Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm > GI: GERD & PUD > Flashcards

GI: GERD & PUD Flashcards

1
Q

Pathophys of GERD (6)

A
  • decreased salivation
  • decreased basal LES pressure
  • LES relaxation
  • impaired esophageal clearance
  • dec acid clearance
  • delayed gastric emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Severity of GERD is related to:

A

amount of time esophagus is exposed to acid and pepsin

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

aggravating factors for GERD (6)

A 
diet
exercise
pregnancy
tight clothing
cigarettes
alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

substances which “cause” GERD

A 
nicpotine
iron
potassium
alcohol
narcotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

complications of GERD (4)

A

Erosive esophagitis
strictures
barrett’s esophagus
esophageal adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Peptic ulcer disease consists of

2

A

gastric ulcers

duodenal ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

duodenal ulcers may result from

A

h pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 common forms of PUD

A

H pylori
NSAID induced
stress related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

non pharm therapy for PUD

A

dietary change

lifestyle change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pharmacologic goals for PUD

A

eradicate h pylori
relieve pain
heal ulcers/erosions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how to “heal” ulcers and erosions of PUD

A

PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

step up management for PUD/GERD

A

treat with OTC antacids and escalate to rx H2 blockers and PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

step down treatment for PUD/GERD

A

starting with highest treatment and going down

Rx H2 blockers or PPI first, de escalate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when is metocloperamide prescribed for GERD?

A

only after confirmed diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

follow up for GERD/PUD

A

additional drugs and lifestyle changes like PPIs or misoprostol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MoA Antacids

3

A
  • neutralize acid by increasing intragastric pH
  • inhibits conversion of pepsinogen to pepsin
  • may also stimulate production of mucosal prostaglandins and LES tone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stimulating prostaglandins: antacids

A

protective to GI mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

types of antacids (4)

A

aluminum
magnesium
calcium
bismuth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

antacids for ulcers

A

symptomatic relief but do not provide healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

antacid suspensions vs pills

A

suspensions are better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

AE aluminum based antacid

A

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

AE of magnesium based antacid

A

diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

antacids decrease absorption of drugs which require

A

an acidic environment to work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

solution for antacid drug interactions

A

separate drugs and antacids by 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
aluminum plus magnesium
maalox | mylanta
26
calcium carbonate
tums
27
sodium bicarb / bismuth
peptic bismol
28
ae pepto bismol
black tongue | dark stool
29
antacid duration/dosing
quick onset, short duration, many doses per day
30
antacids in renal disease
watch for accumulation
31
histamine-2 receptor antagonists MoA
inhibit histamine receptors on parietal cells in stomach, decreasing secretion of H+ ions
32
MoA PPI
allow acid to be made but inhibit the final step of secretion by inhibiting H+/K+ ATPase on parietal cells
33
H2 blockers are 1st line for
mild to moderaste PUD or GERD
34
H2 blockers/PPI may be used for (6)
``` tx of ulcers maintenance of remission tx of h pylori tx of nsaid ulcers erosive/non erosive esophagitis PUD/GERD ```
35
h2 blockers or PPI for duodenal ulcer duration of therapy
4-8 wks
36
h2 blockers/PPI for gastric ulcers: duration of therapy
4-8 wks
37
h2 blockers/PPI for GERD: duration of therapy
8 weeks
38
monitoring parameters for h2 blockers (4)
relief of symptoms healing of ulceration adverse effects renal function
39
4 common h2 blockers
cimetidine nizatidine ranitidine famotidine
40
cimetidine interacts c
warfarin lidocaine theophylline
41
ranitidine interacts with
warfarin | diazepam
42
H2 blockers are first line for _, while PPIs are first line for _
h2: mild to mod PUD/GERD ppi: mod to severe PUD/GERD
43
patient teaching for PPI
do not chew or crush | take before 1st meal of day
44
risks in long term use of PPI
fractures hypomagnesemia c diff
45
short term risk of PPI
CAP
46
pt with osteoporosis who needs a PPI
limit dose/duration ensure adequate ca/vit d bone density screening
47
hypomagnesemia with PPIs
comes into play with patients who are on meds which also waste mag
48
PPI drug examples
``` dexlansoprazole lansoprazole omeprazole rabeprazole pantoprazole esomeprazole ```
49
safest PPI in terms of drug interactions
pantoprazole
50
common AE of PPIs (3)
nausea diarrhea HA
51
metoclopramide MoA
stimulates motility of upper GI and increases LES tone
52
metoclopramide increases
anal contractions and peristalsis
53
dosing time: metoclopramide
30 min before meals and sleep
54
AE of metoclopramide
``` galactorrhea diarrhea EPS depression drowsiness ```
55
metoclopramide is contraindicated with
parkinsons | bowel obstruction
56
monitoring for metoclopramide
renal function
57
metoclopramide interacts with
anti cholinergics MAOI levodopa
58
sucralfate MoA
promotes mucosal defenses by reacting with HCl in stomach to form a paste and bind to ulcer, allowing it to heal.
59
sucralfate does not
have acid-reducing capacity
60
sucralfate should be given as
adjunct, not on its own
61
NSAID induced ulcers
adverse effect related to inhibition of COX 1 or seen dose dependently with cox 2 inhibitors
62
cox sites
cox 1: GI, kidney | cox 2: inflammation sites
63
tx of nsaid induced ulcer
dc nsaid, start PPI or H2 blocker.
64
nsaid induced ulcer in the pt who needs to continue nsaid
use PPI and see if the NSAID can be changed to either celecoxib or meloxicam
65
prevention of NSAID induced ulcers:
misoprostol | PPI
66
using misopristol prophylactically is indicated for patients who are
> 60 y/o prior hx GIB high dose NSAID therapy receiving anticoags/steroids
67
MoA misoprostol
prostaglandin E1 analog stimulates production of mucous/HCO3 cytoprotective
68
AE misoprostol (4)
diarrhea abd pain spontaneous abortion postmenopausal bleeding
69
Misoprostol is CI in
women of childbearing age
70
h pylori and nsaid induced ulcers
tx of h pylori is recommended for pts taking NSAIDs who have ulcers and h pylori
71
tx of h pylori (2 options)
clarithromycin, amoxicillin, PPI clarithromycin, metronidazole, PPI depending on previous hx of macrolide exposure (resistance)
72
if you can't use clarithromycin in triple therapy, what are your next 3 options for h pylori tx?
bismuth quadruple therapy: bismuth, metronidazole, tetracycline, PPI concomitant: ppi/clarith/amox/metro levo triple therapy: PPI, levo, amoxicillin
73
bismuth quadruple therapy
bismuth/metro/tetra/ppi
74
concomitant therapy for h pylori in areas where clarithro resistance is high
PPI, clarithro, amox, metro
75
levo triple therapy for H pylori
PPI, levo, amox

Pharm (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions