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Pharmacology > GI DRUGS & Disorders > Flashcards

GI DRUGS & Disorders Flashcards

1
Q

Goal of tx for N/V :

A

Treat cause but often have to treat symptoms

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2
Q

For N/V, HX is critical. What are 5 essentials in getting a good HX?

A
  1. Onset
  2. PMH
  3. LMP(females)
  4. Appearance of emesis (coffee grounds or undigested food)
  5. recent bowel habits
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3
Q

N/V diagnostics :

A

X-ray
KUB
Ultrasound
labs: LFT’s

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4
Q

3 types of med can choose for N/V:

A
  1. Serotonin 5-HT Receptor antagonists (Zofran, Aloxi)
  2. Antidopaminergics
  3. Pepto
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5
Q

Causes of N/V:

A
  1. GI DISORDER: GERD, gastritis, constipation, pancreatitis, hepatitis
  2. Intracerebral / CNS / ⬆️ ICP
  3. Illness: microbial; H. Pylori
  4. Medications: Oc’s, antidepressants (like Celexa), antibiotics, chemo
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6
Q

How do the Serotonin 5 HT 3 receptor antagonists work (method of action/MOA)?

A

Selective 5-Ht3receptor antagonist, binds in both periphery and CNS, Reducing intestinal vagus nerve stimulation.
Not clear if result of CNS or peripheral antagonism.
blocks different NT than Compazine and Phenergan

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7
Q

Pharmacokinetics of 5ht receptor antagonists:

A 
Well absorbed po
Enhanced with food
SL And IV preps available
Metab via liver
70% protein bound
Excreted via urine
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8
Q

Name 2 5Ht receptor antagonists:

A

Zofran and Aloxi

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9
Q

Adverse effects of 5ht receptor antagonists:

A 
Headache
Diarrhea
Dizziness
Constipation **
QTprolongation **
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10
Q

5ht receptor antagonists

Contraindicated in:

A

Congenital Long QT syndrome

Allergy

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11
Q

Who might not tolerate Zofran due to the side effect of constipation?

A

A pregnant pt with morning sickness

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12
Q

Pepto bismol (Bismuth Subsalicylate): MOA

A

= a derivative of salicylic acid, related to aspirin

  • works to ⬇️ GI irritation&raquo_space; ⬇ ️nausea
  • also antidiarrheal properties / reduces bowel irritation (weak bacteriocidal activities for infectious diarrhea )
  • also antacid properties
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13
Q

Pharmacokinetics Pepto Bismol:

A

Bismuth poorly absorbed but coats ulcers well
Subsalicylate hydrolyzed in stomach to salicylate
Bismuth is excreted in stool ** Can CAUSE BLACK STOOLS!**
Sub salicylate excreted in urine as salicylate

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14
Q

Side effects of PeptoBismol

A

Nausea
Constipation
Discolored tongue
Black stools

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15
Q

Contraindications for Pepto Bismol

A

Pediatrics (risk of Reye Syndrome)

Allergy

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16
Q

Phenothiazines: Phenergan, Compazine

A

MOA

  • antidopaminergic / blocks dopamine receptors in brain thus blocking vagus nerve in GI tract
  • Phenergan also has antihistamine effect on H 1 receptors
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17
Q

Phenothiazine

Pharmacokinetics / pharmacodynamics

A

Metabolized by liver

Excreted in stool

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18
Q

Side effects of phenothiazine

A

Sedation, dizziness, mood changes,constipation

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19
Q

Contraindications of Phenothiazines

A

Allergy
Severe HTN
BPH
PTS

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20
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

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21
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

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22
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

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23
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
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24
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

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25
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
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26
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

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27
Q

Antacids: adverse effects

A

N/V, constipation, dependence

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28
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

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29
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

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30
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

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31
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

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32
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

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33
Q

Carafate pregnancy category:

A

B ( off label for peds)

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34
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

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35
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
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36
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

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37
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

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38
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

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39
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

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40
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
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41
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

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42
Q

PPI’s: contraindications

A

Allergy

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43
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

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44
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

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45
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

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46
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

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47
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

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48
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

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49
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

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50
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

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51
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

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52
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

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53
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

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54
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

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55
Q

Reglan: adverse effects

A 
EPS secondary to dopamine blockade;
Elevated prolactin;
Galactorrhea;
GYNECOMASTIA 😜
Irreversible tardiness dyskinesia
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56
Q

Contraindications in Reglan

A

Allergy

Concurrent use of drugs capable of causing EPS/TD

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57
Q

Reglan in pregnancy and breastfeeding?

