NV,D,C,IBS,GERD/PUD

Question 1

antihistamine options for NV

Answer 1

dimenhydrinate
diphenhydramine
meclizine
doxylamine
scopolamine
hydroxyzine

Question 2

generic for Bonine

Answer 2

meclizine

Question 3

generic for Unisom

Answer 3

doxylamine

Question 4

generic for dramamine

Answer 4

dimenhydrinate

Question 5

phenothiazines used for NV

Answer 5

promethazine
prochlorperazine

Question 6

generic name for phenergan

Answer 6

promethazine

Question 7

genetic name for compazine

Answer 7

prochlorperazine

Question 8

side effects of phenothiazines

Answer 8

hypotension, QTcP, EPS

Question 9

BBW for phenergan (promethazine)

Answer 9

tissue damage – DO NOT GIVE IV

Question 10

main 5-HT3 antagonist used for NV

Answer 10

ondansetron (zofran)

Question 11

side effects of zofran

Answer 11

constipation, headache, QTcP

Question 12

prokinetics used for NV

Answer 12

metoclopramide
erythromycin

Question 13

generic for reglan

Answer 13

metoclopramide

Question 14

side effects of Reglan

Answer 14

EPS, QTcP, diarrhea

Question 15

side effects of erythromycin

Answer 15

NV, diarrhea, QTcP

Question 16

corticosteroid used for NV

Answer 16

dexamethasone

Question 17

1st and 2nd line for general NV

Answer 17

1. 5HT3 > metoclopramide
2. phenothiazine

Question 18

first line for disorders of balance

Answer 18

antihistamines

Question 19

1st and 2nd line for NV of pregnancy

Answer 19

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

Question 20

1st and 2nd line for gastroparesis

Answer 20

1. metoclopramide
2. erythromycin

Question 21

Apfel Criteria for post-op NV (4)

Answer 21

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

Question 22

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

Answer 22

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

Question 23

treatment for moderate risk PONV (score 2-3)

Answer 23

5HT3 at end of surgery

Question 24

treatment for low risk PONV (score 0-1)

Answer 24

no planned therapy

Question 25

rescue therapy for PONV

Answer 25

5HT3 antagonist or drug from another class

Question 26

general approach of treatment for acute constipation

Answer 26

osmotic, sitmulant

Question 27

general approach of treatment for chronic constipation

Answer 27

1. bulk forming 2. osmotic/stimulant

Question 28

therapies used for chronic idiopathic constipation

Answer 28

lubiprostone linaclotide plecanatide

Question 29

generic for amitiza

Answer 29

lubiprostone

Question 30

generic for linzess

Answer 30

linaclotide

Question 31

generic for trulance

Answer 31

plecanatide

Question 32

side effects of lubiprostone

Answer 32

diarrhea and nausea

Question 33

side effects of linzess

Answer 33

diarrhea

Question 34

side effect of plecanatide

Answer 34

lower diarrhea rate

Question 35

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

Answer 35

1. osmotics- miralax, lactulose 2. stimulants- bisacodyl, senna

Question 36

RX options for opioid induced constipation

Answer 36

methylnaltrexone naloxegol naldemidine lubiprostone

Question 37

generic for Relistor

Answer 37

methylnaltrexone

Question 38

generic for Movantik

Answer 38

naloxegol

Question 39

generic for Symproic

Answer 39

naldemidine

Question 40

what class of drugs is relistor, movantik, and symproic

Answer 40

M receptor peripheral antagonists

Question 41

treatment options for diarrhea (3)

Answer 41

loperamide diphenoxylate + atropine octeotride

Question 42

generic for Lomitol

Answer 42

diphenoxylate + atropine

Question 43

why is atropine in Lomitol?

Answer 43

limits abuse, drug is a control

Question 44

self care diarrhea options

Answer 44

pepto bismol, pedialyte, imodium

Question 45

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

Answer 45

IBS diagnosis criteria

Question 46

treatment options for IBS-C (5)

Answer 46

lubiprostone linaclotide procanatide tenapanor Tegaserod

Question 47

generic for Ibsrela

Answer 47

tenapanor

Question 48

side effect of IBS-C treatment

Answer 48

diarrhea

Question 49

treatment for IBS-D (3)

Answer 49

rifaximin eluxadoline alosetron

Question 50

generic for xifaxan

Answer 50

rifaximin

Question 51

generic for Viberzi

Answer 51

eluxadoline

Question 52

generic for lotronex

Answer 52

alosetron

Question 53

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

Answer 53

SIBO present 14 day course repeated twice PRN

Question 54

what is the REMS for alosetron

Answer 54

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

Question 55

what is the adverse event associated with viberzi

Answer 55

sphincter of oddi spasm/dysfunction

Question 56

contraindications to viberzi

Answer 56

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

Question 57

options for any subtype of IBS

Answer 57

antidepressants (TCAs, SSRIs) soluble fiber Dicyclomine

Question 58

heartburn > 3months or refractory to OTC therapy

Answer 58

GERD

Question 59

empiric treatment started with > 3months of refractory GERD

Answer 59

lifestyle mod + 8 weeks PPI QD

Question 60

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

Answer 60

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

Question 61

when is long term PPI treatment required for GERD

Answer 61

Barrett's esophagus strictures severe erosive esophagitis

Question 62

potential outcomes from long term PPI use

Answer 62

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

Question 63

stomach acid eating away at the GI lining

Answer 63

PUD

Question 64

2 major causes of PUD

Answer 64

H. pylori NSAIDs

Question 65

diagnosis for NSAID PUD

Answer 65

EGD when symptoms + history

Question 66

diagnosis for H pylori PUD

Answer 66

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

Question 67

treatment of H. pylori PUD

Answer 67

14 day therapy with antibiotics + PPI

Question 68

triple therapy regimen for H pylori PUD

Answer 68

PPI BID clarithromycin 500 mg BID amoxicillin 1 g BID

Question 69

bismuth quad therapy regimen for H pylori PUD

Answer 69

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

Question 70

when is PUD prophylaxis required with NSAID use

Answer 70

DAPT (ASA + P2Y12) multiple risk factors present

Question 71

treatment of NSAID PUD

Answer 71

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

Question 72

acid suppression regimen for UGIB

Answer 72

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

Question 73

generic for zegerid

Answer 73

omeprazole

Question 74

generic for prevacid

Answer 74

lansoprazole

Question 75

generic for aciphex

Answer 75

rabeprazole

Question 76

generic for protonix

Answer 76

pantoprazole

Question 77

generic for nexium

Answer 77

esomeprazole

Question 78

generic for dexilant

Answer 78

dexlansoprazole

Question 79

generic for tagamet

Answer 79

cimetidine

Question 80

generic for pepcid

Answer 80

famotidine

Question 81

genetic for axid

Answer 81

nizatidine

Question 82

generic for zantac

Answer 82

ranitidine