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NCLEX Pharm > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What are antacids?

A

Medications that react with gastric acids to produce neutral salts. They inactivate pepsin and enhance mucosal protection

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2
Q

What pH should stomach acid be to deem antacids effective?

A

The pH of the stomach should be above 5

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3
Q

What is Misoprostol?

- What is it used for?

A

A gastric protectant. Antisecretory medication that enhances mucosal defences.
- Used to prevent gastric ulcers caused by NSAID and aspirins

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4
Q

When should Misoprostol be given?

A

With meals

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5
Q

Contraindications for Misoprostol?

A

Abdominal pain and pregnancy

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6
Q

What is Sucralfate?

A

Gastric protectant that creates a protective barrier against acid and pepsin

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7
Q

When should Sucralfate be given?

A

On an empty stomach

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8
Q

Sucralfate impedes absorption of which meds?

- How do we stop this?

A

Warfarin, phenytoin, theophylline, digoxin, and some antibiotics.
- Admin these other meds 2 hours apart

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9
Q

What are histamine receptor antagonists?

A

Meds that suppress secretion of gastric acid, alleviate symptoms of heartburn, prevent and reduce the occurrence of ulcers, promote healing from GERD

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10
Q

Contraindications for histamine receptor antagonists?

A

hypersensitivity, and cautiously for those with renal or hepatic dysfunction

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11
Q

What is Cimetidine?

A

It is a histamine receptor antagonist

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12
Q

How should Cimetidine be taken?

A

On an empty stomach as food will slow it’s aborption. Also not to be given with antacids.

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13
Q

What is especially dangerous about Cimetidine?

- What effects of this would we see?

A

It can pass through the blood-brain barrier and cause CNS effects.
- mental confusion, agitation, psychosis, depression, anxiety and disorientation

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14
Q

What meds, when given with Cimetidine, are at increased risk of overdose?

A

Warfarin, phenytoin, theophylline, and lidocaine, because Cimetidine causes reduced hepatic drug-metabolizing enzymes.

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15
Q

What is ranitidine, famotidine and nizatidine?

A

They are all histamine receptor antagonists.

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16
Q

Name the (4) classifications of antacids

A

Aluminium compounds, Magnesium compounds, Calcium compounds, and Sodium Bicarbonate

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17
Q

Special considerations for Aluminium compounds

A

May cause hypophosphatemia (also a treatment for hyperphosphatemia), have high sodium so avoid in pts with HTN and heart failure, may cause constipation

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18
Q

Special considerations for Magnesium compounds

A

Magnesium hydroxyde is also a laxative, contraindicated with obstruction, appendicitis, abdominal pain NYD, and need to monitor for magnesium toxicity

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19
Q

Special considerations of Calcium compounds

A

May cause acid rebound, rapid-acting and cause carbon dioxide release in the stomach, avoid milk and vitamin D products to avoid Milk-Alkali syndrome

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20
Q

Special considerations for Sodium bicarbonate

A

Promotes flatulence by liberating carbon dioxide, Careful with pt’s with HTN or heart failure, can cause systemic alkalosis in pt’s with renal failure, useful for treating acidosis

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21
Q

What are proton pump inhibitors (PPIs)?

- Uses

A

Suppress gastric acid secretion

- Used to treat active ulcer disease erosive esophagitis, and pathological hypersecretory conditions

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22
Q

Side effects of PPIs

A

Headache, diarrhea, abdominal pain, nausea

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23
Q

Name the (5) PPIs

A

Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole

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24
Q

What are the 2 types of treatment used to treat H. Pylori?

