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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
how can macrolides work for upper GI hemorrhage
to clean tract prior to endoscopy | ertythromycin=diarrhea
26
definition of constipation
≥ 2: straining, incomplete evac, ≤ 2 BMs in 1 week. F>M.
27
drugs that cause constipation
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.
28
1st line for constipation
Psyllium. Bulk forming. Use: Constipation, diarrhea, IBS, can lower total cholesterol and LDL
29
ADE of bulk forming meds like psyllium
Bloating, flatus, OBSTRUCTION, can affect blood sugar
30
all mush and no push. May not work. Use with laxative.
: Docusate ADE: skin rash, cramping, throat irritation.
31
Osmotic laxatives
Magnesium citrate, sodium phosphate, Magnesium hydroxide, Bisacodyl rectal.
32
Osmotic lax like mag cirtrate should be avoided in
Lyte changes, can increase Mg, AVOID IN CHF, OLD, RENA
33
bowel prep for colonoscopies
PEG-ES. Drink 4L prior to exam, mix with ice cold water.
34
Prevention of chronic constipation in pt with cramps without flatulance
: Polyetheylene glycol (Mirilax
35
very expensive anti constipation med
Lubiprostone (Amitizia, $$). Preg C. Stimulates CHLORIDE channel opening. ADE: Dyspnea
36
peripheral mu receptor antag for cosntipation
Naloxegol (Movantik) Dana thinks these are terrible because they can throw people into with-drawl Pegylated to reduce BBB crossing but still can.
37
good sample regimen Dana gave us for constipation
Mirilax (for prevention, no cramps), Senna (gentle stimulant laxative), Docusate (stool softener)
38
NEVER give antidiarrheal for
for bloody diarrhea, high fever, or systemic tox!
39
1st line for diarrhea
Stop solids 24hr, avoid dairy, oral rehydration if volume depleted
40
you can fast with this type of diarrhea
osmotic Bacterial diarrhea in children: FEED THEM
41
treats diarrhea and constipation
Bismuth
42
Bismuth ADE
TINNITUS, n/v, GOUT ATTACK
43
DDI bismuth
Anticoagulants, decreases tetracycline.
44
opioid agonists
Diphenoxylate with atropine (Lomotil), Difenoxin + atropine (Motofen), Loperamide (Immodium, OTC), Paregoric.
45
Motofen what type of drug is it and what are the ADE
opioid agonists | anti-SLUD, tachy, hyperthermia, esp in kids.
46
this antidiarrheal durg is Preg C. Fatal arrhythmia if you try to inject/OD
Loperamide
47
Bile binding resins useful in diarrhea
Cholestyramine | Colestipo
48
Octreotide can be used for many things , like AIDS-related diarrhea, dumping syndrome whata re some ADE
``` 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
IBS first line
Dietary mod. 2 week trial no lactose or gluten. Eat less gas-producing food, exercise more
50
IBS second line
SSRI
51
IBS constipation tx
fiber, NO TCA, Lubriprostone (Amitzia)
52
Alosetron (Lotronix) can be used for
severe diarrhea IBS with consent
53
ADE if scopolamine
VERY antichol (Anti-SLUD), hallucinations in elderly! red hot mad blind
54
other motion sickness med
Dimenhydrinate (Dramamine), diphenhydramine (Benadryl) meclizine (Antivert). ADE: avoid ETOH. Avoid in narrow angle glaucoma, BPH, asthma
55
only motion sickness for pts iwht narrow angle glaucoma
zofran
56
Phenothiazines | Prochlorperazine/Compazine, promethazine
Block dopamine and muscarinic receptors in CTZ. can be used for N/V
57
prochlorperazine/Compazine, PROMETHAZINE (lil wayne) SE
EPS (tardive dyskinesia), hypot, LOWER SEIZURE THRESHOLD, hypersensitivity, Compazine makes you really sleepy. Rare: Blood dyscrasias, QT prolong, melanosis, SKIN NECROSIS
58
most popular benzamide
metoclopromide
59
how is corticosteroids used for N/V
enhance the effectiveness of zofran | for chemo
60
5HT3 antagonist
anti n/v odansetron (ZOFRAN) can give to pregnant women or chemo pts
61
ADE of 5ht3
prolonged QT especially in dolasteron bad tachy too with dolasetron odansetron and granisetron cause brady
62
apprepitant or emend is what class of drug
neurokinin receptor antagonist used for N/v | crosses BBB and used for highly emetogenic chemo
63
dronnabinol is a
cannabinoid and antiemetic
64
what aminosalicylates could you give for UC
5-ASA mesalamine -liquid enema sulfasalazine- need to give with folic acid balsalazide osalazine (last line)
65
mesalamaine ADE
pericarditis, pancreatitis, hepatitis rare
66
when would you use corticosteroids for IBD
moderate to severe ACTIVE not for maintenance prednisone 1-2wek can be used in pregnancy
67
azathioprine is what kind of medication
immunosupressive used in Chron's and UC that allows for the reduction of steroids
68
azathioprine is CI in
pregnancy (D) | and can't be used with allopurinol
69
methotrexate can be used for what form of ibd
Chrons
70
can TNF inhibitors be used in pregnancy?
yes! for chron's and mod/severe UC can reduce number of fistulas and maintain closure
71
TNF inhibitors
prevent TH1 response infliximab adalimumab certolizumab
72
humaizide IgG that can be used for chron's
natalizumab | monoclocnal AB
73
adjuncts to pancreatic enzymes include
H2Ra or PPI
74
bile acid therapy for gallstones
ursodiol
75
portal hypertension and cirrohsis
propranolol to prevent bleeding 2nd line nitrates variceal bleed: oreotide
76
w/ hepatic encephalopathy you need to
limit dietary protein and take lactulose

Pharm II (16 decks)

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