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Patho1 > GI pharm > Flashcards

GI pharm Flashcards

1
Q

what is the side effects associated with aluminum as an antacid?

A

constipation

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2
Q

what is the side effects associated with calcium as an antacid?

A

constipation

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3
Q

what is the side effects associated with magnesium as an antacid?

A

diarrhea

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4
Q

what is the side effects associated with aluminum + magnesium as an antacid?

A

not constipation or diarrhea - just a balanced approach

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5
Q

what are two examples or antacids that are aluminum + magnesium?

A

Maalox, Mylanta

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6
Q

why is it ideal to use a combination approach to treat h. pylori?

A

to minimize resistance and because h. pylori loves an acidic environment but we can’t get antibiotics to work in a highly acidic environment

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7
Q

what class is cimetidine / famotidine?

A

H2 receptor antagonist

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8
Q

what class is omeprazole / pantoprazole / esomeprazole?

A

PPI

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9
Q

what class is sucralfate?

A

mucosal protectant

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10
Q

what class is ondanestron?

A

serotonin blocker

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11
Q

what class is dimenhydramine, meclizine, and hydrozyzine?

A

antihistamines

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12
Q

what class is metoclopromide?

A

dopamine antagonists / prokinetic agent

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13
Q

what class is sulfasalazine?

A

5-aminosalicylate

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14
Q

what class is infliximab?

A

disease modifying anti-rheumatic drug (DMARD)

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15
Q

what is the MOA of H2 receptor antagonists?

A

blocks H2 receptors in the stomach, which reduces acid secretion by 60-70%, which increases gastric pH

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16
Q

what are the indications for H2 receptor antagonists?

A

PUD, GERD, prophylaxis, heartburn/dyspepsia

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17
Q

what are the side effects for H2 receptor antagonists?

A

generally well tolerated - except in elderly, then can have CNS alteration and an increased risk of pneumonia

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18
Q

what is the route for H2 receptor antagonists?

A

IV and PO

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19
Q

how long should you wait in between giving a H2 receptor antagonist and an antacid?

A

~ 1 hours

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20
Q

are H2 receptor antagonists CYP inhibitors or agonists?

A

inhibitors

21
Q

what 3 medications can H2 receptor antagonists increase the levels for?

A

warfarin, phenytoin, theophylline

22
Q

if pushed too fast what can H2 receptor antagonists cause?

A

bradycardia

23
Q

what is the MOA of PPIs?

A

inhibiting the proton pump by binding directly to it, this irreversibly inhibits the HCl secretion

24
Q

what are PPIs used for?

A

short term treatment of GERD and PUD (if long term usually are rx)

25
Q

what are the short term and long term side effects of PPIs?

A

short term - generally nothing
long term - increased risk of pneumonia, bone loss / hip fracture, stomach cancer

26
Q

are H2 receptor antagonists or PPIs generally more effective?

A

PPI

27
Q

what is the MOA of mucosal protectants?

A

they change into a thick gel when in contact with gastric acid - this provides a barrier to the stomach

28
Q

what are mucosal protectants used for?

A

ulcers

29
Q

what are the side effects of mucosal protectants?

A

generally nothing, maybe some constipation

30
Q

how are mucosal protectants taken?

A

PO

31
Q

when should you take mucosal protectants in relation to other meds?

A

~ 2 hours before (it decreases the absorption of other drugs because it coats the stomach)

32
Q

what are the side effects of antacids?

A

diarrhea / constipation, rebound acid

33
Q

why do antacids need to be spaced out from other drugs?

A

they generally have a chelating effect which pulls the drugs out of the system and causes them to not be absorbed as well

34
Q

what is the MOA of ondansetron?

A

blocks serotonin receptors in the brain and in afferent vagal nerves in the stomach and intestines to decrease N/V

35
Q

what are the side effects of serotonin blockers?

A

headache, diarrhea, dizziness, serotonin syndrome

36
Q

how is ondansetron given?

A

PO , IV

37
Q

what medications must a nurse know about before giving ondansetron?

A

SSRI, SNRI, MAOI, TCA, buspirone, tramadol

38
Q

antihistamines increase fall risk - true or false?

A

true

39
Q

what is the MOA of metoclopramide?

A

blocks dopamine receptors which increase the tone of the LES while also increasing peristalsis

40
Q

what are the side effects of metoclopramide?

A

sedation, extrapyramidal symptoms (dystonia, pseudoparkinsonism, akathisia (inability to remain still), tardive dyskinesia, restlessness, neuroleptic malignant syndrome (fever, altered LOC, muscle rigidity, and autonomic dysfunction)

41
Q

what population of people are more at risk of developing EPS with metoclopramide?

A

those taking anti-psychotic medications

42
Q

what are the side effects of diphenoxylate with atropine or loperamide?

A

drowsiness, constipation
anticholinergic
bradycardia
cardiac arrest / arrhythmia

43
Q

what are the side effects for sulfasalazine?

A

fever, nausea, rash, HA, hematologic disorders

44
Q

what groups of patients does the nurse need to be cautious giving sulfasalazine to?

A

anemia, lots of comorbidities

45
Q

what is the MOA of infliximab?

A

monoclonal antibodies neutralize TNF alpha which causes a decreased inflammatory response

46
Q

what is infliximab used for?

A

IBD

47
Q

what are the side effects for infliximab?

A

immunosuppression
cancer, HF, infusion reactions

48
Q

what monitoring needs to be done while taking infliximab?

A

therapeutic dose monitoring and CRP

49
Q
A

Patho1 (22 decks)

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