A

Triple therapy and quadruple therapy (combinations of either 3 or 4 meds)

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25
Name the (3) combinations used for triple therapy of H. Pylori
- Esomeprazole, amoxicillin, clarithromycin - Lansoprazole, amoxicillin, clarithromycin - Lansoprazole, amoxicillin, levofloxacin
26
Name the (2) combinations used for quadruple therapy of H. Pylori
- Esomeprazole, metronidazole, tetracycline, bismuth subsalicylate - Ranitidine, metronadizole, tetracycline, bismuth subsalicylate
27
What are prokinetic agents? | - Name the most common one
Meds that stimulate the motility of the upper gastrointestinal tract and increase the rate of gastric emptying without stimulating gastric, biliary, or pancreatic secretions - Metoclopramide is the most common one (and the only named in the Saunders book)
28
What are the uses of prokinetic agents?
Used to treat gastroesophageal reflux and paralytic ileus. Also used to treat nausea and vomiting.
29
Side effects of prokinetic agents | - What is the most major side effect?
Restlessness, drowsiness, extrapyramidal reactions, dizziness, insomnia and headache. - It can cause parkinsonian reactions (muscle spasm, jerkyness, slow movement, tremors...)
30
When do we admin prokinetic agents?
Usually 30 mins before meals and then at bedtime
31
Contraindications of prokinetic agents
Mechanical obstruction, perforation, or GI hemmoraghe
32
What meds antagonize Metoclopramide?
Anticholinergics (like Atropine) and opioids
33
What meds produce an additive effect fort Metoclopramide?
Alcohol, sedatives, cyclosporine, and tranquilizers
34
What are Bile Acid sequestrants?
They are meds that act by abosrbing and combining with intestinal bile salts which then are secreted in feces preventing intestinal reabsorption
35
What are the uses of Bile Acid sequestrants?
Used to treat hypercholesterolemia in adults, biliary obstruction, and pruritus associated with biliary disease
36
What is the main reason for medication non-compliance for Bile Acide sequestrants?
The taste of the medication (especially if in powder form). We can fix this by combining the med with juices or other flavoured products.
37
Side effects of Bile Acid sequestrants
Nausea, bloating, constipation, fecal impaction, and intestinal obstruction.
38
Nam the (2) bile acid sequestrants
Colesevelam and Cholestyramine
39
What medication is used to treat hepatic encephalopathy
Lactulose
40
What is Lactulose used for?
Used to treat constipation but also used in the prevention and treatment of portal systemic encephalopathy , including hepatic precoma/coma by increases peristalsis and bowel evacuation. (Ammonia is secreted through the bowel).
41
What is the normal ammonia level?
Normal ammonia level is 6-47 mcmol/L (10-80 mcg/dL)
42
What are Pancreatic Enzyme replacement? | - Name the most common one
Meds used to supplement or replaceancreatic enzymes and thus improve nutritional status and reduce the amount of fatty stools. - Most common oneis Pancrelipase
43
When should Pancrelipase be taken?
Should be taken with all meals and snacks
44
Side effects of Pancrelipase
Abdominal cramps, abdominal pain, nausea, vomiting, and diarrhea
45
What medications interfere with the action of Pancrelipase?
Products containing calcium carbonate and products containing magnesium hydroxide
46
What are the 2 forms of inflammatory bowel disease?
Ulcerative colitis and Crohns disease
47
Name and explain the 5 categories of meds used to treat IBD?
Antimicrobials: Prevent or treat a secondary infection. 5-aminocalicylates: decrease GI inflammation Corticosteroids: decrease GI inflammation Immunosuppressants: suppress the immune response Immunomodulators: modulate immune response to induce and maintain remission
48
Name the (4) antimicrobial agents used to treat IBD
Cirpofloxacin, Metronidazole, Rifaximin, Clarithromycin
49
Name the (3) 5-aminosalycilates used to treat IBD