A

Safe in pregnancy; off-label use in peds; not safe in breast feeding

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58
Q

Other thoughts about Reglan and drug / drug interactions:

A

Do not use Reglan and Compazine together related to both act on dopamine receptors

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59
Q

Constipation fun facts

A

= decreased passage of stool, straining, pellet-like stools,unable to pass
Causes can be related to MEDS, MEALS, Or METS (side effects, diet, tumors)
**MIRAlax= first line of TX

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60
Q

Even funner diarrhea facts

A 
= loose liquid stools / defined as 3 + / day
Causes:
Infections
Meds
Inflammatory bowel diseases
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61
Q

Antidiarrheals: opioid agonists
(Loperamide /Immodium)
MOA?

A

Slows intestinal motility through opioid receptor activation, also reduces fecal volume and increases viscosity

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62
Q

Antidiarrheal

Pharmacokinetics

A
  • little po absorption
  • significant first pass metab**
  • excreted in stool
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63
Q

Adverse effects of antidiarrheals:

A

Fatigue, dizziness, constipation, nausea

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64
Q

Contraindications for antidiarrheals:

A

High fever
Bloody diarrhea
Acute UC flare
Age les than 2 yo

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65
Q

Pregnancy and antidiarrheals?

A

Safe in pregnancy unknown if distributed in breastmilk

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66
Q

Irritable Bowel Syndrome Basics

A

= functional GI DISORDER; no identifiable causes
»Dx of exclusion, once other GI problems ruled out
3 types:
1. Diarrhea -predominant
2. Constipation-predominant
3. Mixed
Tx» often lifestyle modifications, but some meds available

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67
Q

Meds for Irritable Bowel Syndrome

A
  1. Antispasmodics

2. 5HT3 antagonists

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68
Q

Antispasmodics for Irritable Bowel Syndrome:

MOA?

A

Dicyclomine, hyoscyamine
“Levsin”* can be used in all 3 presentations of IBS!*
-inhibits cholinergic receptors on smooth muscle
-not specific to GI smooth muscle so at high doses have significant anti cholinergic side effects (dry mouth, dry mucous, urinary retention…it is NON selective)

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69
Q 
5HT3 antagonist (Alosetron/ Lotronex) 
MOA?
A

Modulates enteric nervous system slows GI activity

for diarrhea-predominant IBS ONLY

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70
Q

Inflammatory Bowel Disease:

What two diseases make up this category?

A
  1. Crohn’s Disease “TOP TO BOTTOM” can affect any portion of GI TRACT
  2. Ulcerative Colitis (COLON ONLY)
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71
Q

What is the first line of TX For Inflammatory Bowel Disease?

A

Steroid

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72
Q

For inflammatory bowel disease, remission maintenance meds =

A

First line is Aminosalicylates;

immunomodulators becoming popular because may allow pt to avoid a steroid

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73
Q

For Inflammatory Bowel- acute phase med & MOA

A

GLUCOCORTICOIDS FOR ACUTE FLARE
MOA= anti-inflammatory corticosteroids, reduces inflammation by suppressing migration of polymorphonuclear leukocyte so, decreases prostaglandin synthesis

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74
Q

Glucocorticoid-

Pharmacokinetics

A
  • not well absorbed, Enterocort has max 21% bioavailability
  • metabolized extensively in liver
  • excreted in urine
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75
Q

Glucocorticoid

Adverse effects

A

H/A, N/V

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76
Q

Contraindications

Glucocorticoid

A

Allergy

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77
Q

Glucocorticoids in Irritable Bowel Syndrome:

What phase again?

A

ACUTE PHASE NOT FOR DISEASE REMISSION

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78
Q

Enterocort- 2 facts:

A
  1. High fat meal will delay Enterocort absorption

2. Rectal preparations are the first line for UC FLARE

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79
Q

Inflammatory Bowel Disease:

Maintenance meds are called- and MOA-

A

sulfasalazine (Azulfidine), mesalamine (ASACOL! ☎️! Your ass is calling!), balsalazide (Cozaal)
MOA is uncertain with these meds but thought to block prostaglandin synthesis,may also inhibit cellular functions of NK Cells, mucosal lymphocytes and macrophages

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80
Q

Aminosalicylates

Pharmacokinetics

A

Well absorbed in small intestine but not much colonic absorption
Up to 78% protein bound
Metab via liver
Excreted via stool

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81
Q

Aminosalicylates

Adverse effects

A

nausea, GI upset, H/A, bone marrow suppression ( leukopenia, anemia, thrombocytopenia)

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82
Q

Given that Aminosalicylates can cause bone marrow suppression, how can a provider determine if this is a med-related adverse event?

