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INCO 2 > Medications In PUD & Gerd > Flashcards

Medications In PUD & Gerd Flashcards

1
Q

Meds given in PUD

A
  1. Antacids
  2. H2 receptor blocker/antagonist
  3. Cytoprotective drugs( carafate-sucrfate)
  4. Prostaglandin analogue( cytotec-misoprostol)
  5. Proton pump inhibitor
  6. Anticholinergics
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2
Q

Treatment for H.pylori infection

A

Amoxicillin( amoxil)
Clarithromycin (biaxin)
Metronidazole ( flagyl
Tetracycline (achromycin)

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3
Q

Why alcohol is avoided when taking flagyl & tetracycline

A

To prevent DISULFIRAM LIKE MANIFESTATIONS

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4
Q

Disulfiram like manifestations/rxns(8)

A

Headache & hypotension
Tachycardia & palpitations
Flushing & dyspnea
N/v
Chest pain
Respi & circu collapse
Convulsion

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5
Q

Contraindicated in pregnancy bec it has teratogenic effect

A

Tetracycline ( achromycin)

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6
Q

Reduces gastric acid (HCL) and gastric motility

A

Anticholinergic or Antispasmodic

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7
Q

Example of anticholinergic ( BRALN-P

A

Bentyl
Robinul
atropine sulfate
Levsin
Nulev
Propantheline bromide

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8
Q

Suppressing gastric acid secretion by binding to acid secreting enzyme( parietal) H+K+ATpase

A

PPI

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9
Q

Common SE of PPI( HAND)

A

Headache
Abdominal pain
Nausea
Diarrhea

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10
Q

Promotes 90% ulcer healing after 4 weeks

A

PPI

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11
Q

Example of PPI( POLER)

A

Pantoprazole
Omeprazole
Lansoprazole
Esomeprazole
Rabeprazole

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12
Q

Example of prostaglandin analogue

A

Cytotec-misoprostol
- requires doctors order
- used to prevent NSAID-induced ulcer
- given with meals

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13
Q

SE of PA( C-M)

A

Diarrhea & abdominal pain

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14
Q

What drug is abortifacient

A

PA( CM)

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15
Q

It replaces gastric prostaglandin

A

PA( CM)

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16
Q

Action of prostaglandin

A
  • Stimulates prod of mucus, bicarbonate ( shield from acidic environment)
  • Improves blood flow-> promoting healing
  • anti-inflammatory
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17
Q

Coats ulcer( forming barrier against acid, bile, pepsin) and enhances prostaglandin synthesis

A

Cytoprotective drugs (CS)

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18
Q

CD( CS) taken in_______ and SE

A

Empty stomach ( 30-60 min before meals)
given 1 hour apart if taken with antacids
Constipation

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19
Q

Classification of antacids

A

Aluminum, magnesium, calcium compounds & sodium bicarbonate

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20
Q

Example of antacids( 6)

A
  1. Amphogel, alu-cap, dialume (aluminum hydroxide gel)
  2. Basaljel (aluminum carbonate)
  3. Maalox (aluminum-magnesium hydroxide)
  4. Milk of magnesia
  5. Gaviscon
  6. Calcium carbonate ( TUMS)
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21
Q

Meds that relives flatulence

A

Simethicon

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22
Q

Antacids is given

A

1-2 hours after eating

23
Q

Antacids( aluminum compounds) interfere with effect of which meds

A

Tetracycline
Warfarin sodium ( coumadin)
Digoxin( lanoxin)
Iron
Some antibiotics ( H2 receptor: cimetidine)

24
Q

SE pf H2 receptor blockers/antagonist ( DAD WC)

A

Diarrhea
Abd. Cramps
Dizziness
Weakness
Confusion

25
Q

Histamine 2 receptor blockers best taken in

A

Morning & at bedtime WITHOUT food

26
Q

This meds are well tolerated with fewer SE & must be continued for 8 weeks

A

Histamine receptor blockers

27
Q

H2 receptor used with caution with impaired

A

Renal function (check BUN, creatinine)
Hepatic fxn ( ALT, AST & bilirubin)

