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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
Histamine 2 receptor blockers best taken in
Morning & at bedtime WITHOUT food
26
This meds are well tolerated with fewer SE & must be continued for 8 weeks
Histamine receptor blockers
27
H2 receptor used with caution with impaired
Renal function (check BUN, creatinine) Hepatic fxn ( ALT, AST & bilirubin)
28
It contains significant amount of sodium so it must be use with caution in pt with
Aluminum compounds ( A. Hydroxide) With HPN & CHF ( same as sodium bicarb)
29
Used to treat hyperphosphatemia
Aluminum hydroxide
30
A. Hydroxide decreases effect of
Tetracycline Warfarin sodium Digoxin ( lanoxin) Iron
31
C. SE OF Aluminum compounds
Constipation
32
Usually given in combination with A. Hydroxide to prevent diarrhea
Magnesium compounds
33
Magnesium compounds is contraindicated in
- 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
Classification of antacids that are rapid acting and causes belching & flatulence ( same as sodium bicarbonate)
Calcium compounds
35
Other SE of calcium compounds
Milk Alkali syndrome ( HANFU) - headache - urinary frequency -nv - fatigue - anorexia
36
What should be avoided in calcium compounds
Milk and VitD supplements
37
Used for tx of metabolic acidosis bit may result to systemic acidosis
Sodium bicarbonate
38
Classification of histamine receptor blockers
1. Cimetidine ( tagamet) 2. Ranitidine ( zantac) 3. Famotidine( pepcid) 4. Nizatidine ( axid)
39
Administration of cimetidine or ______
PO, IM, IV NOT taken with food- delays drug absorption
40
IV cimetidine administration causes
Hypotension & Cardiac dysrhythmia
41
SE of cimetidine Mainly neurologic since it cross BBB: MAP- DAD
Mental confusion Agitation Psychosis Depression Anxiety Disorientation
42
Anti- androgenic effect of cimetidine
Gynecomastia Increased libido Impotence
43
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
Warfarin sodium ( Coumadin) Phenytoin ( dilantin) Theophylline Lidocaine
44
Type of H2 RB that has uncommon SE since it does not cross BBB
Ranitidine ( zantac) Given PO, IM and IV Not affected by food
45
H2 RB given at best at
If given twice a day: morning ( before breakfast) & bedtime If once: bedtime
46
No antacids 1 hour before or after taking H2 RB
47
Avoid what when taking H2 RB: SANA
Smoking Alcohol NSAIDS aspirin
48
Longterm effect of H2 RB use
Gynecomastia & impotence : female Breast tenderness: male
49
Adverse effect of H2 receptor B ( DR- MFC)
Diarrhea Rashes & bruising Malaise Fatigue Confusion
50
Do not crush tablets to prevent decreased drug potency
51
Melena indicates perforation & GI bleeding/ REPORT
52
Promotility ( prokinetic) example
Metoclopramide
53
Prokinetic or promotility not given in pts with
Gi destruction Bleeding Hx of parkinsons
54
Time to give Pro-motility if PO, IVP, infusion
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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