Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

nur 326 > GI pharm > Flashcards

GI pharm Flashcards

1
Q

GERD and PUD

A

H2 receptor antagonists
PPI
mucosal protectants
antacids
antiemetics

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

increase protective factors

A

antacids
sucralfate

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

decrease aggressive factors

A

H. pylori
target gastric acid secretion: H2 blockers and PPI (parietal cells)

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

H. pylori tm

A

several abx and gastric acid I
combo therapy to minimize resistance (likes acidic env and most abx dont thrive well there)
need confirmed case before treating bc resistance
10-14 days, adherence not great bc v expensive and up to 12 pills/day

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

cimetidine
famotidine

A

h2 receptor antagonists
moa: block h2 receptors in stomach, reduce gastric acid secretion 60-70%, increases stomach pH
PO, IV at least 1 hr apart from antacids, OTC
I: GERD, PUD, ulcer prophylaxis - asp pna, heartburn/dyspepsia

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

h2 receptor antagonists: SE

A

well tolerates, CNS effects in elderly, slight increased risk of pna in elderly
interactions: inhibit cyp450 (cimetidine, thats why famotidine is used 1st line)
can increase warfarin, phenytoin, theophylline bc cyp450 I (esp cimetidine)
give IV slowly to avoid bradycardia

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

PPIs

A

omeprazole
patopracole
esomeprazole
moa: bind PP, inhibit H/K ATPase enzyme system (proton pump), irreversibly inhibits secretions of HCl - primary driver for stomach acid secretion
more effective than H2RA
I: short term treatment of PUD and GERD

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

PPI SE

A

short = safe
long (years) = increased risk of pna, bone loss/hip fracture, stomach cancer, benefits outweigh risks for most
few interactions

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

mucosal protectant

A

sucralfate
sucrose base, aluminum hydroxide
moa: alters when exposed to gastric acid, sticky thick gel -> protective barrier
I: duodenal ulcers, gastric ulcers, chronic gastritis
PO - tablet or suspension, take before you eat

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

sucralfate: SE

A

no major
may cause C
decrease drug abs, PO take 2 hrs apart

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

antacids: SE

A

Al and Ca based = c
Mg based = d
Mg + Al = balanced
acid rebound
chelation, altered gastric abs of many drugs (separate by 2hr)

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

antacids

A

moa: neutralize acid by approximately 50%
I: PUD (heal), GERD (s), stress ulcers (prophyl), heartburn and indigestion (for some)

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

antiemetics

A

serotonin blockers
antihistamines
anticholinergics
dopamine antagonists
prokinetics

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

ondanestron

A

serotonin blocker
moa: block serotonin receptors in chemoreceptor trigger zone in brain and in afferent vagal nerves in stomach and SI
PO or IV
I: n/v, esp in chemo/radiation

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

ondanestron: SE

A

common
mild HA, d, dizzy, c
serotonin S
be aware of other drugs that affect serotonin (SSRI, SNRI, TCA, MAOIs, buspirone, tramadol)

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

antihistamines

A

dimenhydrinate
meclizine
hydroxyzine
moa: block release of histamine H1 receptors in inner ear
I: treat dizzy and n -> antiemetics and antivertigo associated with motion sickness

17
Q

antihistamines: SE

A

sedation, drowsy, dizzy
anticholinergic effect!
FALL RISK - esp elderly
not given IV -> tissue necrosis, gangrene

18
Q

dopamine antagonists

A

prokinetic agent = metoclopramide
moa: block dopamine receptors, increase tone of lower ES (GERD), increase peristalsis in stomach and intestine (diabetic gastroparesis and post op)
I: n/v associated with chemo/radiation/opioids, GI motility issues, paralytic ileus

19
Q

dopamine antagonists: SE

A

sedation
severe: extrapyramidal symptoms, restlessness, neuroleptic malignant S

20
Q

extrapyramidal s

A

drug induced movement disorders
metoclopramide + antipsychotic meds
akathisia: may feel restless, tense, constant desire to move
acute dystonia: invol muscle contractions
parkinsonism -> rigid muscles in limbs
tardive dyskinesia -> late onset, progressive S, repetitive facial movements - tongue twisting, cheek puffing, chewing motions, lip smacking, grimacing
neuroleptic malignant S -> worst, life threatening, muscle rigid 1st, fever, drowsy, confusion -> seizure