A

Establish a timeline- when started drug RX vs. when abnormal labs began

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83
Q

Inflammatory Bowel Disease: meds,MOA

A

Azathioprine (imuran), 6-MP (purinethol)
MOA: leads to immunocompromise, reduces immune response. Does this by blocking synthesis of purine, which then hinders DNA, RNA, and protein synthesis in fast growing cells like lymphocytes

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84
Q

Purine Analogs: pharmacokinetics

A

Imuran better absorbed than 6 MP
APPROX 30% protein bound
Metab via liver
Excreted via urine

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85
Q

Purine Analogs: adverse effects

A

PANCYTOPENIA, infection, hepatotoxicity, pancreatitis

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86
Q

Purine Analogs: contraindications

A

Pregnancy, breastfeeding;

Active malignancy

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87
Q

Long term use of purine analogs can lead to

A

Malignancies, especially lymphoma

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88
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

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89
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

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90
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

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91
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
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92
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

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93
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
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94
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

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95
Q

Antacids: adverse effects

A

N/V, constipation, dependence

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96
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

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97
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

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98
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

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99
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

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100
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

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101
Q

Carafate pregnancy category:

A

B ( off label for peds)

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102
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
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1
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2
3
4
5
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104
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

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1
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3
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5
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105
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

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106
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

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107
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
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109
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

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110
Q

PPI’s: contraindications

A

Allergy

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111
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

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1
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2
3
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112
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

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113
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

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114
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

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115
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

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116
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

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117
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

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118
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

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119
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

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120
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

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121
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
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2
3
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122
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

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3
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5
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123
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
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124
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

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1
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2
3
4
5
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125
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
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2
3
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5
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126
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
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5
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127
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
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2
3
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129
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

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130
Q

Antacids: adverse effects

A

N/V, constipation, dependence

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131
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

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132
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
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2
3
4
5
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133
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

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134
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

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1
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2
3
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5
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136
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
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137
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

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1
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2
3
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5
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141
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
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2
3
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5
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142
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

PPI’s: contraindications

A

Allergy

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1
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2
3
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5
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146
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
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149
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
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2
3
4
5
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150
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
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151
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
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154
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
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155
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
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165
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
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166
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
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171
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
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172
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
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181
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
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201
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
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202
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
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2
3
4
5
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203
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

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204
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

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2
3
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5
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205
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

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206
Q

Carafate pregnancy category:

A

B ( off label for peds)

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207
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
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2
3
4
5
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209
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
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2
3
4
5
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210
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

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211
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

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5
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212
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
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2
3
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5
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215
Q

PPI’s: contraindications

A

Allergy

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216
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
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217
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
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2
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5
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218
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

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2
3
4
5
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219
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

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2
3
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5
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220
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

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221
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
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2
3
4
5
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222
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

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1
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3
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223
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

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224
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

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225
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

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2
3
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226
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
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227
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
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2
3
4
5
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228
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
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230
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
231
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
232
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
233
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
234
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

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1
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2
3
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235
Q

Antacids: adverse effects

A

N/V, constipation, dependence

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1
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2
3
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5
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236
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
237
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
238
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
239
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
240
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
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241
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
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242
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
243
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
244
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
245
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
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246
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
247
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
248
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
249
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
250
Q

PPI’s: contraindications

A

Allergy

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1
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2
3
4
5
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251
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
252
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
253
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
254
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
255
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
256
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
257
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
258
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
259
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
260
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
261
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
262
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
263
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
264
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
265
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
266
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
267
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
268
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
269
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
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270
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
271
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
272
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
273
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
274
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
275
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
276
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
277
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
278
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
279
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
280
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
281
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
282
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
283
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
284
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
285
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
286
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
287
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
288
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
289
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
290
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
291
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
292
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
293
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
294
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
295
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
296
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
297
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
298
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
299
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
300
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
301
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
302
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
303
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
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304
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

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305
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
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2
3
4
5
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306
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
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307
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
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308
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

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1
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2
3
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5
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309
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

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2
3
4
5
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310
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

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311
Q

Carafate pregnancy category:

A

B ( off label for peds)

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312
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
313
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
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314
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
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2
3
4
5
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315
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

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316
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

