GI FINAL-PUD Flashcards

1
Q

Calcium Carbonate

A

Tums

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2
Q

Magnesium

Aluminum Carbonate

A

Mylanta, Rolaids

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3
Q

Magnesium
Aluminum
Simethicone

A

Maalox

Mylanta Classic

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4
Q

Sodium Bicarb

Aspirin

A

Alka-seltzer

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5
Q

Duration for Antacids

Onset for Antacids

A

30-60 minutes, doesnt require systemic absorption

O: 3-5 minutes

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6
Q

What is the dosing problem with Antacids?

A

Frequent dosing throughout the day, 4-6x

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7
Q

What does Magnesium cause?

A

Diarrhea

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8
Q

What does Aluminum cause?

A

Constipation

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9
Q

Side Effects of Antacids

A
Unpleasant taste
Constipation
Diarrhea
Bloating
Belching
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10
Q

Why would Antacids be problematic in Renal impairment?

A

Al+ and Mg+ accumulate

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11
Q

Famotidine

A

Pepcid

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12
Q

Ranitidine

A

Zantac

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13
Q

Cimetidine

A

Tagamet

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14
Q

Nizatidine

A

Axid

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15
Q

MOA of H2RA

A

Reversibly inhibits H2 receptors decreasing acid secretion

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16
Q

When should you take H2RAs?

A

30-60 minutes before meals

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17
Q

HR2A Dose adjustment based on CrCL

A

CrCL<30 Cimetidine
CrCl<50 Ranitidine
CrCl<60 Famitidine

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18
Q

H2RA that has QT Prolongation

A

Famotidine

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19
Q

H2RA that increases liver enzymes

A

Ranitidine

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20
Q

Cimetidine problems…

A

2C19 Inhibitor

SE: Gynecomastia, impotence, increase SCr

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21
Q

Important caution in H2RAs

A

CNS effects–>delirium, dementia, cognitive impairment

Increased confusion in severely ill or impaired

22
Q

Dexlansoprazole

A

Dexilant

23
Q

Esomeprazole

A

Nexium

24
Q

Lansoprazole

A

Prevacid

25
Q

Omeprazole

A

Prilosec

26
Q

Pantoprazole

A

Protonix

27
Q

Rabeprazole

A

Aciphex

28
Q

Omeprazole+ Sodium Bicarbonate

A

Zegerid

29
Q

MOA of PPI

A

Irreversible H+/K+ATPase Pump Inhibitor which blocks gastric acid secretion Most effective agents

30
Q

PPI that can cause SJS/TEN

A

IV Pantoprazole

31
Q

PPIs can cause what deficiencies

A

Hypomagnesemia

B12 Deficiency

32
Q

PPI that interacts with clopidogrel

A

Lansoprazole-Prevacid

33
Q

PPI that increases Liver enzymes

A

Nexium

34
Q

PPI that can help Nocturnal symptoms if taken at night…

A

Omeprazole + Sod Bicarb

ZEGERID

35
Q

Which PPIs should be taken 30-60 minutes before breakfast

A

Omeprazole
Pantoprazole
Rabeprazole

36
Q

PPI with minimal CYP450 Impact for intxns

A

Pantoprazole

37
Q

Colloidal Bismuth

A

Pepto-Bismol

38
Q

Carafate

A

Sucralfate

39
Q

MOA of Pepto-Bismol

A

Protective Layer & enhances mucous, bicard, and prostaglandin secretion

40
Q

MOA of Carafate

A

ACID: cross links to form sticky paste that sticks to everything. Inhibits pepsin-mediated breakdown of proteins in the ulcer.
ALSO-Stimulates PG and EGF*

41
Q

Should you take other meds with Carafate?

A

2 hours before or 4 hours after for some meds (Warfarin, Phenytoin, Digoxin, Thyroid hormone…)

42
Q

Misoprostol

A

Cytotec

43
Q

PGE1 Analog name and what it does

A

Misoprostol-Cytotec

Increases mucus secretion and bicarb

44
Q

Patient population you should be concerned giving Misoprostol

A

PREGGO

  • causes birth defects, premature birth
  • Dont give child bearing years without RELIABLE documented birth control
45
Q

4 types of Peptic Ulcers

A

H.Pylori
NSAIDs
Zolinger (ZES)
Stress

46
Q

H Pylori Treatments

A

Triple 14 day: PPI + Clarithromycin + Amoxicillin

Quad 10-14 day: PPI +bismuth subs+ tetracycline + metronidazole

47
Q

When to test for H Pylori eradication

A

4wk after ab completion and 1-2 week after PPI d/c

48
Q

How to tx HPylori thats resistant to Clarithromycin

A

PPI + Amoxicillin 1000mg BID 5days
THEN
PPI + Clarithromycin 500mg BID + Tinidazole 500mg BID 5days

49
Q

Drug option for failed HPylori tx

A

Rifabutin (MYCOBUTIN)

-used only after 1-2 failed normal regimens

50
Q

Lab values indicating Stress Ulcer Prophylaxis

A

Plts<50,000
INR>1.5
PTT>2xcontrol value

OR MECHANICAL VENT >48HRS