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Pharmacology > GI/Hormones > Flashcards

GI/Hormones Flashcards

1
Q

PPI drugs

- best to treat H. Pylori and GERD

A

omeprazole (Prilosec)

pantoprazole (Protonix)

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2
Q

Omeprazole (Prilosec)

-longest acing drug to prevent secretion

A

very effective, slow onset, 2-3 weeks for it to work

MOA
- suppress acid secretion by irreversibly inhibit H, K-ATPase (enzyme that makes gastric secretions)

INDICATIONS
- PUD caused by NSAIDS

Given IV in ICU to prevent stress ulcers
-stress ulcers do NOT cause PUD only cushings and curlings

ADR:

  • HA, N/V/D
  • rebound acid hypersecretion
  • hypomagnesemia (tremors seen/dysrhythmias)
  • B12 deficiency (seen in neuropathies)
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3
Q

Omeprazole (Prilosec) should only be used no longer than __-__ weeks unless absolutely necessary.

A

6-12 weeks

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4
Q

Pantaprazole (Protonix)

A
  • PO or IV
  • last 24 hours
  • given in ICU to reduce risk of “stress ulcers”
  • powder, 40 mg/vial reconstituted for IV
  • given over 15 mins

ADR:

  • HA, Nausea, diarrhea
  • dyspepsia
  • diziness
  • hypomagnesemia
  • osteoporosis/fractures
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5
Q

H2 Receptor Antagonists (H2RA’s) drugs

  • both drugs equally effective
  • less effective than PPI’s
A

cimetidine (Tagamet)

ranitidine (Zantac)

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6
Q

Cimetidine (Tagamet) rare side-effects

A
  • confusion
  • hallucinations
  • CNS depression
  • CNS excitation
  • pneumonia
  • IV bolus causing hypotension/dysrhythmias
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7
Q

Ranitidine (Zantac) rare SE:

A
  • increase risk of pneumonia due to gastric pH elevation

- renal impairment

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8
Q

Metoclopramide (Reglan)

  • Dopamine antagonist drug
A
  • promotes gastric emptying (by increasing tone and motility of GI tract BY increasing actions of acetylcholine)
  • suppresses emesis by blocking dopamine and serotonin
  • given IV for N/V
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9
Q

Metoclopramide (Reglan) ADR

A 
tardive dyskinesia 
GI obstruction
perforation
hemorrhage
sedation and diarrhea
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10
Q

Effective antiulcer drug

A

Sucralfate (Carafate)

  • coats ulcer so acid does not eat ulcer
  • MOA: makes viscid, sticky gel that adheres to the crater surface and prevents acid from reaching area for about 6 hours
  • Drug interactions with abx, antifungal, anti-epilieptics, bronchodilators, thyroid medications

DO NOT give oral meds within 30 minutes

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11
Q

Antacids are ___ acting but ___ duration

A

FAST acting but SHORT duration

faster than PPIs and H2RAs

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12
Q

Antacids neutralize stomach acid providing relief, it does NOT heal. ___ heals.

A

PPIs (Prilosec)

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13
Q

_____ promotes diarrhea while _____ promotes constipation.

A

Maalox (magnesium) ; Mylanta (aluminum)

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14
Q

Avoid the use of Maalox/Mylanta in _____ patients due to high sodium content; would use ____.

A

Cardiac; riopan

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15
Q

Maalox/Mylanta administration

  • separate H2 blockers and antacids by 2 hours
A
  • tablets CHEWED thoroughly
  • glass of water or milk (preferred)
  • given 7 times/day after meals

*liquid formation (more effective) –> shake thoroughly

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16
Q

Surfactant laxative to soften stool

A

docusate (Colace)

17
Q

Stimulant laxative used for testing purposes

A

bisacodyl (DULCOLAX)

18
Q

Osmotic laxative used for procedures such as colonoscopy; or hepatic disease (increase in ammonia)

A

Lactulose

19
Q

Treatment of laxative abuse

A
  • ABRUPT CESSATION
  • increase activity, fiber, fluids
  • bowel training
20
Q

Anti-diarrheal Agents

A

diphenoxylate (Lomotil) *not on module

Loperamide (Imodium)

21
Q

Diphenoxylate (Lomotil) is an ____ anti-diarrheal agent that can cause MS like effects in high doses. Decreases intestinal motility and slowing of intestinal transit time. allows more absorption of fluid and electrolytes.