28
Q

It contains significant amount of sodium so it must be use with caution in pt with

A

Aluminum compounds ( A. Hydroxide)
With HPN & CHF ( same as sodium bicarb)

29
Q

Used to treat hyperphosphatemia

A

Aluminum hydroxide

30
Q

A. Hydroxide decreases effect of

A

Tetracycline
Warfarin sodium
Digoxin ( lanoxin)
Iron

31
Q

C. SE OF Aluminum compounds

A

Constipation

32
Q

Usually given in combination with A. Hydroxide to prevent diarrhea

A

Magnesium compounds

33
Q

Magnesium compounds is contraindicated in

A
  • Appendicitis ( causes rupture d/t increased peristaltic movement)
  • renal impairment( aggravates it: hypermagnesemia: s/sx= decreased ( BURP) Bp, uo, RR & PR) Calcium gluconate antidote
34
Q

Classification of antacids that are rapid acting and causes belching & flatulence ( same as sodium bicarbonate)

A

Calcium compounds

35
Q

Other SE of calcium compounds

A

Milk Alkali syndrome ( HANFU)
- headache
- urinary frequency
-nv
- fatigue
- anorexia

36
Q

What should be avoided in calcium compounds

A

Milk and VitD supplements

37
Q

Used for tx of metabolic acidosis bit may result to systemic acidosis

A

Sodium bicarbonate

38
Q

Classification of histamine receptor blockers

A
  1. Cimetidine ( tagamet)
  2. Ranitidine ( zantac)
  3. Famotidine( pepcid)
  4. Nizatidine ( axid)
39
Q

Administration of cimetidine or ______

A

PO, IM, IV
NOT taken with food- delays drug absorption

40
Q

IV cimetidine administration causes

A

Hypotension &
Cardiac dysrhythmia

41
Q

SE of cimetidine
Mainly neurologic since it cross BBB: MAP- DAD

A

Mental confusion
Agitation
Psychosis
Depression
Anxiety
Disorientation

42
Q

Anti- androgenic effect of cimetidine

A

Gynecomastia
Increased libido
Impotence

43
Q

These drugs should be reduced in dosage to avoid drug interaction and also reduced in clients with renal impairment ( causes nephrotoxicity) when taken with cimetidine

A

Warfarin sodium ( Coumadin)
Phenytoin ( dilantin)
Theophylline
Lidocaine

44
Q

Type of H2 RB that has uncommon SE since it does not cross BBB

A

Ranitidine ( zantac)
Given PO, IM and IV
Not affected by food

45
Q

H2 RB given at best at

A

If given twice a day: morning ( before breakfast) & bedtime
If once: bedtime

46
Q

No antacids 1 hour before or after taking H2 RB

A
47
Q

Avoid what when taking H2 RB: SANA

A

Smoking
Alcohol
NSAIDS
aspirin

48
Q

Longterm effect of H2 RB use

A

Gynecomastia & impotence : female
Breast tenderness: male

49
Q

Adverse effect of H2 receptor B ( DR- MFC)

A

Diarrhea
Rashes & bruising
Malaise
Fatigue
Confusion

50
Q

Do not crush tablets to prevent decreased drug potency

A
51
Q

Melena indicates perforation & GI bleeding/ REPORT

A
52
Q

Promotility ( prokinetic) example

A

Metoclopramide

53
Q

Prokinetic or promotility not given in pts with

A

Gi destruction
Bleeding
Hx of parkinsons

54
Q

Time to give Pro-motility if PO, IVP, infusion

A

PO: 30 min before meals @ bedtime
IVP: over 1-2 min
Slow infusion( diluted) : 15-30 min

INCO 2 (6 decks)

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