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Therapeutics > NV,D,C,IBS,GERD/PUD > Flashcards

NV,D,C,IBS,GERD/PUD Flashcards

1
Q

antihistamine options for NV

A

dimenhydrinate
diphenhydramine
meclizine
doxylamine
scopolamine
hydroxyzine

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2
Q

generic for Bonine

A

meclizine

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3
Q

generic for Unisom

A

doxylamine

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4
Q

generic for dramamine

A

dimenhydrinate

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5
Q

phenothiazines used for NV

A

promethazine
prochlorperazine

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6
Q

generic name for phenergan

A

promethazine

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7
Q

genetic name for compazine

A

prochlorperazine

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8
Q

side effects of phenothiazines

A

hypotension, QTcP, EPS

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9
Q

BBW for phenergan (promethazine)

A

tissue damage – DO NOT GIVE IV

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10
Q

main 5-HT3 antagonist used for NV

A

ondansetron (zofran)

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11
Q

side effects of zofran

A

constipation, headache, QTcP

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12
Q

prokinetics used for NV

A

metoclopramide
erythromycin

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13
Q

generic for reglan

A

metoclopramide

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14
Q

side effects of Reglan

A

EPS, QTcP, diarrhea

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15
Q

side effects of erythromycin

A

NV, diarrhea, QTcP

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16
Q

corticosteroid used for NV

A

dexamethasone

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17
Q

1st and 2nd line for general NV

A
  1. 5HT3 > metoclopramide
  2. phenothiazine
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18
Q

first line for disorders of balance

A

antihistamines

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19
Q

1st and 2nd line for NV of pregnancy

A
  1. antihistamines + B6
    (doxylamine/Unisom + B6)
    Diclegis or Bonjesta if OTC do not work
  2. 5-HT3 > metoclopramide
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20
Q

1st and 2nd line for gastroparesis

A
  1. metoclopramide
  2. erythromycin
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21
Q

Apfel Criteria for post-op NV (4)

A

female
nonsmoker
hx of motion sickness or PONV
planned used of post-op opioids

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22
Q

what treatment is used for PONV if score 4 (high risk)

A

scopolamine patch 2 hours before anesthesia
IV dexamethasone after anesthesia
5HT3 at end of surgery

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23
Q

treatment for moderate risk PONV (score 2-3)

A

5HT3 at end of surgery

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24
Q

treatment for low risk PONV (score 0-1)

A

no planned therapy

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25
Q

rescue therapy for PONV

A

5HT3 antagonist or drug from another class

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26
Q

general approach of treatment for acute constipation

A

osmotic, sitmulant

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27
Q

general approach of treatment for chronic constipation

A
  1. bulk forming
  2. osmotic/stimulant
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28
Q

therapies used for chronic idiopathic constipation

A

lubiprostone
linaclotide
plecanatide

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29
Q

generic for amitiza

A

lubiprostone

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30
Q

generic for linzess

A

linaclotide

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31
Q

generic for trulance

A

plecanatide

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32
Q

side effects of lubiprostone

A

diarrhea and nausea

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33
Q

side effects of linzess

A

diarrhea

34
Q

side effect of plecanatide

A

lower diarrhea rate

35
Q

1st and 2nd line OTC options for opioid induced constipation

A
  1. osmotics- miralax, lactulose
  2. stimulants- bisacodyl, senna
36
Q

RX options for opioid induced constipation

A

methylnaltrexone
naloxegol
naldemidine
lubiprostone

37
Q

generic for Relistor

A

methylnaltrexone

38
Q

generic for Movantik

A

naloxegol

39
Q

generic for Symproic

A

naldemidine

40
Q

what class of drugs is relistor, movantik, and symproic

A

M receptor peripheral antagonists

41
Q

treatment options for diarrhea (3)

A

loperamide
diphenoxylate + atropine
octeotride

42
Q

generic for Lomitol

A

diphenoxylate + atropine

43
Q

why is atropine in Lomitol?

A

limits abuse, drug is a control

44
Q

self care diarrhea options

A

pepto bismol, pedialyte, imodium

45
Q

chronic pain at least 1 day a week in the last 3 months associated with defecation, change in stool frequency, and change in stool consistency

A

IBS diagnosis criteria

46
Q

treatment options for IBS-C (5)

A

lubiprostone
linaclotide
procanatide
tenapanor
Tegaserod

47
Q

generic for Ibsrela

A

tenapanor

48
Q

side effect of IBS-C treatment

A

diarrhea

49
Q

treatment for IBS-D (3)

A

rifaximin
eluxadoline
alosetron

50
Q

generic for xifaxan

A

rifaximin

51
Q

generic for Viberzi

A

eluxadoline

52
Q

generic for lotronex

A

alosetron

53
Q

when is xifaxan considered? what is the course of therapy?

A

SIBO present
14 day course repeated twice PRN

54
Q

what is the REMS for alosetron

A

severe constipation and ischemic colitis
discontinue in 4 weeks if no benefit occurs

55
Q

what is the adverse event associated with viberzi

A

sphincter of oddi spasm/dysfunction

56
Q

contraindications to viberzi

A

pancreatitis, alcoholism of 3 or more drinks/day, do not have a gallbladder
due to sphincter of oddi effect

57
Q

options for any subtype of IBS

A

antidepressants (TCAs, SSRIs)
soluble fiber
Dicyclomine

58
Q

heartburn > 3months or refractory to OTC therapy

A

GERD

59
Q

empiric treatment started with > 3months of refractory GERD

A

lifestyle mod + 8 weeks PPI QD

60
Q

what to do after initial GERD treatment if symptoms
resume?
improve?
do not improve?

A

resume- find lowest dose
improve- d/c therapy
do not improve- continue PPI, consider +/- H2RA PRN, go to BID PPI

61
Q

when is long term PPI treatment required for GERD

A

Barrett’s esophagus
strictures
severe erosive esophagitis

62
Q

potential outcomes from long term PPI use

A

C diff, gastroenteritis, SIBO, pneumonia, CKD + AKI, bone fracture, dementia, MI

63
Q

stomach acid eating away at the GI lining

A

PUD

64
Q

2 major causes of PUD

A

H. pylori
NSAIDs

65
Q

diagnosis for NSAID PUD

A

EGD when symptoms + history

66
Q

diagnosis for H pylori PUD

A

Invasive- EGD, tissue sample + culture
Noninvasive- Ab blood test, UBT

67
Q

treatment of H. pylori PUD

A

14 day therapy with antibiotics + PPI

68
Q

triple therapy regimen for H pylori PUD

A

PPI BID
clarithromycin 500 mg BID
amoxicillin 1 g BID

69
Q

bismuth quad therapy regimen for H pylori PUD

A

PPI BID
bismuth salicylate/subcitrate
tetracycline 500 mg QID
metronidazole 250 mg QID

70
Q

when is PUD prophylaxis required with NSAID use

A

DAPT (ASA + P2Y12)
multiple risk factors present

71
Q

treatment of NSAID PUD

A

PPI QD x 4-8 weeks if d/c NSAID
chronic PPI if cannot d/c NSAID

72
Q

acid suppression regimen for UGIB

A

IV PPI x 3 days: 80 mg panto/eso bolus then 40 mg IV BID
discharge on BID PO x 2 weeks then switch to QD

73
Q

generic for zegerid

A

omeprazole

74
Q

generic for prevacid

A

lansoprazole

75
Q

generic for aciphex

A

rabeprazole

76
Q

generic for protonix

A

pantoprazole

77
Q

generic for nexium

A

esomeprazole

78
Q

generic for dexilant

A

dexlansoprazole

79
Q

generic for tagamet

A

cimetidine

80
Q

generic for pepcid

A

famotidine

81
Q

genetic for axid

A

nizatidine

82
Q

generic for zantac

A

ranitidine

Therapeutics (20 decks)

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