Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm II > GERD and PUD > Flashcards

GERD and PUD Flashcards

1
Q

What modulates gastric acid secretion?

A

paracrine (histamine), neuroendocrine (Ach), and endocrine (gastrin) pathways which activate their respective receptors (H2, M3, CCK2).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What limit extent of acid secretion

A

Somatostatin-secreting D cells and prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some lifestyles that are related to developing heartburn?

A

High fat meals

tobacco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

4 mechanisms for developing gastric reflux?

A

Decreased Lower Esophageal Sphincter Pressure
Prolonged Esophageal Clearance
Mucosal Resistance
Delayed Gastric Emptying Time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Food causes for decreased LES

A 
fatty meals
peppermint
chocolate
caffeine
garlic
onions
chili pepers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

1/2 of patients with GERD have prolonged ______ clearance.

A

acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are foods that are mucosal irritants?

A

spicy food
citrus juice
tomato juice
coffee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is a medication used for osteoporosis where patients must take with a large glass of water and stay upright due to forming of an esophageal ulcer.

A

Alendronate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some lifestyle factors that can cause GERD?

A 
Obesity
smoking
high-fat meals
tight fitting clothing
pregnancy
stress
laying flat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the body’s way of trying to handle extra acid?

A

Hypersalivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can you diagnose GERD

A

Hx
Endoscopy
24 hr ambulatory pH monitoring
Pre-emtively treating w/ omeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Complications of GERD

A

Esophagitis
Esophageal strictures
Barrett’s esophagus
adenocarcinoma of esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are ways to suppress gastric acid production?

A

Antacids after meals and at bedtime
H2 histamine receptor antagonist
Covalent inhibitors of H+, K+-ATPASe of pariteal cells (PPIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some promotility therapies for GERD?

A

Metoclompramide (doapmine antagonist)

Bethanechol (cholinergic agent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a disadvantage of antacids?

A

Short duration

must separate from other drugs (can prevent absorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can magnesium antacids cause?

A

Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can aluminum based antacids cause?

A

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can calcium and sodium bicarb based antacids cause?

A

gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what products can can cause fluid overload in pts. with CHF, renal failure, cirrhosis, pregnancy, or any salt-restricted diet; avoid in anyone taking supplemental calcium or with renal dysfunction

A

sodium bicarb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some clinically significant drugs that will bind to antacids

A

quinolone, isoniazid, tetracycline

Ferrous sulfate, quinidine, sulfonylurea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is teh MOA of H2-receptor angatonists

A

reversibly inhibit histamine-2 receptors on parietal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name some H2 receptor antagonists

A

Famotidine
Nizatidine
Ranitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How are H2 receptor antagonists excreted

A

Unchanged in urine

need dose adjustment with renal problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a rare, reversible ADR of H2 receptor antagonists

A

thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Drug that inhibits teh metabolism of warfarin, phenytoin, nideipine, propranolol

A

Cimetidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what drugs required an acidic environment to be absorbed

A

Ketoconazole, itraconazole, ferrous sulfate

27
Q

eliminate symptoms and heal esophagitis more frequently and rapidly than other drugs

A

PPIs

28
Q

When should PPIs be given?

A

Once daily before breakfast

or BID have one before breakfast, before dinner

29
Q

List some PPIs

A

Omeprazole

end in “prazole”

30
Q

MOA of PPIs

A

Inhibit the action of the H+,K+ -ATPase.

31
Q

All PPIs are _______ and they need the acidic environment to work.

A

prodrugs

32
Q

What drugs can you not use with PPI

A

antacids

H2 antagonist

33
Q

with PPIs may have a higher incidence of what?

A

CAP

34
Q

How are PPIs metabolized?

A

P450s

35
Q

Omprazole and esomeprazole reduce the metabolism of what?

A

DIazepam
Phenytoin
Warfarin

36
Q

What are 2 promotility agents

A

Metoclopramide

Bethanechol

37
Q

Contraindication so r metoclopramide?

A

Parkinson’s
mechanical obstruction
concomittant use of dopamien antagonists, anticholinergics, pheochromocytoma

38
Q

Drug that is a promotlilty agent but can cause a fatal cardiac dysrhythmia

A

Cisapride

39
Q

A mucosal protectant that has non-absorbable alumnium salts. only recommended for mild cases of GERD, good for healing. Needs acid to turn into goo

A

sucralfate

40
Q

For patients that are resistant to therapy what can you do

A

Use PPIs and H2 receptor antagonists in alternating method

41
Q

If patients really aren’t responsive to GERD therapy what can you do?

A

Antireflux surgery

Endoluminal therapies

42
Q

most common cause of duodenal ulcer

A

H. pylori

43
Q

when will you have pain with a duodenal ulcer?

A

1-3 hours after eating

gets better with eating

44
Q

what often cases gastric ulcers?

A

NSAIDs

worse with food

45
Q

who has to be hospitalized with ulcerations?

A

Elderly, those with bleeding and perf

46
Q

classify H. pylori

A

Gram- rod

47
Q

what can H. pylori lead to?

A

PUD
gastric lymphoma
adenocarcinoma

48
Q

what are the transmission methods of H. Pylori

A

Fecal-oral

oral-oral

49
Q

How can you document infection with H. Pylori

A

Usually a blood test

Breath test for urea (faster)

50
Q

What is a syndrome with gastric acid hypersection and recurring ulceration from a gastrin-secreting tumor?

A

Zollinger-Ellison Syndrome

51
Q

How do you treat zollinger-Ellison syndrome?

A

PPIs

chemo

52
Q

What are complications of H. Pylori.

A

Zollinger-Ellison Syndrome
Upper GI Bleed
Perf
Obstruction

53
Q

Caused by scarring or edema of duodenal bulb or pyloric channel land lead to gastric retention. Symptoms include Early satiety, bloating, anorexia, nausea, vomiting, weight loss

A

Obstruction

54
Q

What is your DOC for symptoms with H. pylori?

A

PPIs

55
Q

What are antibiotics for H. Pylori?

A

Amoxicillina and clarithromycin

metronidazole and clarithromycin

56
Q

What is a 4 drug regimen for H. Pylori?

A

H2 blocker (cheaper)
Pepto-Bismol
Metronidazole (can cause GI problems)
Tetracycline

57
Q

If there is a treatment failure with H. Pylori what do you do?

A 
Change antibiotics
try the 4 drug regimen 
extend treatment duration
asses AEs
assess compliance
58
Q

what 2 things are enhanced with bismuth subsalicylate?

A

Mucous and bicarb

59
Q

what is misoprostol?

A

synthetic analogue of prostaglandin E.

60
Q

What does misoprostol do?

A

Imitates the action of endogenous prostaglandins (PGE2 and PGI2) in maintaining the integrity of the gastroduodenal mucosal barrier.
Promotes healing

61
Q

when is misoprostol indicated?

A

ulcer healing

ulcer prophylaxis w/ NSAID used

62
Q

ADRs of misoprostol

A

Diarrhea

Constipation

63
Q

Contraindications w/ misoprostol.

A

Hypotension
Breastfeeding
Pregnant

Pharm II (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions