GERDFC

Question 1

what is the MOA of alteplase?

Answer 1

causes fibrinolysis by binding to fibrin in a thrombus and coverts entrapped plaminogen to plasmin.

Question 2

what is the dose of alteplase?

Answer 2

0.9 mg/kg IV (max 90 mg) IV over 60 mins with 10% of dose given as a bolus over 1 minute.

Question 3

what is the timeframe for alteplase administration?

Answer 3

within 3 hours of of symtom onset

Question 4

what is the role of antihypertensive therapy in stroke?

Answer 4

to decrease BP and qualify patients for alteplase therapy - decrease BP gradually

Question 5

what is the MOA of osmotic diuretics such as mannitol?

Answer 5

increases the osmotic pressure to reduce intracranial pressure associated with cerebral edema.l

Question 6

what routes of administration are approved for nimodipine?

Answer 6

Oral only

Question 7

what are agents used for secondary prevention in pts with previous stroke?

Answer 7

ASA, Plavis, Aggrenox

Question 8

what is the dose of aggrenox?

Answer 8

dipyrimadole/asa 200/25

Question 9

what is the CYP interaction with clopidogrel?

Answer 9

it is a prodrug metabolized by CYP2C19. avoid with 2C19 inhibitors (azole, omeprazole)

Question 10

what are some drugs that can decrease LES pressure?

Answer 10

anticholingerics, barbituates, dihydropyridine CCBs, estrogen, nitrates, NSAIDS

Question 11

what is a side effect of aluminum found in some antacids?

Answer 11

can cause constipation

Question 12

what is side effect of magnesium in antacids?

Answer 12

can cause diarhea

Question 13

when should PPIs be taken?

Answer 13

30 minutes before breakfast because they inhibit proton pumps that are actively secreting acid.

Question 14

omeprazole - Brand

Answer 14

Prilosec=

Question 15

esomeprazole - Brand

Answer 15

Nexium

Question 16

esomeprazole + naproxyn

Answer 16

vivomo

Question 17

rabeprazole brand

Answer 17

aciphex

Question 18

what are side effects of long term PPI use?

Answer 18

increase risk of osteoporosis/fracture, can increase risk of pneumonia in hospitalized pts, can increase risk of c.diff infections

Question 19

which PPIs can be opened and mixed with apple juice or put down tube?

Answer 19

lansoprazole, esomeprazole, omeprazole

Question 20

what drugs require an acidic pH and might have decreased absorption with PPIs?

Answer 20

azoles, calcium carbonate, iron

Question 21

what are two cytoprotective agents used for GERD?

Answer 21

misopostol(Cytotec) and sucralfate (Carafate)

Question 22

What is prego category of misoprostol?

Answer 22

Cat X - used for medical termination of preganancy

Question 23

what is a common side effect of sucralfate?

Answer 23

constipation

Question 24

why is metoclopramide sometimes used for GERD?

Answer 24

dopamine antagonist that enhances motility and accelerates gastric emptying and increases LES tone.

Question 25

what pt population should avoid using metoclopramide?

Answer 25

parkinsons pts

Question 26

what are the 3 common peptic ulcers?

Answer 26

H. pylori, NSAID-inuced ulcers, stress ulcers

Question 27

duodenal ulcers are ____________ by eating while gastric ulcers are _____________ by eating.

Answer 27

duodenal = relieved

Question 28

what is triple therapy for H. pylori?

Answer 28

PPI+ 2 antibiotics

Question 29

What is quadruple therapy for H.pylori?

Answer 29

PPI + bismuth+ metronidazole + tetracycline

Question 30

what is a major side effect of clarithromycin?

Answer 30

abnormal metallic taste