Liver drugs

Question 1

Pancrelipase (Creon) class and MOA

Answer 1

Pancreatic enzyme replacement - actual enzyme replacement

Question 2

Pancrelipase (Creon) indications

Answer 2

Dec secretion of pancreatic enzymes

Question 3

Pancrelipase (Creon) SE

Answer 3

rare

Question 4

Pancrelipase (Creon) NC

Answer 4

Take with every meal or snack or else won’t digest

Question 5

Lactulose class

Answer 5

Hyperosmotic lax - derivative of natural sugar lactulose

Question 6

Lactulose MOA

Answer 6

Reduced blood ammonia levels by converting ammonia to ammonium which is water soluble and can’t be reabsorbed - creates acidic enviro acids draw water into colon to make poop

Question 7

Lactulose indications

Answer 7

Dec ammonia abs in hepatic encephalopathy; given to titrate number of stools or by ammonia levels

Question 8

Lactulose NC

Answer 8

• PO or enema/rectal
• Only given if s/s hepatic encephalopathy (LOC chx)
• not given if pt is hypokalemic (bc low K inc renal ammonia production)
• titrated to 2-3 soft stools/day

Question 9

Rifaximin MOA

Answer 9

Inhibits bac RNA synth by binding to bac DNA (first used as abx for GI infx)

Question 10

Rifaximin indications

Answer 10

Second line if lactulose not working, can be given preventatively

Question 11

Rifaximin SE

Answer 11

Peripheral edema, N, ascites, dizzy, fatigue, pruritus, skin rash, ab pain, anemia

Question 12

Rifaximin NC

Answer 12

• may be prophylactic
• PO
• inc risk C.diff–monitor