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Pharm MSU NUR909 > GI > Flashcards

GI Flashcards

1
Q

GERD drug classes

A

-Antacids
-H2 receptor antagonists
-PPIs
-Mucosal protectant
-Promotility agents

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2
Q

Antacids-meds

A

Aluminum, calcium carbonate, sodium bicarbonate, and magnesium OTC

alginic acid (Gaviscon) - forms a protective layer

Be weary of sugar and sodium contents for dm and htn

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3
Q

Histamine-2 Receptor Antagonists

A

Cimetidine, Famotidine, Nizatidine, Ranitidine

tolerance over time, renal dosing required, cimetidine interaction with plavix and known for impotence and gynocomastia

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4
Q

Proton Pump Inhibitors
-meds
-adverse effects

A

Esomeprazole, omeprazole, omeprazole + sodium bicarbonate, lansoprazole, rabeprazole, pantoprazole, dexlansoprazole

decreased calcium absorption, hypomagnesemia, increased risk of c-diff

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5
Q

Promotility agents

A

metoclopramide-

therapy >12 weeks not recommended due to risk of irreversible tardie dyskinesia

confusion, dizziness, fatigue, headache, hyperprolactinemia, and extrapyramidal symptoms

erythromycin- Qt prolongation

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6
Q

Mucosal Protectant

A

Sucralfate-

forms protective coating

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7
Q

two predominant causes of peptic ulcer disease

A

Helicobacter pylori and NSAIDs

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8
Q

Primary treatment for H. pylori

A

quadruple therapy for 14 days

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9
Q

preferred quadruple therapy for H. pylori

A

PPI BID
Clarithromycin 500mg BID
Amoxicillin 1000mg BID
Metronidazole 500mg BID

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10
Q

quadruple therapy for H. pylori if previous exposure to macrolide or allergy to pnc

A

PPI BID
Bismuth subsalicyclate 262mg QID
Tetracycline 500mg QID
Metronidazole 250mg QID

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11
Q

triple therapy for H. pylori if no prior exposure to macrolide and regional resistance to Clarithromycin < 15%

A

PPI BID
Clarithromycin 500mg BID
Amoxicillin 1000mg BID
or Metronidazole 500mg BID

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12
Q

Risk factors for NSAID-induced ulcers

A

age > 65
male gender
previous GI hx
-recent pud or previous GIB
coexisting significant dx
-cardiovascular or hepatic/renal
impairment
concomitant therapy with:
-aspirin
-anticoagulants
-coritcosteroids
-SSRIs

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13
Q

medications for prevention of GI mucosal injury with PUD

A

PPI, Misoprostol, high dose H2-receptor antagonist like famotidine

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14
Q

Potential causes of diarrhea

A

abx
metformin
misoprostol
colchicine
others..

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15
Q

medications for diarrhea

A

Loperamine (Imodium) - OTC
Diphenoxylate and atropine (Lomotil)
Bismuth subsalicylate (Pepto Bismol) - OTC
Bile salt-binding resins
Octreotide (Sandostatin)

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16
Q

Medications associated with causing constipation

A

Aluminum or calcium-containing antacids
Anticholinergic agents
Beta-blockers
Calcium-channel blockers
Calcium supplements
Oral iron supplements
Opioids

17
Q

Medication classes to help with constipation

A

Fiber/bulk laxatives
Osmotic laxatives
Stimulant laxatives
Stool softeners
Saline laxatives
Chloride channel activator
Guanylate cyclase-C agonists

18
Q

Fiber/Bulk Laxatives

A

Hold water in the stool, increase stool weight, increase colonic distention, and improve frequency of bowel movements

-Methylcellulose (Citrucel), calcium polycarbophil (FiberCon), psyllium (Metamucil)

-bloating, cramping

-onset 12-72 hours

19
Q

Osmotic Laxatives

A

Promote secretion of water into the lumen of the colon and stimulates movement of the bowel

-lactulose, polyethylene glycol (Miralax)

-Diarrhea

-Onset 12-96 hours

20
Q

Stimulant Laxatives

A

Increase intestinal motility and colonic secretions

-bisacodyl (Dulcolax), sennosides (Senokot)

-Cramping

-Onset: oral- 6-10 hours, rectal- 15-60 mins

Drug class of choice to prevent opioid induced constipation

21
Q

Stool Softeners

A

Improve interaction of water and stool

-Docusate (Colace)

-Diarrhea, cramping

-Onset 12-72 hours

22
Q

Saline laxatives

A

Draw water into intestines and colon by osmosis to increase motility

-magnesium hydroxide, mag citrate, oral sodium phosphate liquid

-cramping, dehydration, electrolyte disturbances

-Onset- 30 mins to 6 hours

23
Q

Chloride channel activator

A

Increase intestinal fluid secretion and improve fecal transit

-lubiprostone (Amitiza)

-headache, nausea, diarrhea

24
Q

Guanylate cyclase-C agonist

A

Increase intestinal fluid secretiopn and improve feccal transit

-linaclotide (Linzess), plecanatide (Trulance)

-diarrhea

25
Q

Diarrhea-predominant IBS- medications, fiber?, associated with what?

A

-no benefit for adding fiber
-loperamide, non-systemically absorbed abx (rifaximin), serotonin-3 agonist (alosetron-Lotronex), opioid agonist )eluxadoline- Viberzi)
-can be associated with psychological symptoms such as anxiety and depression

26
Q

Constipation-predominant IBS

A

-OTC laxatives- Miralax
-Selective C-2 chloride channel activators- lubiprostone (Amitiza), linaclotide (Linzess)
-5-HT4 agonists- tegaserod (Zelnorm)-emergency use only due to increased risk of MI, unstable angina, and stroke

27
Q

Both types of IBS

A

Antispasmodics- hyoscyamine (Levsin), dicyclomine (Bentyl) - dry mouth, dizziness, blurred vision

Antidepressants- SSRIs and tricyclic though tricyclic can cause constipation and is predominantly used for diarrhea

28
Q

Medications associated with causing nausea

A

-Chemo
-Opioids
-Glucagon-like 1 peptide agonists- liraglutide, exenatide
-Chantix

29
Q

Non-prescription medication for nausea

A

Antacids

H1 Antagonists-
dimenhydrainate (Dramamine)
diphenydramine (Benaryl)
meclizine (Bonine)

30
Q

Prescription nausea medications

A

-Anticholinergics
scopolamine (Transderm-scop)
-H1 Antagonist
promethazine (Phenergan)
hydroxyzine (Vistaril)
-Serotonin Antagonists
alosetron (Lotronex)
dolasetron (Anzemet)
granisetron (Granisol)
ondansetron (Zofran)
palonosetron (Alexi)
-Antidopaminergics
-metoclopramide (Reglan)

31
Q

Serotonin Antagonists for Nausea

A

Selevtively inhibit serotonin at the 5HT3 receptor in the small bowel, vagus nerve, and chemoreceptor trigger zone

-indications are for chemo-induced and post-op nausea/vomiting

-QT prolongation, headache

32
Q

Nausea and Vomiting in Pregnancy

A

Monotherapy: vitamin B6 10-25 mg 3 or 4 times per day
Add: doxylamine 12.5mg 3 or 4 times per day
Add: promethazine 12.5mg every 4 hours OR dimenhydrinate 50-100mg every 4-6 hours not to exceed 200mg/day if also taking doxylamine

Pharm MSU NUR909 (9 decks)

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