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5
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317
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
318
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
319
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
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2
3
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5
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320
Q

PPI’s: contraindications

A

Allergy

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321
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
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322
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
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2
3
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5
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323
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

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2
3
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5
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324
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
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2
3
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5
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325
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

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5
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326
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
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2
3
4
5
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327
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

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1
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3
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5
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328
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

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329
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

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330
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

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1
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2
3
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5
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331
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
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332
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
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2
3
4
5
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333
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
334
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
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335
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
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336
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
337
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
338
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
339
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
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340
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
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341
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
342
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
343
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
344
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
345
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
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346
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
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347
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
348
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
349
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
350
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
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351
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
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2
3
4
5
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352
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
353
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
354
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
355
Q

PPI’s: contraindications

A

Allergy

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1
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2
3
4
5
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356
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
357
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
358
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
359
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
360
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
361
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
362
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
363
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
364
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
365
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
366
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
367
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
368
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
369
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
370
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
371
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
372
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
373
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
374
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
375
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
376
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
377
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
378
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
379
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
380
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
381
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
382
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
383
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
384
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
385
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
386
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
387
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
388
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
389
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
390
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
391
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
392
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
393
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
394
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
395
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
396
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
397
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
398
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
399
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
400
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
401
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
402
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
403
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
404
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
405
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
406
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
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3
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5
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407
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
408
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
409
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

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1
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2
3
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410
Q

Antacids: adverse effects

A

N/V, constipation, dependence

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1
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2
3
4
5
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411
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
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412
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
413
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
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2
3
4
5
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414
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
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2
3
4
5
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415
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

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1
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416
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
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2
3
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5
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417
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
418
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
419
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
420
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

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1
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2
3
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5
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421
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
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2
3
4
5
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422
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
423
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
424
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
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425
Q

PPI’s: contraindications

A

Allergy

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2
3
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5
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426
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
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427
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
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2
3
4
5
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428
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

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1
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2
3
4
5
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429
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
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2
3
4
5
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430
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

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1
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2
3
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5
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431
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
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432
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

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1
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3
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5
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433
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

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2
3
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5
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434
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

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1
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3
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5
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435
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
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2
3
4
5
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436
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
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437
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
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438
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
439
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
440
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
441
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
442
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
443
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
444
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
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445
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
446
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
447
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
448
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
449
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
450
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
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451
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
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452
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
453
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
454
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
455
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
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456
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
457
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
458
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
459
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
460
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
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461
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
462
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
463
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
464
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
465
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
466
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
467
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
468
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
469
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
470
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
471
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
472
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
473
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
474
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
475
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
476
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
477
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
478
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
479
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
480
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
481
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
482
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
483
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
484
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
485
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
486
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
487
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
488
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
489
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
490
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
491
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
492
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
493
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
494
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
495
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
496
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
497
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
498
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
499
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
500
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
501
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
502
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
503
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
504
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
505
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
506
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
507
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
508
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
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509
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
510
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
511
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
512
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
513
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
514
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
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515
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
516
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
517
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
518
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
519
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
520
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
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521
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
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522
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
523
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
524
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
525
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
526
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
527
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
528
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
529
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
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530
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
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531
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
532
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
533
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
534
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
535
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
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536
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
537
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
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538
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
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539
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
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540
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
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541
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
542
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
543
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
544
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
545
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
546
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
547
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
548
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
549
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
550
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
551
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
552
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
553
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
554
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
555
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
556
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
557
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
558
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
559
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
560
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
561
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
562
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
563
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
564
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
565
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
566
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
567
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
568
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
569
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
570
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
571
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
572
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
573
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
574
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
575
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
576
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
577
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
578
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
579
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
580
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
581
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
582
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
583
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
584
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
585
Q

Antacids: adverse effects

A

N/V, constipation, dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
586
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
587
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
588
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
589
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
590
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
591
Q

Carafate pregnancy category:

A

B ( off label for peds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
592
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
593
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
594
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
595
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
596
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
597
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
598
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
599
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
600
Q

PPI’s: contraindications

A

Allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
601
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
602
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
603
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
604
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
605
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
606
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
607
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
608
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
609
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

610
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

611
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

612
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

613
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

614
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

615
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

616
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
617
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

618
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
619
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

620
Q

Antacids: adverse effects

A

N/V, constipation, dependence

621
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

622
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

623
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

624
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

625
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

626
Q

Carafate pregnancy category:

A

B ( off label for peds)

627
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

628
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
629
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

