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pharmacology module III exam II > GERD > Flashcards

GERD Flashcards

1
Q

antacids

A

aluminum hydroxide
calcium citrate
al/mg hydroxide

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2
Q

antacids MOA

A

neutralizes acids - raises pH

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3
Q

antacids uses

A

mild-intermittent heartburn or reflux - <1 episode/wk

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4
Q

calcium based antacids side effects

A

constipation
hypercalcemia
alkalosis
acute or chronic renal injury

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5
Q

aluminum based antacids side effects

A

constipation
hypophosphatemia

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6
Q

magnesium based antacids side effects

A

diarrhea
hypermagnesemia

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7
Q

aluminum based antacids caution with

A

renal failure (al retention = neurotoxic)

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8
Q

magnesium based antacids caution with

A

renal failure

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9
Q

surface agents

A

sucralfate
sodium alginate
bismuth

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10
Q

surface agents MOA

A

coats esophageal/gastric mucosa, creates physical barrier between mucosa and acid

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11
Q

surface agents use

A

short term management of GERD symptoms - swallow after meals, avoid drinking/eating after

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12
Q

sucralfate side effects

A

constipation
aluminum toxicity

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13
Q

sucralfate caution with

A

renal failure (aluminum toxicity)
diabetes - can cause hyperglycemia

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14
Q

H2 receptor antagonists

A

cimetidine
famotidine

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15
Q

H2 receptor antagnoists MOA

A

block stimulation of gastric parietal cells by competing with histamine at H2 receptors

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16
Q

H2 receptor antagonists uses

A

GERD, dyspepsia, PUD

17
Q

H2 receptor antagonists side effects

A

HA, dizziness, diarrhea, constipation
cimetidine: gynecomastia
prolonged use (>2 years) may lead to B12 deficiency

18
Q

H2 receptor antagonists caution with

A

renal impairment (dose adjust)

19
Q

PPIs

A

omeprazole
esomeprazole
lansoprazole
pantoprazole

20
Q

PPI MOA

A

block the gastric H/K-ATPase inhibiting gastric acid secretion

21
Q

PPI uses

A

GERD, dyspepsia, PUD, h pylori

22
Q

PPI education

A

take 30-60min before first meal of the day
taper off is taken >6mo to avoid rebound gastric hypersecretion

23
Q

PPI long term risks

A

malabsorption of some minerals and vitamins (mag, Ca, B12)
increased risks of some diarrheal illness C diff infection, microscopic colitis
increased risk of bacterial pneumonia
acute interstitial nephritis, chronic kidney disease
gastric polyps

24
Q

PPI side effects

A

HA, nausea, abd pain, diarrhea

25
Q

PPi interactions

A

decreased absorption of certain HIV protease inhibitors
increased concentration of digoxin, carbamzepine theophyline, warfarin, diazepam, phenytoin
increased methotrexate concentration/toxicity
can decrease anti platelet effects of clopidogrel
can decrease absorption of PO iron

26
Q

H pylori triple therapy

A

clarithromycin + amoxicillin + PPI

27
Q

PUD quad therapy

A

bismuth subsalicylate + tetracylate + metronidazole + PPI

28
Q

bismuth MOA

A

stimulates prostaglandins/mucosa/bicarbinate production in stomach - mild microbial activity with h pylori - reduces inflammation in stomach (is ulcer protective/coating)

29
Q

side effects of bismuth

A

black stools, black tongue
neurotoxicity - encephalopathy, aseptic meningitis, seizures

30
Q

bismuth caution with

A

increased risk of bleeding
neurotoxicity
tinnitus

31
Q

quad therapy side effects

A

diarrhea/abnormal stools, nausea, HA
skin: SJS
intercranial HTN, photosensitivity (tetracycline)

32
Q

quad therapy caution with

A

BLACK BOX WARNING: metronidazole is carcinogenic in mice and rats
hepatic impairment

33
Q

misoprostol MOA

A

synthetic prostaglandins E1 analogs - prostaglandins inhibit acid secretion by reducing the ability of parietal cells to respond to histamine

34
Q
A
35
Q

misoprostol use

A

prevention of NSAID induced gastric ulcers

36
Q

misprostol side effects

A

diarrhea, abd pain, HA

37
Q

misprostol drug interactions

A

avoid with magnesium containing antacids

38
Q

misprostol caution with

A

BLACK BOX WARNING: containdicated in pregnancy or women of childbearing age - birth defects, premature birth, abortion, uterine rupture
can induce uterine contractions

39
Q
A

pharmacology module III exam II (6 decks)

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