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Pharm II > Final GI review > Flashcards

Final GI review Flashcards

1
Q

Rx that covers that creates a protective coating over esophagus

A

gavison

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2
Q

the antacid is chewed tabelets that alters the elasticity of mucous covered bubbles

A

Simethicone

can help with flatulance?

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3
Q

H2 blockers names and dosage

A

cimitidine 400-800
ranitidine 150
nizatidine 150
famotidine 20

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4
Q

ADE with antacids

A

alkuria
CaP04 stones
risk of UTI in pts w/ DM

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5
Q

why do you want to avoid taking other medications with antacids

A

because of the enteric coating medications have may release prematurely

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6
Q

Alka seltzer can cause

A

alkalosis and should always be avoided in renal failure

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7
Q

H2 blockers are especially effective at

A

night

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8
Q

at high doses H2 blockers cna cause

A

reversible thrombocytopenia CNS confusion rare arrhythmia or angioedema

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9
Q

famotidine specifice ADE

A

HA

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10
Q

cimetidine specific ADE

A

gynecomastia also a CYP guy so not practical q

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11
Q

PPIs how do they work

A

irreversibly pink to the H/k-atpase in gastric parietal cell and inhibits 90% of gastric acid keeping pH greater than 4

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12
Q

inidcations PPI and how to use

A 
active ulcer 
H pylori
ZES
Barretts 
take on an empty stomach  30-60 before food
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13
Q

ADE of PPI

A

n/d/c HA dizzy B12 deficiency respiratory infections increased risk of hip fractures observational MI risk

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14
Q

what is the thing about asians and PPI

A

have 4x increase in omeprazole do not use especially if on clopidrigrol

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15
Q

which pregnancy category are PPI

A

B unless omeprazole which is C

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16
Q

what should we give our stress ulcer pt to prevent bleeding in the ICU

A

NOT AN H2 BLOCKER–> DEATH

only prophylax with famotidine 20 mg

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17
Q

mucosal protective agents for pts with PUD

A

misprostol, sucralfate, bismuth

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18
Q

what is misoprostol and what is the most important thing about it

A

PGE1 anaolg binds to pG receptor on parital cell
ABORTS PREGNANCY

CATEGORY X
but you can give for protection in a pt on NSAID

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19
Q

sucralfate

A

this is for difficult to treat ulcers can use in critically ill ICU pt instead of PPI

must give alone because it attaches to a lot of drugs

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20
Q

which population should we not use sucralfate on

A

really any pts on a lot of durgs but especially NOT pts on dialysis

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21
Q

wat population should we avoid bismuth in

A

Avoid in renal –> toxic

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22
Q

two types of quad therapy

A 
PPI BID (Ph >6) + CAMX2days
clair, amox, metro

or PPI BID+ BMT4xd = bismuth, metro, tetra.

need to use BMT w/ PNC allergy

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23
Q

when would you use metoclopramide

A

if failed PPI in GERD

increases LES pressure accelerates gastric emptying and dopamine agonist

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24
Q

cholinomimetic agents for GI motility

A

bethanechol and neostigmine

cause SLUD
macrolides like erh

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25
Q

how can macrolides work for upper GI hemorrhage

A

to clean tract prior to endoscopy

ertythromycin=diarrhea

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26
Q

definition of constipation

A

≥ 2: straining, incomplete evac, ≤ 2 BMs in 1 week. F>M.

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27
Q

drugs that cause constipation

A

PG synthesis inhibitors, opiates, Antichol (Antihist, Parkinsons drugs, Phenothiazines, TCAs), Muscle bockers (D-tubocurarine, Succinyl), Al antacids, Barium, CCB, Clonidine, Non-K-sparing diuretics (Spirono), IRON.

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28
Q

1st line for constipation

A

Psyllium. Bulk forming. Use: Constipation, diarrhea, IBS, can lower total cholesterol and LDL

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29
Q

ADE of bulk forming meds like psyllium

A

Bloating, flatus, OBSTRUCTION, can affect blood sugar

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30
Q

all mush and no push. May not work. Use with laxative.

A

: Docusate

ADE: skin rash, cramping, throat irritation.

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31
Q

Osmotic laxatives

A

Magnesium citrate, sodium phosphate, Magnesium hydroxide, Bisacodyl rectal.

32
Q

Osmotic lax like mag cirtrate should be avoided in

A

Lyte changes, can increase Mg, AVOID IN CHF, OLD, RENA

33
Q

bowel prep for colonoscopies

A

PEG-ES. Drink 4L prior to exam, mix with ice cold water.

34
Q

Prevention of chronic constipation in pt with cramps without flatulance

A

: Polyetheylene glycol (Mirilax

35
Q

very expensive anti constipation med

A

Lubiprostone (Amitizia, $$). Preg C. Stimulates CHLORIDE channel opening. ADE: Dyspnea

36
Q

peripheral mu receptor antag for cosntipation

A

Naloxegol (Movantik)

Dana thinks these are terrible because they can throw people into with-drawl
Pegylated to reduce BBB crossing but still can.