630
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

631
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

632
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

633
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
634
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

635
Q

PPI’s: contraindications

A

Allergy

636
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

637
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

638
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

639
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

640
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

641
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

642
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

643
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

644
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

645
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

646
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

647
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

648
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

649
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

650
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

651
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
652
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

653
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
654
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

655
Q

Antacids: adverse effects

A

N/V, constipation, dependence

656
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

657
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

658
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

659
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

660
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

661
Q

Carafate pregnancy category:

A

B ( off label for peds)

662
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

663
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
664
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

665
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

666
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

667
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

668
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
669
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

670
Q

PPI’s: contraindications

A

Allergy

671
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

672
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

673
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

674
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

675
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

676
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

677
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

678
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

679
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

680
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

681
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

682
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

683
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

684
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

685
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

686
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
687
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

688
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
689
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

690
Q

Antacids: adverse effects

A

N/V, constipation, dependence

691
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

692
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

693
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

694
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

695
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

696
Q

Carafate pregnancy category:

A

B ( off label for peds)

697
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

698
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
699
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

700
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

701
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

702
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

703
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
704
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

705
Q

PPI’s: contraindications

A

Allergy

706
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

707
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

708
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

709
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

710
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

711
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

712
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

713
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

714
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

715
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

716
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

717
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

718
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

719
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

720
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

721
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
722
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

723
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
724
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

725
Q

Antacids: adverse effects

A

N/V, constipation, dependence

726
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

727
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

728
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

729
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

730
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

731
Q

Carafate pregnancy category:

A

B ( off label for peds)

732
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

733
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
734
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

735
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

736
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

737
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

738
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
739
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

740
Q

PPI’s: contraindications

A

Allergy

741
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

742
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

743
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

744
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

745
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

746
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

747
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

748
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

749
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

750
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

751
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

752
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

753
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

754
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

755
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

756
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
757
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

758
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
759
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

760
Q

Antacids: adverse effects

A

N/V, constipation, dependence

761
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

762
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

763
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

764
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

765
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

766
Q

Carafate pregnancy category:

A

B ( off label for peds)

767
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

768
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
769
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

770
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

771
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

772
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

773
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
774
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

775
Q

PPI’s: contraindications

A

Allergy

776
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

777
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

778
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

779
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

780
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

781
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

782
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

783
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

784
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

785
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

786
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

787
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

788
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

789
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

790
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

791
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
792
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

793
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
794
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

795
Q

Antacids: adverse effects

A

N/V, constipation, dependence

796
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

797
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

798
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

799
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

800
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

801
Q

Carafate pregnancy category:

A

B ( off label for peds)

802
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

803
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
804
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

805
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

806
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

807
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

808
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
809
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

810
Q

PPI’s: contraindications

A

Allergy

811
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

812
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

813
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

814
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

815
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

816
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

817
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

818
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

819
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

820
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

821
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

822
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

823
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

824
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

825
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

826
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
827
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

828
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
829
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

830
Q

Antacids: adverse effects

A

N/V, constipation, dependence

831
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

832
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

833
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

834
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

835
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

836
Q

Carafate pregnancy category:

A

B ( off label for peds)

837
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

838
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
839
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

840
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

841
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

842
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

843
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
844
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

845
Q

PPI’s: contraindications

A

Allergy

846
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

847
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

848
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

849
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

850
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

851
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

852
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

853
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

854
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

855
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

856
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

857
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

858
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

859
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

860
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

861
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
862
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

863
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
864
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

865
Q

Antacids: adverse effects

A

N/V, constipation, dependence

866
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

867
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

868
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

869
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

870
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

871
Q

Carafate pregnancy category:

A

B ( off label for peds)

872
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

873
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
874
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

875
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

876
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

877
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

878
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
879
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

880
Q

PPI’s: contraindications

A

Allergy

881
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

882
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

883
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

884
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

885
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

886
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

887
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

888
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

889
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

890
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

891
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

892
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

893
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

894
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

895
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

896
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
897
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

898
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
899
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

900
Q

Antacids: adverse effects

A

N/V, constipation, dependence

901
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

902
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

903
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

904
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

905
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

906
Q

Carafate pregnancy category:

A

B ( off label for peds)

907
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

908
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
909
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

910
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

911
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

912
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

913
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
914
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

915
Q

PPI’s: contraindications

A

Allergy

916
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

917
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

918
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

919
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

920
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

921
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

922
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

923
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

924
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

925
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

926
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

927
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

928
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

929
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

930
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

931
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
932
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

