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Pharm Exam 4 > GI > Flashcards

GI Flashcards

1
Q

GERD Treatment

A

Antacids
Mucosal Protective Agents
H2 Receptor Antagonists
PPIs

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2
Q

Antacids

A 
Aluminum hydroxide (Gaviscon)
Magnesium hyrdoxide (Malox, Milk Mg)
Calcium carb (Tums)
Sodium bicarb (alka selzter)
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3
Q

Antacid MOA

A

Local acid neutralization by weak bases (to form salt and water)

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4
Q

Mg Hydroxide causes

A

Diarrhea

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5
Q

Aluminum Hydroxide causes

A

Constipation

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6
Q

Four Histamine Receptor Agonists (H2RAs)

A

Pepcid
Axid

Zantac
Tagamet

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7
Q

H2RAs MOA

A

Competitively Inhibit parietal H2 receptors (Decreases HCL production)

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8
Q

H2RAs Zantac Drug interactions

A

Warfarin
Procainamide
Ketoconazole
Glipizide

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9
Q

H2RAs Tagamet Problems

A

P450 INHIBITOR

Interacts w drugs that require acid environment
Azoles**

ADRS
Gynecomastia
Cognitive
Bradycardia
Agranulocytosis
Dizzy, diarrhea, headache
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10
Q

Pepcin and Axid ADRs

A

Headache
Dizziness
Diarrhea
Constipation

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11
Q

PPIs

A

Prazoles! (Omepraole, Esomeprazole, Pantoprazole)

Prilosec (OTC)
Prevacid (OTC)

Nexium
Protonix
Dexilant

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12
Q

PPI MOA

A

Irreversibly blocks proton pumps on parietal cells

Decreases acid production 80-90%

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13
Q

ADRs
Nausea, diarrhea, constipation, flatulence, abdominal pain
Myopathy, arthralgia, headache
Decreased absorption of B12, magnesium
Increased incidence of C.diff
Increased fracture risk
Increased incidence of pneumonia (double)

A

PPI’s

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14
Q

First Line treatment Gastric Ulcers

A

PPI
Amoxicillin
Clarithromycin

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15
Q

Alternative / 2nd line treatment for Gastric Ulcers

A

PPI
Amoxicillin

Metronidazole / Tinidazole

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16
Q

Cytoprotective Agents

A

Bismuth subsalycilate (Pepto Bismal) - BLACK TONGUE/STOOL

Sucralfate (Carafate) - GOOEY GEL, CXI renal disease

Misoprostol (Cytotec) - stimulates mucin and bicarb, PREG X

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17
Q

Bismuth Subsalycilate Contraindications

A

Kid/Teen recovering from viral infection (Reyes)

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18
Q

Short term treatment of duodenal ulcer. Creates a gooey gel that adheres to ulcer

A

Sucralfate

CONTRAINDICATED FOR RENAL DISEASE

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19
Q

Used to prevent NSAID ulcer

A

Misoprostol (Cytotec)

PREGNANCY CATEGORY X - CAN INDUCE MISCARRIAGE

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20
Q

PREGNANCY CATEGORY X - CAN INDUCE MISCARRIAGE

A

Misoprostol (Cytotec)

21
Q

When to avoid bulk-forming laxatives

A

Fluid restricted diet
fecal impaction
megacolon

Caution for diabetes - dextrose content

22
Q

Stool Softeners

A

Docusate Sodium (Colase)

Docusate Calcium (Kaopectate)

23
Q

MOA stool softeners

A

Emollient

Increase “wetting” of intestine fluid

24
Q

Stool softeners good for

A

Post Op
Post MI
Colostomy
(need to avoid straining)

25
Q

Mineral Oil warnings

A

Do not take at bedtime (pneumonia)

Do not take w meals (decrease Vitamin absorption)

Anal leakage

26
Q

Saline Laxatives

A 
Magnesium citrate, sulfate, oxide, hydroxide)
Sodium phosphate (Fleet)
27
Q

Saline Lax MOA

A

Ions draw water into large intestine

28
Q

2nd line option for occasional constipation

A 
Glycerine (Fleet ,Ped Lax)
Polyethylene Glycol (Miralax)
29
Q

Prescription only lax, opioid constipation, chronic constipation.

Also used for hepatic encephalopathy by lowering ammonia levels

A

Lactulose

30
Q

Sugar Alcohol LAx

A

Sorbitol
Mannitol
Xylitol

Osmotic Lax

31
Q

Stimulant Lax - increase peristaltic activity intestines via mucosal inflammation

A

3rd line, except in opioid use

Sennosides (Ex Lax)
Bisacodyl (Ducolax)
Castor Oil ** CXI Pregnancy**
Aloe
Cascara
32
Q

Stimulant Lax that causes stool and urine discoloration

A

Sennosides / Senna (Ex Lax)

33
Q

Best choice for opiod induced constipation

A

Emollient + Stimulant

Docusate + Senna

34
Q

Oral Lax options for children 2-6 yrs

A

Docusate or Magnesium hydroxide (Milk Mg)

or Senna

Glycerin suppositories

35
Q

First choice lax for elderly

A

Bulk / fiber if fluid requirement can be tolerated

Otherwise, glycerin suppository

36
Q

Lax for pregnancy

A

Senna, Bisacodyl (Ducolax)

PEG (Miralax)

Docusate (Colase, softener)

37
Q

Intestinal Secretagogues (increases fluid and motility)

for chronic idiopathic constipation and/or IBS

A

Lubiprostone - not for bowel obstruction or prego
Lincaclotide - guanylate cyclase agonist
Plecanatide ‘’

38
Q

Antimotility Agents

A

Loperamide (Imodium)

Diphenoxylate/atrophine (Lomotil) - contorlled substance

Diphenoxine/atropine (Motofen)

Morphine

39
Q

Treatment of choice for most cases of diarrhea

A

Imodium (Loperamide)

40
Q

Imodium MOA

A 
Opioid agonist (slows motility, gives a chance to absorb water)
*poorly absorbed by CNS*
41
Q

Atropine

A

Anticholinergic - decreases peristalsis and secretions

Controlled Substance - Causes sedation, potentiates barbituates / EToH

42
Q

Antisecretory agents

A

Lactase
Bismuth subsalycilate
Probiotics
Octreotide

43
Q

Overdose of Bismuth subsalicylate

A

Neurotoxicity

44
Q

Injectable Somastatin analog. Used for diarrhea associated w carcinoma. Acromegaly.

A

Somastatin analog

45
Q

Anticholinergics for IBS

A

Dicyclomine
Methscopalamine

antispasmotics

46
Q

Severe IBS-D in women who have not responded to standard treatments should try

A

Alosetron

something w serotonin

47
Q

Stop Alosetron immediately

A

CONSTIPATION - can cause obstruction

48
Q

Drug of choice for ulcerative colitis with extensive disease (ACG guidelines)

A

Sulfasalazine

49
Q

Tnf-α inhibitors

Ratatouille
My Little Pony

A

Remicade
Simponi

Crohn’s / UC , last option

Pharm Exam 4 (3 decks)

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