37
Q

good sample regimen Dana gave us for constipation

A

Mirilax (for prevention, no cramps), Senna (gentle stimulant laxative), Docusate (stool softener)

38
Q

NEVER give antidiarrheal for

A

for bloody diarrhea, high fever, or systemic tox!

39
Q

1st line for diarrhea

A

Stop solids 24hr, avoid dairy, oral rehydration if volume depleted

40
Q

you can fast with this type of diarrhea

A

osmotic

Bacterial diarrhea in children: FEED THEM

41
Q

treats diarrhea and constipation

42
Q

Bismuth ADE

A

TINNITUS, n/v, GOUT ATTACK

43
Q

DDI bismuth

A

Anticoagulants, decreases tetracycline.

44
Q

opioid agonists

A

Diphenoxylate with atropine (Lomotil),

Difenoxin + atropine (Motofen),

Loperamide (Immodium, OTC), Paregoric.

45
Q

Motofen what type of drug is it and what are the ADE

A

opioid agonists

anti-SLUD, tachy, hyperthermia, esp in kids.

46
Q

this antidiarrheal durg is Preg C. Fatal arrhythmia if you try to inject/OD

A

Loperamide

47
Q

Bile binding resins useful in diarrhea

A

Cholestyramine

Colestipo

48
Q

Octreotide can be used for many things , like AIDS-related diarrhea, dumping syndrome whata re some ADE

A 
Sinus brady, 
A.R.,
 HA,
 pruritis,
 hyper/hypoglycemia, 
hypothyroidism if used long-term, 
GI discomfort (30-60% in ppl with acromeg), gallstones (rare cholecystitis), 
steatorrhea, rare ADEK defi
49
Q

IBS first line

A

Dietary mod. 2 week trial no lactose or gluten. Eat less gas-producing food, exercise more

50
Q

IBS second line

51
Q

IBS constipation tx

A

fiber, NO TCA, Lubriprostone (Amitzia)

52
Q

Alosetron (Lotronix) can be used for

A

severe diarrhea IBS with consent

53
Q

ADE if scopolamine

A

VERY antichol (Anti-SLUD), hallucinations in elderly!

red
hot
mad
blind

54
Q

other motion sickness med

A

Dimenhydrinate (Dramamine), diphenhydramine (Benadryl)
meclizine (Antivert).

ADE: avoid ETOH. Avoid in narrow angle glaucoma, BPH, asthma

55
Q

only motion sickness for pts iwht narrow angle glaucoma

56
Q

Phenothiazines

Prochlorperazine/Compazine, promethazine

A

Block dopamine and muscarinic receptors in CTZ.

can be used for N/V

57
Q

prochlorperazine/Compazine, PROMETHAZINE (lil wayne)

SE

A

EPS (tardive dyskinesia), hypot, LOWER SEIZURE THRESHOLD, hypersensitivity, Compazine makes you really sleepy. Rare: Blood dyscrasias, QT prolong, melanosis, SKIN NECROSIS

58
Q

most popular benzamide

A

metoclopromide

59
Q

how is corticosteroids used for N/V

A

enhance the effectiveness of zofran

for chemo

60
Q

5HT3 antagonist

A

anti n/v
odansetron (ZOFRAN)
can give to pregnant women or chemo pts

61
Q

ADE of 5ht3

A

prolonged QT especially in dolasteron
bad tachy too with dolasetron

odansetron and granisetron cause brady

62
Q

apprepitant or emend is what class of drug

A

neurokinin receptor antagonist used for N/v

crosses BBB and used for highly emetogenic chemo

63
Q

dronnabinol is a

A

cannabinoid and antiemetic

64
Q

what aminosalicylates could you give for UC

A

5-ASA

mesalamine -liquid enema
sulfasalazine- need to give with folic acid
balsalazide
osalazine (last line)

65
Q

mesalamaine ADE

A

pericarditis, pancreatitis, hepatitis rare

66
Q

when would you use corticosteroids for IBD

A

moderate to severe ACTIVE
not for maintenance

prednisone 1-2wek

can be used in pregnancy

67
Q

azathioprine is what kind of medication

A

immunosupressive used in Chron’s and UC that allows for the reduction of steroids

68
Q

azathioprine is CI in

A

pregnancy (D)

and can’t be used with allopurinol

69
Q

methotrexate can be used for what form of ibd

70
Q

can TNF inhibitors be used in pregnancy?

A

yes!
for chron’s and mod/severe UC

can reduce number of fistulas and maintain closure

71
Q

TNF inhibitors

A

prevent TH1 response

infliximab
adalimumab
certolizumab

72
Q

humaizide IgG that can be used for chron’s

A

natalizumab

monoclocnal AB

73
Q

adjuncts to pancreatic enzymes include

A

H2Ra or PPI

74
Q

bile acid therapy for gallstones

75
Q

portal hypertension and cirrohsis

A

propranolol to prevent bleeding
2nd line nitrates
variceal bleed: oreotide

76
Q

w/ hepatic encephalopathy you need to

A

limit dietary protein and take lactulose

Pharm II (16 decks)

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