933
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
934
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

935
Q

Antacids: adverse effects

A

N/V, constipation, dependence

936
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

937
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

938
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

939
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

940
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

941
Q

Carafate pregnancy category:

A

B ( off label for peds)

942
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

943
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
944
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

945
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

946
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

947
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

948
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
949
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

950
Q

PPI’s: contraindications

A

Allergy

951
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

952
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

953
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

954
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

955
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

956
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

957
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

958
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

959
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

960
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

961
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

962
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

963
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

964
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

965
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

966
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
967
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

968
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
969
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

970
Q

Antacids: adverse effects

A

N/V, constipation, dependence

971
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

972
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

973
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

974
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

975
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

976
Q

Carafate pregnancy category:

A

B ( off label for peds)

977
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

978
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
979
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

980
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

981
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

982
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

983
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
984
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

985
Q

PPI’s: contraindications

A

Allergy

986
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

987
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

988
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

989
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

990
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

991
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

992
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

993
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

994
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

995
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

996
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

997
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

998
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

999
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1000
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1001
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1002
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1003
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1004
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1005
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1006
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1007
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1008
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1009
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1010
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1011
Q

Carafate pregnancy category:

A

B ( off label for peds)

1012
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1013
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1014
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1015
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1016
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1017
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1018
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1019
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1020
Q

PPI’s: contraindications

A

Allergy

1021
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1022
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1023
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1024
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1025
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1026
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1027
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1028
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1029
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1030
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1031
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1032
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1033
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1034
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1035
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1036
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1037
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1038
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1039
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1040
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1041
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1042
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1043
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1044
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1045
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1046
Q

Carafate pregnancy category:

A

B ( off label for peds)

1047
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1048
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1049
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1050
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1051
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1052
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1053
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1054
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1055
Q

PPI’s: contraindications

A

Allergy

1056
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1057
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1058
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1059
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1060
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1061
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1062
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1063
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1064
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1065
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1066
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1067
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1068
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1069
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1070
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1071
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1072
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1073
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1074
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1075
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1076
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1077
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1078
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1079
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1080
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1081
Q

Carafate pregnancy category:

A

B ( off label for peds)

1082
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1083
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1084
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1085
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1086
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1087
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1088
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1089
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1090
Q

PPI’s: contraindications

A

Allergy

1091
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1092
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1093
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1094
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1095
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1096
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1097
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1098
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1099
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1100
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1101
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1102
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1103
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1104
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1105
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1106
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1107
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1108
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1109
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1110
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1111
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1112
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1113
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1114
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1115
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1116
Q

Carafate pregnancy category:

A

B ( off label for peds)

1117
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1118
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1119
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1120
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1121
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1122
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1123
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1124
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1125
Q

PPI’s: contraindications

A

Allergy

1126
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1127
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1128
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1129
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1130
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1131
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1132
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1133
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1134
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1135
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1136
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1137
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1138
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1139
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1140
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1141
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1142
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1143
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1144
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1145
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1146
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1147
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1148
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1149
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1150
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1151
Q

Carafate pregnancy category:

A

B ( off label for peds)

1152
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1153
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1154
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1155
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1156
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1157
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1158
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1159
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1160
Q

PPI’s: contraindications

A

Allergy

1161
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1162
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1163
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1164
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1165
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1166
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1167
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1168
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1169
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1170
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1171
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1172
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1173
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1174
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1175
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1176
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1177
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1178
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1179
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1180
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1181
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1182
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1183
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1184
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1185
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1186
Q

Carafate pregnancy category:

A

B ( off label for peds)

1187
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1188
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1189
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1190
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1191
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1192
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1193
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1194
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1195
Q

PPI’s: contraindications

A

Allergy

1196
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1197
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1198
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1199
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1200
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1201
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1202
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1203
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1204
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1205
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1206
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1207
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1208
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1209
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1210
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1211
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1212
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1213
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1214
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1215
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1216
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1217
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1218
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1219
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1220
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1221
Q

Carafate pregnancy category:

A

B ( off label for peds)

1222
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1223
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1224
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1225
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1226
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1227
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1228
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1229
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1230
Q

PPI’s: contraindications

A

Allergy

1231
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1232
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1233
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1234
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1235
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1236
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1237
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1238
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1239
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1240
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1241
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1242
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1243
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1244
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1245
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1246
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1247
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1248
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1249
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1250
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1251
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1252
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1253
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1254
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1255
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1256
Q

