GERDFC Flashcards
what is the MOA of alteplase?
causes fibrinolysis by binding to fibrin in a thrombus and coverts entrapped plaminogen to plasmin.
what is the dose of alteplase?
0.9 mg/kg IV (max 90 mg) IV over 60 mins with 10% of dose given as a bolus over 1 minute.
what is the timeframe for alteplase administration?
within 3 hours of of symtom onset
what is the role of antihypertensive therapy in stroke?
to decrease BP and qualify patients for alteplase therapy - decrease BP gradually
what is the MOA of osmotic diuretics such as mannitol?
increases the osmotic pressure to reduce intracranial pressure associated with cerebral edema.l
what routes of administration are approved for nimodipine?
Oral only
what are agents used for secondary prevention in pts with previous stroke?
ASA, Plavis, Aggrenox
what is the dose of aggrenox?
dipyrimadole/asa 200/25
what is the CYP interaction with clopidogrel?
it is a prodrug metabolized by CYP2C19. avoid with 2C19 inhibitors (azole, omeprazole)
what are some drugs that can decrease LES pressure?
anticholingerics, barbituates, dihydropyridine CCBs, estrogen, nitrates, NSAIDS
what is a side effect of aluminum found in some antacids?
can cause constipation
what is side effect of magnesium in antacids?
can cause diarhea
when should PPIs be taken?
30 minutes before breakfast because they inhibit proton pumps that are actively secreting acid.
omeprazole - Brand
Prilosec=
esomeprazole - Brand
Nexium
esomeprazole + naproxyn
vivomo
rabeprazole brand
aciphex
what are side effects of long term PPI use?
increase risk of osteoporosis/fracture, can increase risk of pneumonia in hospitalized pts, can increase risk of c.diff infections
which PPIs can be opened and mixed with apple juice or put down tube?
lansoprazole, esomeprazole, omeprazole
what drugs require an acidic pH and might have decreased absorption with PPIs?
azoles, calcium carbonate, iron
what are two cytoprotective agents used for GERD?
misopostol(Cytotec) and sucralfate (Carafate)
What is prego category of misoprostol?
Cat X - used for medical termination of preganancy
what is a common side effect of sucralfate?
constipation
why is metoclopramide sometimes used for GERD?
dopamine antagonist that enhances motility and accelerates gastric emptying and increases LES tone.
what pt population should avoid using metoclopramide?
parkinsons pts
what are the 3 common peptic ulcers?
H. pylori, NSAID-inuced ulcers, stress ulcers
duodenal ulcers are ____________ by eating while gastric ulcers are _____________ by eating.
duodenal = relieved
what is triple therapy for H. pylori?
PPI+ 2 antibiotics
What is quadruple therapy for H.pylori?
PPI + bismuth+ metronidazole + tetracycline
what is a major side effect of clarithromycin?
abnormal metallic taste
