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Advanced Pharm Exam 4 > gi meds > Flashcards

gi meds Flashcards

1
Q

promethazine, prochlorperazine MOA

A

phenothiazines

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2
Q

phenothiazines AEs

A

sedation, hTN, EPS, QT prolongation

promethazine - extravasation (admin slow!)

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3
Q

ondansetron, granisetron, palnosetron MOA

A

serotonin-3 receptor antagonist

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4
Q

serotonin-3 receptor antagonist AEs

A

QT prolongation

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5
Q

fosaprepitant MOA

A

substance P/neurokinin 1 antagonist

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6
Q

hydroxyzine, meclizine, dimenhydrinate MOA

A

h-1 receptor antagonist

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7
Q

histamine-1 receptor antagonist AEs

A

anticholinergic

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8
Q

scopolamine MOA

A

muscarinic receptor antagonist

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9
Q

scopolamine AEs

A

anticholinergic

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10
Q

scopolamine AEs

A

anticholinergic

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11
Q

loperamide, diphenoxylate/atropine, opium tincture MOA

A

antipropulsives

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12
Q

antipropulsives AEs

A

loperamide - consitpation, toxic megacolon

diphenosylate/atropine - anticholinergic AE, abuse potential

tincture - constipation, confusion, sedation, urinary retention, dependence, miosis

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13
Q

who is tegasterod approved for?

A

women <65 due to risk of serious CV events

for IBS-c

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14
Q

what are tegaserod and prucalopride used for?

A

IBS-C

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15
Q

lubprostone MOA

A

chloride channel activator

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16
Q

lubiprostone AE

A

diarrhea

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17
Q

linaclotide, plecanatide MOA

A

guanlyate cyclase receptor agonist

used for IBS-C

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18
Q

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A

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19
Q

alosetron MOA

A

serotonin-3 receptor antagonist

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20
Q

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A

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21
Q

dicyclomine, hyoscyamine, glycopyrrolate MOA

A

muscarinic receptor antagonist

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22
Q

metoclopramide MOA

A

dopamine-2 receptor antagonist

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23
Q

what is metoclopramide used for?

A

gastroparesis

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24
Q

alvimopan, naloxegol, methylnaltrexone, naldemedine MOA

A

mu receptor antagonist

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25
Q

mu receptor antagonist AE

A

abd pain, diarrhea, opioid withdrawal

alvimopan - MI - hospital admin only

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26
Q

polycarbophil, psyllium MOA

A

bulk-forming laxative

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27
Q

senna, bisacodyl MOA

A

stimulant laxative

28
Q

laxatives AE

A

abd pain, bloating/cramping, GI obstruction, electrolyte disturbance, diarrhrea

29
Q

lactulose, polyethylene glucol, mag hydroxide, mag citrate MOA

A

osmotic laxatives

30
Q

antacid components AE

A

calcium - constipation, hyperCa

mag - diarrhea, hypermag

carbonate - eructation

alumninum - constipation, hyperaluminemia, hypophosphatemia

sodium - fluid retention

31
Q

famotidine, cimetidine, nizatadine MOA

A

H2 receptor antagonist

32
Q

H2 receptor antagonist AE

A

sedation, thrombocytopenia, confusion

cimetidine - gynecomastia, decreased libido, impotence

33
Q

esomeprazole, dexlansoprazole, pantoprazole,, omeprazole, lansoprazole, rebeprazole MOA

A

PPI

34
Q

PPI AEs

A

c. diff, pneumonia, hypomag, B12 deficiency, iron deficiency, fractures

take w food (except dexlansoprazole)

35
Q

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A

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36
Q

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A

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37
Q

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A

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38
Q

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A

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39
Q

GERD step up therapy

A

mild & intermittent

H2 antagonist PRN
H2 angagonist BID
Low dose PPI QD
PPI QD

40
Q

GERD step down therapy

A

severe or frequent GERD

PPI QD
low dose PPI QD
BID H2 antagonist
PRN H2 antagonist

41
Q

GERD tx considerations

A

not for long term tx except:

Barrett’s esophagus
severe erosive esophagitis
symptomatic GERD following PPI withdrawal

42
Q

common causes of PUD

A

h. pylori infection
NSAIDS (COX-1 inhibition)
critical illness

43
Q

PUD therapy principles

A

discontinue NSAID
evaluate need for aspirin
treat H. pylori

give PPI!!!
uncomplicated - QD
complicated/H. pylori - BID

44
Q

H. pylori treatment

A

PPI BID & abx

amoxicillin & clarithromycin (resistance) x14d + PPI

bismuth subsalicylate, tetracycline, metronidazole + PPI

45
Q

post op N/V prevention

A

high risk - prophylaxis w 3 antiemetics from different classes

moderate risk - 2 antiemetics from different classes

low risk - depends on anesthesia (inhalation/total IV - dexamethasone + ondansetron)

46
Q

CINV acute emesis occurs

A

within 1-2 h of chemo

47
Q

CINV delayed emesis occurs

A

occurs >24h after chemo

48
Q

3 categories with highest therapeutic index for mgmt of CINV

A

5-hydroxytryptamine receptor antagonist
neurokinin-1 receptor antagonists
glucocorticoids (dexamethasone)

49
Q

tx of highly emetogenic regimens

A

4 days tx

day 1 - NK1RA + 5HT2 + dexameth + olanzapine

day 2-4: dexameth + olanzapine

50
Q

tx of moderately emetogenic regimen

A

day 1 - NK1RA + 5-HT3RA + dexameth

day 2-3: 5-HT3 RA + dexameth

51
Q

low emetogenic regimen

A

day 1 - 5-HT3RA or dexameth

52
Q

chronic constipation tx

A

dietary fiber/ bulk forming laxatives

polyethylene glycol, senna, biscodyl

53
Q

opioid induced consitpation tx

A

stimulant or osmotic laxative

bulk-forming laxative

lubiprostone or peripheral mu receptor antagonist

54
Q

IBS-C tx

A

bulk forming laxative (psyllium)/soluble fiber
polyethylene glycol

libiprostone, linaclotide, plecanatide

55
Q

IBS-D tx

A

loperamide
bile acid sequesterants
aldosetrol

56
Q

IBS-D PRN meds

A

for abd pain/bloating

dicyclomine, glycopyrollate, hyoscyamine

57
Q

IBD med classes

A 
5-aminosalicylate derivative
glucocorticoids
immunosuppressants
TNFA inhibitors
a-4 integrin antagonist
interleukin antagonists
58
Q

most commonly used agent for IBD

A

mesalamine

59
Q

sulfasalazine AE

A

rash, folic acid deficiency, bone marrow suprression, SJS

60
Q

what is lubiprostone used for?

A

IBS-C and opioid induced constipation

61
Q

what are linaclotide and plecanatide used for?

A

IBS-C

62
Q

diphenoxylate MOA

A

structurally similar to meperidine, inhibits GI motility and slows GI propulsion

63
Q

muscarinic receptor antagonist least likely to cross the BBB

A

glycoyrrolate

64
Q

what med should not be give IV?

A

hydroxyzine, AEs through other routes

65
Q

serotonin-3 receptor antagonist with the longest half life and highest receptor selectivity

A

palonosetron

66
Q

misoprostol MOA

A

PGE1 analog - stimulates mucin and bicarb secretion

used for GERD/PUD

Advanced Pharm Exam 4 (13 decks)

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