Carafate pregnancy category:

A

B ( off label for peds)

1257
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1258
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1259
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1260
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1261
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1262
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1263
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1264
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1265
Q

PPI’s: contraindications

A

Allergy

1266
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1267
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1268
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1269
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1270
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1271
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1272
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1273
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1274
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1275
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1276
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1277
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1278
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1279
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1280
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1281
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1282
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1283
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1284
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1285
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1286
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1287
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1288
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1289
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1290
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1291
Q

Carafate pregnancy category:

A

B ( off label for peds)

1292
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1293
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1294
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1295
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1296
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1297
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1298
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1299
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1300
Q

PPI’s: contraindications

A

Allergy

1301
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1302
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1303
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1304
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1305
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1306
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1307
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1308
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1309
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1310
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1311
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1312
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1313
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1314
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1315
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1316
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1317
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1318
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1319
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1320
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1321
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1322
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1323
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1324
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1325
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1326
Q

Carafate pregnancy category:

A

B ( off label for peds)

1327
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1328
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1329
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1330
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1331
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1332
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1333
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1334
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1335
Q

PPI’s: contraindications

A

Allergy

1336
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1337
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1338
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1339
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1340
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1341
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1342
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1343
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1344
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1345
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1346
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1347
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1348
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1349
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1350
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1351
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1352
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1353
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1354
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1355
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1356
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1357
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1358
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1359
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1360
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1361
Q

Carafate pregnancy category:

A

B ( off label for peds)

1362
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1363
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1364
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1365
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1366
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1367
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1368
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1369
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1370
Q

PPI’s: contraindications

A

Allergy

1371
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1372
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1373
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1374
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1375
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1376
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1377
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1378
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1379
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1380
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1381
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1382
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1383
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1384
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1385
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1386
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1387
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1388
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1389
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1390
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1391
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1392
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1393
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1394
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1395
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1396
Q

Carafate pregnancy category:

A

B ( off label for peds)

1397
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1398
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1399
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1400
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1401
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1402
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1403
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1404
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1405
Q

PPI’s: contraindications

A

Allergy

1406
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1407
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1408
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1409
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1410
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1411
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1412
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1413
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1414
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1415
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1416
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1417
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1418
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1419
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1420
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1421
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1422
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1423
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1424
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1425
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1426
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1427
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1428
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1429
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1430
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1431
Q

Carafate pregnancy category:

A

B ( off label for peds)

1432
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1433
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1434
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1435
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1436
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1437
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1438
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1439
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1440
Q

PPI’s: contraindications

A

Allergy

1441
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1442
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1443
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1444
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1445
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1446
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1447
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1448
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1449
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1450
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1451
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1452
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1453
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1454
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1455
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1456
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1457
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1458
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1459
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1460
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1461
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1462
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1463
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1464
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1465
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1466
Q

Carafate pregnancy category:

A

B ( off label for peds)

1467
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1468
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1469
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1470
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1471
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1472
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1473
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1474
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1475
Q

PPI’s: contraindications

A

Allergy

1476
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1477
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1478
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1479
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1480
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1481
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1482
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1483
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1484
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1485
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1486
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1487
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

1488
Q

Acid Reflux/ Gastritis:

prevalence, probable causes?

A

Very prevalent (10%) US pop
Several probable causes:
1. Transient lower esophageal sphincter relaxtion
2. Low resting lower esophageal sphincter
3. Poor esophageal acid clearance
4. Defects in esophagastric motility
5. Impaired mucosal resistance and over protective defenses

1489
Q

Descriptions and symptoms of gastritis

A

Burning sensation, nausea, chest pain, or globus (broad) sensation.
* can be very much like an MI ; differentiating SX - SOB, diaphoresis

1490
Q

Other contributing factors to gastritis?

A

Intake of acidic foods; treatment begins with removing these offenders / lifestyle modifications then mess

1491
Q

4 Types acid reflux/ gastritis meds

A
  1. Antacids
  2. Carafate
  3. H2 receptor antagonists
  4. PPI’s
1492
Q

Antacids: sodium bicarbonate, calcium carbonate, magnesium hydroxide, aluminum hydroxide
MOA?

