin and bicarbonate sec.
    viscous paste that binds to ulcer (6hrs)
    1g 4x/d on empty stomach
    AE: constipation
30
Q

prostaglandin pharma

A

bind to EP3-R, stimulate G1 pathway, inhibit H+/K+ ATPase;
dec. acid, inc. mucin and HCO3 and enhance mucosal BF
h- <30min
3-4x/d
urine excretion

31
Q

prostaglandin analog contraindicated in pregnancy and can cause preterm labor?

A

misoprostol

32
Q

colloidal bismuth compound pharma

A

coats ulcer
inc. PGE, mucus, HCO3
prevent traveler’s diarrhea (binds enterotoxin) (30ml or 2 tabs QID)
direct antimicrobial in H. pylori

33
Q

M1 muscarinic -R antagonist drugs

A

piperazine

telenzipine

34
Q

prostaglandin generation drug

A

rebamipide

35
Q

goals of PUD therapy

A

relief of symptoms
enhancement of ulcer healing
prevent recurrence

36
Q

H2-R blocker interaction

A 
CYP450 
ethanol (except F)
37
Q

PPI pharmacodynamic

A

inhb fasting and meal stim. acid sec.

inhb 90-98% acid

38
Q

PPI nutrition AE

A

dec. absp. of vit. B12

39
Q

PPI respi and enteric AE

A

inc. respi and enteric infx

40
Q

PPI gastrin AE

A

inc. serum gastrin 1.5-2 fold

41
Q

PPI dec acid AE

A

atrophic gastritis; intestinal metaplasia; gastric adenoCa

42
Q

omeprazole interaction

A

clopidogrel
warfarin
diaepam
phenytoin

43
Q

esomeprazole interaction

A

diazepam

44
Q

lansoprazole interaction

A

theophylline

45
Q

Rabeprazole & pantoprazole interaction

A

no significant interaction

46
Q

bismuth AE

A

harmless blackening of stool and tongue; encephalopathy; salicylate toxicity

47
Q

high risk for NSAID toxicity

A

hx of previous complicated ulcer

>2 risk

48
Q

mod. risk for NSAID toxicity (1-2)

A

> 65 y/o
high dose NSAID
hx of uncomplicated ulcer
aspirin

49
Q

low risk for NSAID toxicity

A

no risk factor

50
Q

high risk requiring NSAID therapy recomm

A

alternative therapy OR

COX-2 inhb + misoprostol/PPI

51
Q

mod. risk recomm

A

COX-2 inhb alone OR nonsel. NSAID + misoprostol/PPI

52
Q

low risk recomm

A

nonsel. NSAID

53
Q

low GI & low CV risk recomm

A

NSAID alone

54
Q

mod. GI & low CV recomm

A

NSAID + misoprostol/PPI

55
Q

high GI & low CV recomm

A

alternative therapy OR

COX-2 inhb + misoprostol/PPI

56
Q

low GI & high CV risk recomm

A

naprozen + misoprostol/PPI

57
Q

mod. GI & high CV risk recomm

A

naprozen + misoprostol/PPI

58
Q

high GI & high CV risk recomm

A

avoid NSAID or COX-2 inhb

alternative therapy

Pharma (6 decks)

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