21
Q

drug therapy for diarrhea

A

diphenoxylate with atropine
loperamide
moa: decrease intestinal peristalsis, reduce intestinal effluent
SE: drowsy and c
fall and driving precautions esp with other CNS depressants
anticholinergic effects of atropine
serious: cardiac arrest/arrythmias (brady)

22
Q

IBS meds

A

5 aminosalicylates
DMARDs
not great at treating

23
Q

5 aminosalicylates

A

sulfasalazine
I: mild - mod IBS
moa: sulfonamide abx that converts intestine into 5 aminosalicyclic acid AND sulphapyridine
sulphapyridine has no therapeutic effect for IBD because of its SE some pt prefer mesalamine alone

24
Q

sulfasalazine: SE

A

n, fever, rash, HA, hematologic disorders
dont give to pt with sulfa allergy or who have certain types of anemias, caution for use in pt with many diseases - can cause lots of issues

25
Q

DMARDs

A

infliximab
disease modifying antirheumatic drug
moa: monoclonal antibody that neutralizes TNF alpha (inflam mediator)
I: lots, IBD

26
Q

infliximab: SE

A

immune suppression: infection, cancer, HF, infusion rxn, neutropenia
often require therapeutic drug monitoring and biomarker monitoring for inflam (CRP)
screened for TB and other diseases before start, titers drawn, need vax

27
Q

general tm

A

diet mod, sx, pharm

28
Q

bismuth subsalicylate

A

adsorbent
Coats walls of GI tract, bind causative agent for elimination (adsorption)
I: diarrhea
SE: Increased bleeding time, constipation, dark stools and tongue darkening
Same as aspirin
nc: Form of aspirin
Activated charcoal also given in drug overdose

29
Q

Loperamide (otc, slowed peristalsis only, no SE)
Diphenoxylate (with anticholinergic, Rx)

A

antimotility
moa: Slow peristalsis by reducing rhythmic contractions and smooth muscle tone of GI tract, drying effect due to anticholinergic – reduce gastric secretions
I: d
SE: Due to anticholinergic: Urinary retention, headache, dizziness, anxiety, drowsiness, bradycardia, hypotension, dry skin, flushing
nc: Used alone or in combo with adsorbents and opiates

30
Q

Lactobacillius organisms (Bacid, Culturelle)
Saccharomyces boulardii (C. diff)

A

probiotics
moa: replenish bacteria and restore normal flora
I: d r/t abx, S. b is for C. diff
nc: these bacteria make up majority of normal flora of gut, OTC or Rx strength

31
Q
A

Emollient
moa: Both prevent water from moving out of intestines
DS - Lubricate fecal material and walls, promote fat absorption into fecal mass (soften stool)
MO - lubricate intestines
I: DS- Prevent opioid induced constipation
MI - fecal impaction
SE: Skin rashes, decreased absorption of vitamins
NC: DS - given prophylactically for post op
MI - PO and PR (rectal) or enema

31
Q

psyllium

A

Bulk forming laxatives
moa: Act similar to dietary fiber, absorb water into intestine – increasing bulk (volume), distend bowel to initiate flex bowel activity and bowel movement
I: Okay for long term use
Contraindicated for intestinal obstruction or fecal impaction SE: Impaction above strictures, fluid/electrolyte (less than other types of laxatives) imbalance, gas formation, esophageal blockage
nc: Action limited to GI tract – no systemic affects
Take with lots of water to prevent esophageal obstruction or fecal impaction (should be in 8-12 oz of water)

32
Q

Glycerin
Lactulose
Polyethylene glycol

A

hyperosmotic
moa: Increase water content in feces; promote distension, peristalsis, and evacuation
L: works in colon; reduce blood ammonia levels
I: G - common in children – suppository
L - reduce blood ammonia levels – use with liver disease and hepatic encephalopathy
PG - before diagnostic or surgical bowel procedures – total cleansing of bowel, very potent
SE: Abdominal bleeding, rectal irritation, electrolyte imbalance

33
Q

Magnesium salts (Mg citrate, Mg hydroxide, Mg sulfate)
Sodium salts

A

Saline
moa: Increase osmotic pressure and draw water into colon
I: Constipation
SE: Magnesium toxicity (in renal pts), electrolyte imbalance, cramping, diarrhea
nc: Work within 3-6 hrs
Mg salts available OTC
Na salts usually given via fleet enema

34
Q

bisacodyle
senna

A

I: Constipation or whole bowel evacuation – work on entire GI tract
SE: Nutrient malabsorption, gastric irritation, e imbalance
NC: B - PO and PR
OTC

nur 326 (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions