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NUR 326 Exam 3 > GI Pharmacology > Flashcards

GI Pharmacology Flashcards

1
Q

upper GI distress drugs that decrease aggressive factors

A

–treat H. pylori
–H2 blockers
–proton pump inhibitors

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2
Q

upper GI distress drugs that increase protective factors

A

–antacids
–sucralfate

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3
Q

how to treat H. pylori

A

–several antibiotics + gastric acid inhibitor
–combination therapy

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4
Q

why combination therapy to treat H. pylori?

A

–minimize resistance
–H. pylori likes acidic environment

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5
Q

length of Rx for H. pylori

A

10-14 days

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6
Q

adherence to treatment for H. pylori

A

about $200 with up to 12 pills

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7
Q

what are two ways drugs target gastric acid production?

A

–block H2 receptors
–inhibit proton pump

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8
Q

role of histamine

A

promotes production of gastric acid

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9
Q

role of parietal cell

A

makes gastric acid

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10
Q

examples of H2 receptor antagonists

A

–cimetidine (Tagamet)
–famotidine (Pepcid)

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11
Q

MOA of cimetidine/famotidine

A

–block H2 receptors in the stomach
–reduces gastric acid secretion by 60-70%
–increases stomach pH

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12
Q

route for cimetidine/famotidine

A

PO, IV

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13
Q

administration tidbit for cimetidine/famotidine

A

give at least 1 hour apart from antacids

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14
Q

indications for cimetidine/famotidine

A

–GERD
–PUD
–ulcer prophylaxis
–heartburn/dyspepsia

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15
Q

how does cimetidine/famotidine work for ulcer prophylaxis?

A

prevents aspiration pneumonia risk

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16
Q

adverse effects of cimetidine/famotidine

A

–well tolerated
–CNS effects in elderly
–slight increased risk for pneumonia in elderly

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17
Q

interactions of cimetidine/famotidine

A

–inhibits CYP450 enzymes (older)
–newer generation H2RAs do not have this problem (ex. Pepcid)

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18
Q

safety alert for cimetidine/famotidine

A

–can increase levels of warfarin, phenytoin, theophylline
–give IV form slowly to avoid bradycardia

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19
Q

examples of proton pump inhibitors (PPIs)

A

–omeprazole (Prilosec)
–pantoprazole (Protonix)
–esomeprazole magnesium (Nexium)

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20
Q

MOA of omeprazole/pantoprazole/esomeprazole magnesium

A

–binds to proton pump
–inhibits hydrogen potassium ATPase enzyme system
–irreversibly inhibits secretion of HCl

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21
Q

indications for omeprazole/pantoprazole/esomeprazole magnesium

A

short term treatment of PUD and GERD

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22
Q

tidbit about omeprazole/pantoprazole/esomeprazole magnesium

A

more effective than H2RA

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23
Q

adverse effects of omeprazole/pantoprazole/esomeprazole magnesium

A

short term: relatively safe
long term: increased risk for pneumonia, bone loss/hip fracture, stomach CA

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24
Q

nursing implications for omeprazole/pantoprazole/esomeprazole magnesium

A

short term use only

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25
Q

example of mucosal protectant

A

sucralfate (Carafate)

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26
Q

sucralfate (Carafate)

A

unique drug composed of:
–sucrose-base
–aluminum hydroxide

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27
Q

MOA of sucralfate

A

–alters when exposed to gastric acid
–sticky, thick gel –> protective barrier

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28
Q

indication of sucralfate

A

duodenal ulcers, gastric ulcers

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29
Q

route for sucralfate

A

PO (tablet or suspension)

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30
Q

adverse effects of sucralfate

A

–no major
–may cause constipation

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31
Q

interactions with sucralfate

A

–decreased drug absorption
–PO: take 2 hours apart

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32
Q

major bases for antacids

A

–aluminum
–calcium
–magnesium
–Al+Mg

33
Q

example of aluminum antacid

A

amphojel

34
Q

example of calcium antacid

A

tums

35
Q

example of magnesium antacid

A

milk of magnesia

36
Q

example of Al+Mg antacid

A

Maalox, Mylanta

37
Q

side effect of aluminum antacid

A

constipation

38
Q

side effect of calcium antacid

A

constipation

39
Q

side effect of magnesium antacid

A

diarrhea

40
Q

side effect of Al+Mg antacid

A

balanced approach

41
Q

MOA of antacids

A

neutralizes acid by approximately 50%

42
Q

indication of antacids

A

–PUD
–GERD
–stress ulcers

43
Q

adverse effects of antacids

A

–diarrhea or constipation
–acid rebound

44
Q

interactions of antacids

A

–chelation
–altered gastric absorption of many drugs

45
Q

example of serotonin blocker

A

ondansetron (Zofran)

46
Q

MOA of ondansetron

A

blocks serotonin receptors in the trigger zone in the brain and in the afferent vagal nerves in the stomach and small intestine

47
Q

route of ondansetron

A

PO or IV

48
Q

use of ondansetron

A

used to treat N/V (esp. chemo/radiation induced)

49
Q

adverse reactions of ondansetron

A

common –> usually mild
–HA
–dizziness
–diarrhea

50
Q

serious adverse reactions of ondansetron

A

–serotonin syndrome

51
Q

drug interactions with ondansetron

A

–SSRIs
–SNRIs
–TCAs
–MAIs
–buspirone
–tramadol

52
Q

examples of antihistamines

A

–dimenhydrinate (Dramamine)
–meclizine (Antivert)
–hydroxyzine (Vistaril)

53
Q

MOA of dimenhydrinate/meclizine/hydroxyzine

A

blocks the release of histamine H1 receptors in the inner ear

54
Q

indications for dimenhydrinate/meclizine/hydroxyzine

A

treatment of dizziness and nausea –> antiemetic and antivertigo associated with motion sickness

55
Q

adverse reactions of dimenhydrinate/meclizine/hydroxyzine

A

–sedation
–drowsiness
–dizziness
–anticholinergic effect
–FALL RISK

56
Q

example of dopamine antagonists: prokinetic agent

A

metoclopramide (Reglan)

57
Q

MOA of metoclopramide

A

–blocks dopamine receptors
–increases tone of LES
–increases peristalsis in both the stomach and the intestine

58
Q

indications of metoclopramide

A

–N/V associated with chemo/radiation/opioids
–GI motility issues
–paralytic ileus

59
Q

side effects of metoclopramide

A

–sedation
–extrapyramidal symptoms
–restlessness
–neuroleptic malignant syndrome

60
Q

extrapyramidal symptoms

A

–akathisia
–acute dystonia
–Parkinsonism
–Tardive dyskinesia
–Neuroleptic malignant syndrome

61
Q

akathisia

A

–may feel restless
–tense
–constant desire to move

62
Q

acute dystonia

A

involuntary muscle contractions

63
Q

Parkinsonism

A

–muscle tremors
–cogwheel rigidity
–drooling
–shuffling gait
–slow movements

64
Q

Tardive dyskinesia

A

–abnormal muscle movements (lip smacking, tongue darting, chewing movements, slow and aimless arm and leg movements)

65
Q

neuroleptic malignant syndrome

A

rigid muscles, fever, confusion

66
Q

what are extrapyramidal symptoms common with?

A

more common with antipsych meds

67
Q

examples for diarrhea drugs

A

–diphenoxylate with atropine (Lomotil)
–loperamide (Immodium)

68
Q

MOA of diphenoxylate with atropine/loperamide

A

–decrease intestinal peristalsis
–reduce the intestinal effluent

69
Q

adverse reactions of diphenoxylate with atropine/loperamide

A

–drowsiness
–constipation
–falling and driving precautions
–anticholinergic effects
–SERIOUS: cardiac arrest/arrythmias

70
Q

example of 5-aminosalicylates

A

sulfasalazine (Azulfidine)

71
Q

indications of sulfasalazine

A

mild to moderate IBD

72
Q

MOA of sulfasalazine

A

sulfonamide antibiotic that converts the intestine into 5-aminosalicylic acid and sulphapyridine

73
Q

side effects of sulfasalazine

A

–nausea
–fever
–rash
–HA
–hematologic disorders

74
Q

precaution for sulfasalazine

A

do not give to patients who are allergic to SULFA drugs or who have certain types of anemias

75
Q

example of DMARDs for IBD

A

infliximab (Remicade)

76
Q

DMARD

A

disease modifying antirheumatic drug

77
Q

MOA of infliximab

A

monoclonal antibody which neutralizes TNF-alpha

78
Q

side effects for infliximab

A

–immune suppression
–infection
–cancer
–heart failure
–infusion reactions
–neutropenia

79
Q

additional note about infliximab

A

often require therapeutic drug monitoring and biomarker monitoring for inflammation

NUR 326 Exam 3 (11 decks)

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