Lecture 4: Gastrointestinal Flashcards
Gastric defense may be harmed by three things?
-EtOH, NSAIDs, and prednisone(long term)
What is the treatment goal of GERD? (2)
(1) complete resolution if symptoms
(2) healing of the esophagitis
Proton pump inhibitors reduce stomach acid production by what percentage?
90%
Assuming equivalent dosage, what would be equivalent to omeprazole?
Pantoprazole (because all PPIs are equivalent)
What is the stem for PPIs?
-prazole
You can use PPIs to treat peptic ulcer disease (including ulceration causes by H. pylori). What medication class do you need to use in combination with the PPI?
Antibiotic
Are PPIs for immediate relief?
No. They take 2-5 days to achieve maximum benefit.
When in the patients’ day is it ideal to take their PPIs?
30 minutes before a meal?
What is a major side effect of log term use of PPIs?
Osteoporosis and fracture (due to decrease in vitamin B12)- takes 3-5 years to get these effects.
what is the stem for Histamine 2 receptor antagonists (H2RA)?
-tidine
Cimetidine (Tagamet) has a major side effect if it is taken along with drugs like warfarin. What worse saw scenario could occur?
Death
What can happen when either H2RAs or PPIs are discontinued (like a patient forgets to take their meds for a week)?
Rebound acid increase (thus, gradual tapering is required)
How many antibiotics (approximately) should be taken when combating H. pylori?
2 or 3 antibiotics plus a PPI.
Why so many? It has a high resistance
How long (in days) is the antibiotic regimen taken for when combating H. pylori?
10-14 days .
What is a possible side effects of bismuth?
Black stool and blackening of the tongue
What is a possible side effect if a patient is taking immunosuppressants (such as TNF-alpha blockers)
Reactivate latent TB
What is the BRAT diet?
You know this shit Steven.
What is the most commonly used medication for Treatment of Emesis?
(5HT3 receptor antagonists)
-setron’s
ondansetron (Zofran)
Can a pregnant person take 5HT3 receptor antagonist safely?
Eh. It’s class B. Animal testing was safe. It has been proven safe in 2nd and 3rd trimester. But the 1st trimester studies are inconclusive. Mauriana wouldn’t trust it
What is a major side effect of long term use of dopamine antagonists?
tardive dyskinesia
What is a short term side effect of dopamine antagonists? (Phenothiazine)
Severe drowsiness
If a patient is found to have a GI bleed from ulceration (or any other GI bleed for that matter)… What medication should they immediately stop taking?
Anti platelets and anticoagulants
PPIs are relatively safe in the short term treatment if GERD. However, due to the reduction in acid, which mineral absorption is effected?
Calcium