Balsalazide, Mesalamine, Sulfasalazine
50
Name the (3) corticosteroids used to treat IBD
Budesonide, Prednisone, Hydrocortisone
51
Name the (4) immunosuppressants used to treat IBD
Azathioprine, Cyclosporine, Mercaptopurine, Tacrolimus
52
Name the (4) immunomodulators used to treat IBD
Adalimumab, Certolizumab, Infliximab, Natalizumab
53
What is IBS?
A gastrointestinal disorder that is characterized by crampy abdominal pain accompanied by diarrhea, constipation or both
54
What are the 4 categories of laxatives used to treat IBS-consipation?
Bulk-forming, stimulants, emollients, osmotics
55
What is Lubiprostone? | - When is it taken?
Lubiprostone: chloride channel activator that increases fluid in the intestines to promote bowel elimination. Used to treat IBD-C. - Taken with food and water
56
What is Linaclotide? | - When is it taken?
Linaclotide: Stimulates receptors in the intestines to promote bowel transit time. Used to treat IBD-C. - Taken daily 30 mins before breakfast
57
Name the (3) bulk-forming laxatives
Methylcellulose, Polycarbophil, Psyllium
58
Name the (2) stimulant laxatives
Bisacodyl and Senna
59
Name the emollient laxative
Docusate sodium
60
Name the (5) Osmotic laxatives
Magnesium hydroxide, magnesium citrate, Sodium phophates, polyethylene glycol and electrolytes, lactulose
61
What is Alosetron? | - uses
It is a selective seratonin receptor antagonist | - Used to treat IBS-D
62
Side effects of Alosetron
Constipation, impaction, bowel obstruction,perforation of bowel, ischemic colitis,
63
What are the 2 categories of antidiarrheal medications
- Opioids and related medications | - Other antidiarrheals
64
Name the (2) opioids and such used to treat diarrhea
Diphenoxylate with atropine sulfate | Loperamide
65
Name the (3) 'other antidiarrheals' used to treat diarrhea
Bismuth subsalicylate, bulk-forming medications, anticholinergic antispasmodics (dicyclomine, glycopyrolate)
66
What should be monitored for antiemetics?
Vital signs, intake and output, signs of dehydration, fluid and electrolyte imbalances
67
What are the 8 categories of antiemetics?
Seratonin antagonists, glucocorticoids, substance P/neurokinin-1 antagonists, benzodiazepine, dopamine antagonists (3 sub-categories: phenothiazine, butyrophenines, others), cannabinoids, anticholinergics, antihistamines
68
Name the 3 Seratonin antagonist antiemetics
Dolasetron, Granisetron, Ondansetron
69
Name the 2 Glucocorticoid antiemetics
Dexamethasone, methylprednisolone
70
Name the 2 Substance P/Neurokinin-1 antagonist antiemetics
Aprepitant and Fosaprepitant
71
Name the Benzodiazepine antiemetic
Lorazepam
72
Name the 4 Phenothiazine antiemetics
Chlorpromazine, Perphenazine, Prochlorperazine, Promethazine,
73
Name the 2 Butyrophenone antiemetics
Haloperidol, Droperidol
74
Name the 2 'other' Dopamine Antagonist antiemetics
Metoclopramide, Trimethobenzamide
75
Name the 2 Cannabinoid antiemetics
Dronabinol, Nabilone
76
Name the Anticholinergic antiemetic
Scopolamine transdermal
77
Name the 5 Antihistamine antiemetic
Cyclizine. Dimenhydrinate, Diphenhydramine, Hydroxyzine, Meclizine hydrochloride
78
What are bulk-forming laxatives?
Meds that absorb water into the feces and increase bul to produce large and soft stools
79
What are stimulant laxatives?
Meds that stimulate motility of large intestine
80
What are emollient laxatives?
Meds that inhibit absorption of water so fecal mass remains large and soft
81
What are osmotic laxatives?
Attract water into the large intestine to produce bulk and stimulate peristalsis
82
What are the interventions for diarrhea
Treat underlying cause, treat dehydration, replace fluids and electrolytes, relieve abdominal discomfort and cramping, reduce passage of stool
83
When do we not use opioids as antidiarrheals?
When we suspect poisons, infections or bacterial toxins

NCLEX Pharm (7 decks)

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