Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology Test 3 > GERD Study Guide > Flashcards

GERD Study Guide Flashcards

1
Q

The three classes of drugs most often used for the management of GERD include?

A

Anatacids
Histamine Receptors subtype (Antihistamine and H2 Receptor Antagonist)
Proton Pump Inhibitors

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

What are the non pharmacological Management of GERD?

A

Quit smoking and alcohol intake
Loose weight if obese or overweight
Avoid large meals
Avoid certain foods that may trigger GERD symptoms
- caffeine, coffee, chocolate, spicy foods, highly acidic food, high fat foods
Avoid tight clothing
Avoid lying down for two hours after eating
Avoid a recumbent position
Raise the head of the bed (wedges or blocks)

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

According to research studies what pharmacological group has superior effects for heartburn, healing the esophagus, and NERD pt heartburn relief?

A

Proton Pump Inhibitor

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

A ____ week course of PPI is recommended for symptom relief and healing for erosive esophagitis

A

8

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

Describe the step down approach

A

PPI started as initial therapy

Then swap to a H2 Receptor Antagonist or PPI dose lowered based on symptom relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PPI therapy should be initiated at what frequency? And given at what time?

A

Once daily dosing
Given before the first meal of the day
Less effective when taken at bedtime

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

List the three types of antacids?

A

Sodium bicarbonate
Aluminum and Magnesium Salts
Calcium Carbonate

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

What is the mechanism of action of antacids?

A

React rapidly with hydrochloride acid in the acid environment of the stomach to neutralize stomach acid

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

What is the formed by the reaction between the antacid and hydrochloride acid?

A

Water and insoluble salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is also formed beside water and insoluble salt, when calcium carbonate and hydrochloric acid?

A

Carbon Dioxide gas is also formed

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

What is the side effect from the carbon dioxide produced by the calcium carbon and hydrochloric acid?

A

Belching and flatulence

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

What is the onset of action of antacids?

A

Minutes

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

What is the duration of action of antacids?

A

1 to 2 hours

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

Describe the history fo ranitidine?

A

The FDA requested manufacturers in April of 2020 to withdraw all prescription and OTC formulations of ranitidine from the market immediately

Due to the presence of a contaminant known as MBDA, which is a probable human carcinogen

The FDA determine that the impurity increases over time, especially when stored at temperatures above room temperature.

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

Zantac is now back on the market, should you let your family take it?

A

Yes, it has a new formulation that contains the active ingredient famotidine instead of ranitidine

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

How many histamine receptors are there in the body?

A

4

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

H1 Receptor Antagonist are known as?

A

Antihistamines

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

Give 3 examples of antihistamines

A

Benadryl
Claritin
Allegra

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

What is the mechanism of action of H2 receptor Antagonist?

A

Competitive inhibitor with histamine for H2 receptor sites

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

Blocking histamine from H2 receptors causes what effect?

A

Diminishes the promotion of acid secretion

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

H2 receptor antagonist perform ______________ binding.

A

Selective

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

The onset of action for H2 receptor antagonist is?

A

30 to 60 minutes

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

What is the duration of action of H2 receptor antagonist?

A

6 to 10 hours

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

What is the major side effect of H2 receptor antagonist?

A

Gynecomastia

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

Gyneomastia occurs in H2 receptor antagonist why?

A

Directly blocking the androgen receptor activation and by affecting estradiol metabolism

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

The side effect with famotidine is?

A

Headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The side effects with cimetidine are?

A

Dizziness
Rashes
Headaches
Gynecomastia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

H2 receptor blockers generic name end in ?

A

Dine

29
Q

What is the mechanism of action of proton pump inhibitors?

A

Irreversibly bind to the proton potassium ATP AKA the proton pump

30
Q

The proton pump is located in the ?

A

Apical membrane of the parietal cells

31
Q

Due to the irreversible nature of PPI binding, the proton pump activity is restored only after what?

A

The body has sufficient time to biosynthesis the new proton potassium ATP

32
Q

What is the onset of action of a PPI

A

30 to 60 minutes

33
Q

How long does it take of dosing for PPI to reach maximum inhibition of acid secretion and why?

A

Several days, because all proton pumps are not inhibited with the first or second dose of a proton pump inhibitor

34
Q

What is the duration of action of a PPI?

A

24 hours

35
Q

What are common adverse effects of a PPI?

A

Gastrointestinal disturbances
Increased risk of bone fractures
Increased incidence of hypomagnesemia
Kidney dysfunction (interstitial nephritis)

36
Q

List the GI disturbances seen with PPI?

A

Diarrhea
Constipation
Nausea
Abdominal pain

37
Q

Why are patients on proton pump inhibitors at risk for bone fractures?

A

Decreased absorption of calcium due to a reduction in the acidic environment which promotes calcium absorption

38
Q

The risk for bone fractures increases for patients taking PPI if what? (3)

A

Advanced age
High prescription PPI
Duration of PPI use is greater than one year

39
Q

What type of calcium supplement is preferred to prevent bone fractures when taking a PPI? Why?

A

Calcium citrate, because it does not require an acidic environment in order to be absorbed.

40
Q

Which patients taking PPIs are at high risk for hypomagnesemia?

A

3 or more months of PPI use

41
Q

The association for hypomagnesemia and patients on PPI therapy is the highest in which patients?

A

Those on PPI therapy for over one year

42
Q

Concurrent use of _______ may increase the potential for symptoms of low magnesium levels when taking a PPI

A

Diuretic

43
Q

What treatment will be effective in treating hypomagnesemia for patients on PPI medication if the case is mild? If the case is severe?

A

Magnesium supplementation

Discontinuation of PPIs if severe

44
Q

Magnesium levels will return to normal ___________ ___________ after discontinuation with a PPI therapy.

A

1 week

45
Q

Symptoms of low magnesium include? (4)

A

Tremors
Seizures
QT prolongation
Cardiac arrhythmias

46
Q

PPI are distributed where?

A

Throughout the body

47
Q

PPI are activated by?

A

PPI are selectively activated by the low pH found in parietal cells

48
Q

Proton pump inhibitors must pass through the stomach as an intact pill to be dissolved where?

A

Small intestine

49
Q

PPI reach their ultimate site of action which is ?

A

Parietal cells via systemic arterioles and capillaries which feed these cells

50
Q

Once converted into its active species, the PPI is _______ in the parietal cells.

A

Trapped

51
Q

PPIs are _______ regarding their efffect on the body

A

Selective

52
Q

Why do we have enteric coating medications?

A

Serve as a barrier to prevent the gastric acids in the stomach from dissolving or degrading drugs after you swallow them, ensuring the dosage and drug are provided to the site of absorption.

53
Q

What would happen if PPI were not enterically coated?

A

They would fall apart rapidly in the stomach acids, they would be inactivated before absorption

54
Q

PPIs must pass through the _______ as an intact pill and dissolve in the _________________, which has a higher pH

A

Stomach

Small intestine

55
Q

What do prokinetic agents do?

A

Help strengthen the LES to have increased pressure and lessen regurg

56
Q

Prokinetic agents provide benefits as an active therapy to help acid suppression in patients with _______ disorders that contribute to reflex symptoms

A

Motility

57
Q

Name a prokinetic agent

A

Metoclopramide/reglan

58
Q

Reglan is a antiemetic and prokinetic medication that acts primarily as a ?

A

Dopamine receptor antagonist

59
Q

Reglan increases ______ pressure and enhances?

A

LES

Gastric emptying

60
Q

Reglan does not contribute to?

A

Esophageal healing

61
Q

Reglan is not recommended for GERD d/t its potential to cause signs and symptoms mimicking?

A

Parkinson disease (AKA extrapyramidal symptoms)

62
Q

EPS includes:

A

Involuntary movement that are seen with Parkinson disease

63
Q

EPS symptoms with Reglan occurs within?

A

24 to 48 hours of initiating therapy

64
Q

EPS symptoms with reglan can last up to?

A

Six months

65
Q

Metoclopramide should not be prescribed for GERD in the absence of individual that have _______. Why?

A

Gastroparesis

Due to the development of tardive dyskinesia

66
Q

Use of metoclopramide for longer than _____ weeks is not recommend.

A

12

67
Q

The tardive dyskinesia with metoclopramide can be ________

A

Irreversible

68
Q

Metoclopramide should not be used in which two patient populations for the risk of developing tardive dyskinesia

A

Pediatric patients

Adults less than 30 years of age

Pharmacology Test 3 (4 decks)

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