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PT3 GI and DERM > GERD and PUD > Flashcards

GERD and PUD Flashcards

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Dermatology Board Prep flashcards
1
Q

PPIs that are always once daily dosing

A

esomeprazole

dexlansoprazole

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2
Q

PPI dose timing

A

take 30-60 minutes before meals on an empty stomach

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3
Q

how long do you need to take PPIs to see a benefit

A

1-4 days

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4
Q

PPIs and osteoporosis

A

ok to do unless patient has more risk factors for hip fracture

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5
Q

PPIs and community-acquired pneumonia

A

increased risk of acquiring for acute use, but no elevated risk in long-term users

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6
Q

PPIs and C.diff

A

PPIs are risk factor and should be used with care in patients at risk

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7
Q

PPIs and clopidogrel

A

no changes needed as there is not increased risk of CV event

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8
Q

PPI side effects

A

well tolerated

sometimes diarrhea or headache

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9
Q

PPI differences in efficacy

A

no major difference

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10
Q

typical PPI course

A

8 weeks

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11
Q

if GERD symptoms still present after typical course

A

maintenance PPI at the minimal effective dose

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12
Q

H2RA adverse effects

A

well tolerated

diarrhea or constipation

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13
Q

which GERD drugs need to decrease dose in renal impairment

A

H2RAs

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14
Q

why don’t we use cimetidine much

A

drug interactions

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15
Q

H2RAs place in therapy

A
  • less effective that PPIs
  • can be used for maintenance if no erosive disease
  • can be used for bedtime relief
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16
Q

calcium carbonate side effect

A

constipation

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17
Q

sodium bicarbonate side effect

A

burps

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18
Q

aluminum hydroxide side effect

A

constipation

19
Q

magnesium hydroxide side effect

A

diarrhea

20
Q

antacid drug interactions

A 
fluroquinolones
tetracyclines
allopurinol
iron
cefuroxime
21
Q

antacid place in therapy

A

infrequent episodic heartburn only

22
Q

empiric therapy for GERD

A
  • PPI rx for 8 weeks
  • if good response stop PPI
  • if still symptoms continue therapy and consider more diagnostics
23
Q

H.pylori treatment options

A
  • clarithromycin triple therapy
  • bismuth quadruple therapy
  • concomitant therapy
24
Q

clarithromycin triple therapy regimens

A
  • clarithromycin 500 BID
  • Amoxicillin 1000 BID/metronidazole 500 mg TID
  • PPI BID
25
Q

clarithromycin triple therapy regimen duration

A

14 days

26
Q

when to use clarithromycin triple therapy regimens

A

in areas of low clarithromycin resistance who have not had a macrolide previously

27
Q

bismuth quadruple therapy regimen

A
  • PPI BID
  • bismuth subsalicylate
  • metronidazole 500 TID
  • tetracycline 500 QID
28
Q

bismuth quadruple therapy regimen duration

A

10-14 days

29
Q

when to use bismuth quadruple therapy regimen

A

patients that have had a macrolide

30
Q

bismuth quadruple therapy regimen adverse effect

A

increased GI effects

31
Q

concomitant therapy regimen

A
  • PPI BID
  • clarithromycin 500 BID
  • amoxicillin 1000 BID
  • metronidazole 500 BID
32
Q

concomitant therapy regimen duration

A

10-14 days

33
Q

testing for H.pylori after treatment

A

-urea breath test, fecal antigen test or biopsy at least 4 weeks after completion of antibiotic treatment and 2 weeks after PPI have been withheld

34
Q

risk factors for NSAID GI toxicity

A
  • age >65
  • high dose of NSAID
  • previous uncomplicated ulcer
  • using with aspirin, corticosteroid or anticoagulant
35
Q

what patients are considered high risk of NSAID GI toxicity

A

more than 2 risk factors present

36
Q

treatments for moderate-high risk of NSAID induced ulcer

A

PPI or misoprostol

stop NSAID

37
Q

duodenal NSAID ulcers should be treated for how long

A

4 weeks

38
Q

gastric NSAID ulcers should be treated for how long

A

8 weeks

39
Q

misoprostol use

A

NSAID ulcers

40
Q

issues with misoprostol

A
  • most cannot tolerate abdominal pain and diarrhea

- contraindicated in pregnancy

41
Q

sucralfate use

A

NSAID ulcers

42
Q

sucralfate MoA

A

forms coating along gastric lining

43
Q

issue with sucralfate

A

troublesome constipation

PT3 GI and DERM (8 decks)

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