A

These are weak bases that fact with gastric acid to form a salt and water, therefore decreasing gastric acidity

1493
Q

Pharmokinetics/ dynamics of antacids

A
  • Some po absorption; 25-35 % availability
  • bicarbonate preps (bioavailability) improves with food bu hydroxide preparations poorly absorbed
  • carbonate excreted via stool
  • aluminum and mag excreted via urine
1494
Q

Pregnancy category of antacids

A

B, safe for breastfeeding as well

1495
Q

Antacids: adverse effects

A

N/V, constipation, dependence

1496
Q

Contraindications for taking antacids:

A

Renal Failure (for those with aluminum and magnesium) - ie, the re ally excreted ones

1497
Q

Carafate: MOA

A

Positively charged sucrose sulfate binds to negatively charged proteins in base of ulcers, forms an ADHERENT/ PROTECTIVE barrier from gastric acids and bile salts

1498
Q

Carafate: pharmacokinetics

A
  • very little absorption, so not metabolized

- excreted in stool

1499
Q

Carafate: adverse effects

A

CONSTIPATION! Gotta love it!

1500
Q

Contraindications for use of Carafate-

A

Allergy; may use with caution with other meds… Can affect absorption

1501
Q

Carafate pregnancy category:

A

B ( off label for peds)

1502
Q

H2 receptor antagonists: Zantac, Pepcid, Tagamet

MOA?

A

Competitive inhibitors of H2 receptors in gastric parietal cells causing a decrease in gastric acid. No H1 or H3 efficacy (therefore not sedating).

1503
Q

H2 receptor antagonists: pharmacokinetics

A
  • good po absorption
  • metabolized via liver
  • excreted in urine
1504
Q

H2 receptor antagonists

Adverse Effects

A

H/A, dizziness, confusion in elderly,

…..GYNECOMASTIA (for real!?!?!)

1505
Q

H2 receptor antagonists- contraindications

A

Potent P450 inhibitor!

Use Tagamet with caution in elderly

1506
Q

Pregnancy category for H2 receptor antagonists

A

B - also safe in peds

1507
Q

Proton Pump Inhibitors- Prilosec / omeprazole, Prevacid / lansoprazole, Protonix / pantoprazole, Nexium/ esomeprazole
MOA?

A

Binds irreversibly to H+/ K+ exchanging ATPase pumps (proton pumps) in gastric parietal cells, decreasing both basal and stimulated gastric acid secretion

1508
Q

PPI’s: pharmacokinetics/ dynamics

A
  • PRODRUG: must survive the acidic environment of stomach to be absorbed into small bowel
  • all have fairly good bioavailability, decreased with po intake
  • metab in liver / inhibits CYP2C19
  • excreted in stool; dose-adjust for hepatic disease
  • little renal excretion
1509
Q

PPI’s: adverse effects

A

H/A, diarrhea, constipation, nausea, increased risk C. diff infection, ⬇️Mg with prolonged use,
⬆️ risk osteoporosis-related fractures with prolonged use

1510
Q

PPI’s: contraindications

A

Allergy

1511
Q

Types of laxatives:

A
  1. Bulk (Metamucil, fibercon)

2. Osmotic laxatives ( milk of mag, lactulose, mg citrate, polyethylene glycol (miralax)

1512
Q

Osmotic laxatives MOA:

A

Causes water retention in stool; soluble but no absorbable compounds

1513
Q

Pharmacokinetics of osmotic laxatives

A

NO PO absorption/ excreted in stool unchanged

1514
Q

Adverse effects of osmotic laxatives:

A

Diarrhea

abdominal complaints

1515
Q

Contraindications of osmotic laxatives:

A
  • Existing electrolyte abnormality

- Age under 2 yo

1516
Q

Osmotic laxatives: great option for long or short term relief?

A

No adverse effects shown up to 12 months of daily use

1517
Q

Bulk laxatives - MOA?

Pharmacokinetics

A

Absorb water and enlarge stools which stimulates propulsive movement through the lower GI tract
-no po absorption; excreted through stool as unchanged drug

1518
Q

Adverse effects of bulk laxatives:

A

N/V, abdominal fullness

1519
Q

Contraindications of bulk laxatives:

A

Bowel obstruction, under age of 6

1520
Q

Pregnancy Category bulk laxatives

A

B; safe in pregnancy and breastfeeding

1521
Q

Gastric motility agent (Metoclopramide/ Reglan) MOA

A

Binds to dopamine D2 receptors in CNS, as well as some 5-HT3 antagonism: gastric motility is caused by the D2 antagonism

1522
Q

Reglan: pharmacokinetics

A

Well-absorbed PO, 65-90% bioavailability
Metabolized via liver
Excreted via urine (decrease dose in renal insufficiency

Pharmacology (17 decks)

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