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Pharmacology 2 > Exam 4 - GERD/PUD > Flashcards

Exam 4 - GERD/PUD Flashcards

1
Q

What does Parietal Secrete?

A

Acid in stomach

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2
Q

3 receptors on Parietal Call? What do they do?

A

Histamine H2
Gastrin
Achetylcholine

Activated cAMP by secreting H+ via Proton Pump

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3
Q

What do Prostaglandins stimulate secretion of?

A

Mucous and Bicarb

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4
Q

What are the gastric defenses?

A

Muscous and bicarb

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5
Q

What causes mucosal damage? What contributes?

A

Increased acid levels which overcome protective barrier. H Pylori and NSAIDs contribute.

Results in PUD, GERD, and stress-related mucosal injury.

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6
Q

Define PUD and cause?

A

Ulcers in lining of duodenum or gastric areas.

D/T NSAIDs, H Pylori, increased HCl, steroids, iron, bisphosphonates, smkoing

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7
Q

Define Stress Ulcers and cause?

A

Acute gastric or duodenal ulcers. Often in trauma patients.

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8
Q

Define GERD and causes

A

Retrograde passage of gastric contents from stomach to esophagus.

Inflammation of mucosa from increases gastric acid. D/T relaxes LES, increased gastric pressure, decreased gastric emptying time.

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9
Q

Signs and symptoms of GERD? Tx?

A

Heart burn, belching, chronic cough, hoarseness, dental erosions, angina

Tx= Antacids, OTC H2-antagonists, or PPI

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10
Q

Antacid MOA, use, and onset/duration?

A

Neutralizes acid and increases pH using Al, Ca, Mg. Primary use for intermittent symptoms.

10min onset, 1-2 hour duration

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11
Q

Antacid DDI, warnings, and ADR

A

DDI=Floroquinolones cause chelation; Itraconazole and iron cause increased pH and decreased absorption.

Al and Ca=Constipation
Mg=Diarrhea. Renal impairment warning!

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12
Q

Al and Ca cause what? Mg causes what? Renal issues?

A

Al and Ca=Constipation

Mg=Diarrhea. Renal impairment issues with Mg.

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13
Q

H2-blocker MOA and use?

A

Competes with histamine at H2 receptors on parietal call to decrease acid secretion.

Use: GERD, PUD, stress gastritis. Best for nocturnal acid.

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14
Q

H2-blockers end in what?

A

“-tidine”

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15
Q

H2-blockers warn/ADR with Cimetidine? Renal? Other?

A

Cimetidine=Increases prolactin, gynecomastic and galactorrhea

Increases Warfarin, phenytoin, diazepam, propanolol levels.

Renal dosing! Elderly dosing!

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16
Q

Can H2-blockers develop a tolerance?

17
Q

Who does not get H2-blockers?

A

No preggers

18
Q

Don’t use H2-blocker in which condition? Acid and drug issues?

A

Don’t use in H Pylori.

Reduced acid needed for some drugs.

19
Q

H2-blocker more or less potent than PPI?

20
Q

When to take H2-blockers?

A

Before bed

21
Q

PPI MOA and use?

A

Stops proton pump from secreting H+ to make HCl.

Use: GERD, PUD, dyspepsia without ulcers, stress gastritis, mucosal bleeding, hypersecretory issues, ICU patients

22
Q

When to take PPI?

A

30-60 min before breakfast

23
Q

Long term issues on PPIs?

A

Increased fractures, increased infection from acid barrier (pneumonia, C. Diff).

Decreased Mg and B12 absorption.

24
Q

Do PPIs develop tolerance?

25
Q

PPI more or less effective than H2-blocker?

A

More effective!

26
Q

Patients find it hard to do what with PPIs?

A

Hard to discontinue. Must taper down.

27
Q

PPI DDI?

A

Clopidogrel=decreases effect

28
Q

Sucralfate MOA and use?

A

Aluminum salt binds with protein and forms barrier around ulcer. Increases prostaglandin secretion which increases mucous and bicarb.

Forms barrier around ulcer and allows healing.

29
Q

Sucralfate ADR?

A

Constipation

30
Q

Prostaglandin Analog MOA and use?

A

Synthetic Prostaglandin which increases mucous and bicarb secretion. Increases mucosal blood flow.

For NSAID-related ulcers.

31
Q

Don’t use Prostaglandin Analogs in who?

A

Preggers!!!

32
Q

Prostaglandin Analog ADRs?

A

Diarrhea, abdominal cramping in 30%.

Uterine contractions.

33
Q

Prostaglandin Analog examples?

A

Misoprostal, Cytotec

34
Q

Bismuth Salts MOA and use?

A

Unknown MOA. Doesn’t effect acid. Binds to and protects mucosal lesions. Coats stomach.

Use: H. Pylori, antimicrobial

35
Q

Bismuth Salts warn/ADRs?

A

Black stool and tongue.

Caution in renal impairments and those already salicylates

36
Q

Motility Agent MOA and use?

A

Metocloproamide. Increases motility of upper GI tract. Does not increase gastric acid secretion. Acts centrally on CTZ.

Use: Anti-nausea, anti-emetic, w/PPI for GERD, gasteroperesis, enteric feeding tubes

37
Q

Motility Agent warn/ADRs?

A

Parkinson movements, drowsy, anxiety, restlessness

38
Q

H Pylori tx?

A

2 weeks of triple or quadruple cocktail.

Triple=Metronidazole/Amoxicillin + Clarithromycin + PPI (CAP)
Quadruple=Metronidazole + TCN +Bismuth + PPI (MTBP)

Pharmacology 2 (17 decks)

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