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Nurs 5229 Clinical Pharmacotherapeutics > GI deck 3 > Flashcards

GI deck 3 Flashcards

1
Q

Stimulants examples

A

cascara, senna, bisacodyl, and castor oil

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2
Q

stimulants action

A

Direct action on intestinal mucosa by stimulating the myenteric plexus

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3
Q

Osmotics example

A

magnesium hydroxide, magnesium citrate, sodium phosphate, polyethylene glycol electrolyte solution, and polyethylene glycol (PEG) 3350

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4
Q

Osmotic action

A

draw water into the intestinal lumen

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5
Q

bulk producing laxative example

A

psyllium, methylcellulose, and polycarbophil

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6
Q

bulk producing laxative action

A

Natural and semi-synthetic polysaccharides and cellulose that mix with water in the intestine

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7
Q

lubrcant example

A

mineral oil

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8
Q

lubricant action

A

Soften stool and lubricates intestine

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9
Q

surfactants example

A

docusate sodium, docusate calcium, and docusate potassium

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10
Q

surfactants action

A

Reduce the surface tension of the oil–water interface on the stool and facilitate admixture of fat and water into the stool

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11
Q

Hyperosmlar laxitive example

A

glycerine, lactulose

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12
Q

hyperosmolar laxitive action

A

Draws water into the intestine

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13
Q

Chloride channel activator example

A

lubiprostone

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14
Q

chloride channel activator action

A

activate CIC-2 chloride channels in the GI tract to produce chloride-rich secretions that soften the stool

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15
Q

Opioid-receptor antagonist example

A

methylnatrexone

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16
Q

opioid receptor antagonist action

A

Mu receptor antagonist

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17
Q

laxative contraindicated in

A

presence of nausea, vomiting, undiagnosed abdominal pain, or if bowel obstruction is suspected or diagnosed

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18
Q

Magnesium hydroxide CI in

A

renal dysfunction

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19
Q

Methylnaltrexone may

A

opioid withdrawal

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20
Q

ADR - Laxative

A

excessive bowel activity, cramping, faltulece and bloating

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21
Q

laxative Raid response and short-term use

A

Stimulants are the drugs of choice.
Osmotic laxatives also work well (magnesium hydroxide, PEG 3350).
Surfactants: docusate

22
Q

Laxative slower response and long-term use

A

bulk forming are safest

23
Q

Rapid-acting laxatives are best taken in the

A

am, lower-acting ones are best taken at bedtime!

24
Q

laxatives patient edcution

A

– prevention is key as laxatives are a temporary fixes. FIBER!

25
Q

pregnancy laxatives

A

Bulk-forming laxatives are safest

PEG (Miralax) or docusate may be used.

26
Q

GERD a common problem

A

in primary care

27
Q

GERD patho

A

Lower esophageal sphincter tone
Gastric content regurgitation into the esophagus
Complaints of burning substernal pain that radiates upward
Persistent acid reflux that occurs more than twice a week considered GERD

28
Q

Goals of GERD tretment

A

reduce or eliminate symptoms, heal esophageal lesions, manage or prevent complications, prevent relapse

29
Q

Best treatment combo for GERD

A

lifestyle modification and drug therapy

30
Q

Drugs used for GERD

A 
Histamine2 (H2) receptor antagonists
Proton pump inhibitors (PPIs)
Antacids
Prokinetics 
Cytoprotective agents
31
Q

Mild GERD

A

OTC antacid or H2RA

32
Q

Moderate to severe GERD

A

Lifestyle and PPI for 8 weeks

33
Q

no response to PPI

A

refer out

34
Q

Pediatric GERD is

A

Very common in infants

Almost 100% in 3-month-old, 4% of 6-month-old, 20% of 12-month-old infants

35
Q

Ped GERD most outgrow by

A

12 to 18 mo

36
Q

Medical management reserved in those pediatrics who are experiencing

A

Poor weight gain
Feeding difficulties
Persistent irritability and pain, apnea, and cyanosis

37
Q

Peptic Ulcer disease incidence

A

12% in men and 10% in women

38
Q

Peptic ulcer disease patho

A

Increased acid and pepsin secretion
Impaired mucosal cytoprotection
Use of nonsteroidal anti-inflammatory drugs (NSAIDs), Helicobacter pylori
Gastric: antral stomach region erosion, raised gastrin
Duodenal: H. pylori releases toxins, phospholipase enzymes promoting inflammation and erosion

39
Q

Peptic ulcer disease can be caused by

A

NSAID and H. Pylori

40
Q

Peptic ulcer disase usualy presents as

A

chronic, upper abdominal pain – often related to eating a meal

41
Q

Peptic ulcer disase Physical exam may show

A

epigastric tenderness or not, often exams show no other signs

42
Q

Peptic ulcer diases in the absence of

A

red flag symptoms” testing for and treating H Pylori and/or empiric acid inhibition therapy is appropriate

43
Q

Red flag symptoms for peptic ulcer diseases

A

Red flag symptoms are: weight loss, bleeding, anemia, vomiting, early satiety, dysphagia

44
Q

All regimens for peptic ulcer disease include a PPI plus

A

antibiotics to treat H. pylori

45
Q

Triple therapy - PPI plus (peptic Ulcer)

A

Clarithromycin: 500 mg twice daily, or
Metronidazole: 500 mg twice daily
Amoxicillin: 1 gm twice daily
Treatment for 10 to 14 days

46
Q

Quadruple therapy – PPI plus

A

Metronidazole: 250 mg four times/day
Tetracycline: 500 mg four times/day
Bismuth subsalicylate: 525 mg four times/day
Treatment for 14 days
Usually used as second-line therapy in patients who fail first-line therapy

47
Q

Levofloxacin-based trip therapy

A 
PPI: twice daily
Levofloxacin: 250 to 500 mg twice daily 
Amoxicillin: 1 g twice daily
Treatment for 10 to 14 days
Second-line or rescue therapy
48
Q

Peptic ulcer uncomplicated

A

treatment with h. pylori with PPI

49
Q

PPI is used for

A

8 to 12 weeks

50
Q

Complicated peptic ulcer what would you do

A

refer for gastroenterologist for edocopy and treatment for H. pylori

51
Q

When do you consider chronic supressive therapy with PPI or H2Ra

A

smokers >60, COPD, CAD, hx of bleeding or perforated ulcer, patients on NSAID

Nurs 5229 Clinical Pharmacotherapeutics (78 decks)

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