A

opioid

22
Q

Loperamide (Imodium)

A
  • structural analog of meperidine (Demerol)

- suppress bowel motility and can reduce volume of discharge in ileostomies

23
Q

Infectious diarrhea may need to be treated with ____

A

antibiotics

24
Q

Anti-emetic drugs ( 7 )

A 
Zofran (ondansetron)
Phenergan (Promethazine)
Metoclopramide (Reglan)
Scopolamine (transderm scop)
Alosetron (Lotronex)
Azulfidine (sulfasalazine)
Palifermin (kepivance)
25
Q

Zofran (Ondansetron)

A
  • 5-HT3 Antagonist (Serotonin)
  • N/V associated with CHEMOTHERAPY

ADR
-rare = tachycardia and angina (specific heart problems)

26
Q

Phenergan (Promethazine)

make sure to take BP, RESP, HR before administering

A
  • Dopamine antagonist
  • mainly used to reduce emesis with SURGERY, cancer chemo and other toxins

MOA:
- block dopamine 2 receptors in the CMZ

ADR:
- EPS (tardive dyskinesia, ataxia, anticholinergic effects, hypotensive)

27
Q

Metoclopramide (Reglan)

mainly used for CHEMO and ELDERLY not eating well

A
  • increase tone and motility of GI tract; for GERD, CINV, and diabetic gastroparesis

MOA

  • block dopamine receptors in CTZ
  • enhance actions of ACETYLCHOLINE
28
Q

Scopolamine (Transderm Scop)

**for AIR/SEA sickness*

A
  • Muscarinic antagonist (anti-cholinergic)

MOA
-suppress nerve traffic in neuronal pathway that connects vestibular apparatus of inner ear to the vomiting center

SE:
-anticholinergic effects (dry mouth, blurred vision, drowsiness, urinary retention, constipation)

ROUTE
-PO, transderm behind ear, SQ

29
Q

Scopolamine and Atropine can cause a _____ _____ so be careful with use.

A

Blown Pupil (extremely dilated)

30
Q

Alosetron (Lotronex) is a specific drug for _____ with ______ as the predominate symptom women.

A

IBS with diarrhea - irritable bowel syndrome

(b/c IBS can have both constipation or diarrhea)
-drug specific for DIARRHEA symptom

MOA
- increase transit time to promote stool movement, decrease abdominal pain, reduce secretions and increase absorption of water and sodium.

  • 5-HT3 serotonin receptor blocker
  • extensive metabolism by CP450 enzyme
31
Q

Azulfidine (sulfasalazine) is used for ____ and ____; most effective for acute episodes of ______ and beneficial for those who have _____.

A

IBD - inflammatory bowel disease
RA - rheumatoid arthritis
Ulcerative Colitis
Crohn’s

MOA
- reduce inflammation with the two compounds: 5-ASA and sulfapyrdidine

ADR

  • Fever
  • Rash
  • agranulocytosis
32
Q

Palifermin (Kepivance)

A
  • approved or oral mucositis (stomatitis) and decreasing incidence and duration of severe mucositis in patient with HEMATOLOGICAL malignancies with those receiving high doses of chemo and whole body irradiation.
  • synthetic form of human keratinocyte growth factor (KGF) – used in recombinant DNA tech

SE:

  • rash
  • taste distortion
  • erythema
  • rise of amylase and lopase
33
Q

Palifermin (Kepivance) should not be given in the same line as _____. Should be given ____ hours before or after chemo since it makes mucositis worse.

A

heparin

24 hrs

Pharmacology (17 decks)

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