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pharmacology module III exam II > IBD - GI > Flashcards

IBD - GI Flashcards

1
Q

metoclopramide MOA

A

dopamine antagonists enhances upper GI tract response to ACH to enhance motility - increases colon motility - shortens transit time

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2
Q

metoclopramide uses

A

gastroparesis, persistent GERD, N/V - can be useful for diabetes - short term use only given risk of TD <12wks

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3
Q

metoclopramide side effects

A

drowsiness, dystonia, HA

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4
Q

metoclopramide caution with

A

BLACK BOX WARNING: can cause tardative dyskinesia (irreversible)
Cl: GI hemorrhage, mechanical obstruction, perforation

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5
Q

domperidone MOA

A

peripheral dopamine antagonists increases esophageal peristalsis, gastric motility and gastric emptying decreases small bowel transit time

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6
Q

domperidone uses

A

gastroparesis/motility disorder, N/V

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7
Q

domperidone side effects

A

HA, migraines, xerostomia

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8
Q

domperidone caution with

A

BLACK BOX WARNING: increased risk of cardiac arrhythmias or sudden cardiac death
caution with other QT prolonging agents
Cl for patients with prolactinomas

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9
Q

erythromycin MOA

A

macrolide antibiotics - motilin agonists - increases gastric contractions

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10
Q

erythromycin uses

A

gastroparesis - use for max 4 wks duration d/t tachyphylaxis

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11
Q

erythromycin side effects

A

cardiovascular arrhythmias, QT prolongation, superinfection (c diff)

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12
Q

erythromycin caution with

A

major inhibitor of CYP3A4
myasthenia gravis - may exacerbate or cause symptoms

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13
Q

neostigmine MOA

A

acetylcholinesterase inhibitor

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14
Q

neostigmine use

A

acute colonic pseudo - obstruction - myasthenia gravis - post op bladder distention/urinary frequency

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15
Q

neostigmine side effects

A

cardiac arrhythmias - especially bradycardia
dizziness, drowsiness, diarrhea

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16
Q

neostigmine caution

A

cardiovascular disease

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17
Q

aminosalicylates MOA

A

work topically on affected/inflamed areas of mucous - anti-inflammatory and immunosuppressive activity

18
Q

prodrug of aminosalicylates

A

sulfasalazine

19
Q

sulfasalazine side effects

A

nausea, HA, rash, arthralgia, bone marrow suppression
oligospermia in men (infertility) - reversible

20
Q

sulfasalazine caution with

A

impairs folate absorption - supplement with daily folate

21
Q

mesalamine side effects

A

nausea, HA, diarrhea, abd pain
nephrotoxicity/intestinal nephritis (rare)

22
Q

mesalamine drug interactions

A

antacids, H2RAs, PPIs can diminish efficacy

23
Q

mesalamine caution with

A

severe renal or hepatic impairment

24
Q

immunosuppressants MOA

A

immunosuppressant

25
Q

immunosuppressants use

A

induce or maintain remission in both UC and crohns - good for pts who cannot maintain remission when steroids are taped down - can reduce steroid dose

26
Q

azathoprine side effects

A

N/V, bone marrow suppression

27
Q

azathoprine drug interactions

A

avoid with allopurinol - leukopenia

28
Q

azathoprine caution with

A

BLACK BOX WARNING: chronic immunosuppression increases the risk of malignancy

29
Q

methotrexate MOA

A

immunosuppressant, anti-inflammatory for IBD, acts as a folate antagonists, inhibiting DNA synthesis repair and cellular replication

30
Q

methotrexate side effects

A

diarrhea, N/V, alopecia, bone marrow suppression, muscositis
severe possibly fatal skin reactions - SJS/TEN

31
Q

methotrexate interactions

A

BLACK BOX WARNING: unexpectedly severe bone marrow suppression and aplastic anemia reported in some patients with concomitant use of MTX

32
Q

methotrexate caution with

A

BLACK BOX WARNING: possibly of serious toxic/fatal side effects - closely monitor for bone marrow, liver, lung, skin, and kidney toxicities including: hepatotoxicity (monitor LFTs), PPI, lung disease, malignant lymphomas
teratogen - cl in pregnancy
give folic acid to reduce effects of side effects

33
Q

umabs administration

A

induction dose (wks 0, 2, 6) - maintenance dose every 8 wks
labs every 2 wks for 2 mo
drug level every 3-4 mo
repeat colonoscopy at 6 mo
must get PPD prior to initiating therapy and while on treatment

34
Q

umabs side effects

A

injection site reactions
infusion reaction
acute and delayed 2 wks - skin rash, joint pain, myalgia, fever
can premedicate with benadryl to avoid this
HA, abd pain, liver toxicity, HF, infections, URIs
rare: t cell lymphoma

35
Q

umabs drug interactions

A

risk of infection is worse with concomitant immunosuppression
no live vaccines while on therapy

36
Q

umabs caution with

A

BLACK BOX WARNING: serious infections d/t immunosuppression
heart disease
liver disease

37
Q

glucocorticoids MOA

A

inhibits production of inflammatory cytokines and inhibits migration of inflammatory migration of inflammatory cells to affected area

38
Q

glucocorticoids uses

A

moderate - severe crohns and UC - helpful in early treatment and during flares

39
Q

rectal glucocorticoids

A

hydrocortisone

40
Q

glucocorticoids side effects

A

hyperglycemia
adrenal suppression
peptic ulcers
immunosuppression
anxiety/jittery
sodium/fluid retention

41
Q

glucocorticoids caution with

A

HF, HTN, diabetes (hyperglycemia), cataracts, glaucoma (increased pressure)
liver disease - may have decreased conversion of prednisone - prednisolone

pharmacology module III exam II (6 decks)

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