drugs for PUD

Question 1

drugs that reduce intragastric activity

Answer 1

antacids
H2-R blocker
PPI

Question 2

promote mucosal defense

Answer 2

sucralfate
prostaglandin analogs
colloidal bismuth compound

Question 3

antacid drugs

Answer 3

sodium bicarbonate
calcium carbonate
Mg/Al hydroxide

Question 4

antacid MOA

Answer 4

weak base

dec. intragastic act.; inc. prostaglandin

Question 5

antacid dosage

Answer 5

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

Question 6

drugs that react with antacid

Answer 6

fluroquinolone
itraconazole
iron
tetracycline

Question 7

sodium bicarbonate AE

Answer 7

belching; exacerbate fluid retention;

Question 8

calcium carbonate AE

Answer 8

belching; Milk-alkali syndrome; hyperCa; metab alkalosis

Question 9

Mg/Al OH AE

Answer 9

Mg- osmotic diarrhea

AL- constipation

Question 10

H2-R blocker drugs

Answer 10

(-tidine)
cimetidine
ranitidine
famotidine
nizatidine

Question 11

H2-R blocker drugs pharmacodynamic

Answer 11

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

Question 12

H2-R blocker drugs pharmacokinetic

Answer 12

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

Question 13

H2-R blocker drugs indication

Answer 13

GERD, PUD, dyspepsia, gastritis

Question 14

H2-R blocker drugs AE

Answer 14

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

Question 15

H2-R blocker drugs with 100% bioavailability

Answer 15

Nizatidine

Question 16

PPI drugs

Answer 16

(LORDEP) -prazole
lansoprazole
omeprazole
rabeprazole
dexlansoprazole
esomeprazole
pantoprazole

Question 17

PPI pharmacokinetics

Answer 17

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

Question 18

hepatic ds reduces clearance of what PPIs?

Answer 18

esomeprazole, lansoprazole

Question 19

first line mgmt for GERD

Answer 19

PPI

Question 20

PPI indication

Answer 20

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

Question 21

PPI for GERD

Answer 21

OLE- omeprazole, lansoprazole, esomeprazole

Question 22

PPI for NSAID-assoc. ulcer

Answer 22

LEP- pantoprazole, esomeprazole, lansoprazole

Question 23

triple therapy for H. pylori

Answer 23

OCA- omeprazole, clarithromycin, amoxicillin

10-14 days

Question 24

PPI general AE

Answer 24

diarrhea, headache, abd pain

Question 25

PPIs with interaction to warfarin

Answer 25

ROLE- rabeprazole, omeprazole, lansoprazole, esomeprazole

Question 26

PPIs with interaction to cyclosporine

Answer 26

OR- omeprazole, rabeprazole

Question 27

px with asthma should avoid what PPI?

Answer 27

omeprazole

Question 28

PPIs with interaction to phenytoin & theophylline

Answer 28

omeprazole

Question 29

sucralfate pharma

Answer 29

- 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

Question 30

prostaglandin pharma

Answer 30

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

Question 31

prostaglandin analog contraindicated in pregnancy and can cause preterm labor?

Answer 31

misoprostol

Question 32

colloidal bismuth compound pharma

Answer 32

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

Question 33

M1 muscarinic -R antagonist drugs

Answer 33

piperazine | telenzipine

Question 34

prostaglandin generation drug

Answer 34

rebamipide

Question 35

goals of PUD therapy

Answer 35

relief of symptoms enhancement of ulcer healing prevent recurrence

Question 36

H2-R blocker interaction

Answer 36

``` CYP450 ethanol (except F) ```

Question 37

PPI pharmacodynamic

Answer 37

inhb fasting and meal stim. acid sec. | inhb 90-98% acid

Question 38

PPI nutrition AE

Answer 38

dec. absp. of vit. B12

Question 39

PPI respi and enteric AE

Answer 39

inc. respi and enteric infx

Question 40

PPI gastrin AE

Answer 40

inc. serum gastrin 1.5-2 fold

Question 41

PPI dec acid AE

Answer 41

atrophic gastritis; intestinal metaplasia; gastric adenoCa

Question 42

omeprazole interaction

Answer 42

clopidogrel warfarin diaepam phenytoin

Question 43

esomeprazole interaction

Answer 43

diazepam

Question 44

lansoprazole interaction

Answer 44

theophylline

Question 45

Rabeprazole & pantoprazole interaction

Answer 45

no significant interaction

Question 46

bismuth AE

Answer 46

harmless blackening of stool and tongue; encephalopathy; salicylate toxicity

Question 47

high risk for NSAID toxicity

Answer 47

hx of previous complicated ulcer | >2 risk

Question 48

mod. risk for NSAID toxicity (1-2)

Answer 48

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

Question 49

low risk for NSAID toxicity

Answer 49

no risk factor

Question 50

high risk requiring NSAID therapy recomm

Answer 50

alternative therapy OR | COX-2 inhb + misoprostol/PPI

Question 51

mod. risk recomm

Answer 51

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

Question 52

low risk recomm

Answer 52

nonsel. NSAID

Question 53

low GI & low CV risk recomm

Answer 53

NSAID alone

Question 54

mod. GI & low CV recomm

Answer 54

NSAID + misoprostol/PPI

Question 55

high GI & low CV recomm

Answer 55

alternative therapy OR | COX-2 inhb + misoprostol/PPI

Question 56

low GI & high CV risk recomm

Answer 56

naprozen + misoprostol/PPI

Question 57

mod. GI & high CV risk recomm

Answer 57

naprozen + misoprostol/PPI

Question 58

high GI & high CV risk recomm

Answer 58

avoid NSAID or COX-2 inhb | alternative therapy