Pancreatic Meds Flashcards
PANCRELIPASE (Viokase) Class
Pancreatic enzymes
PANCRELIPASE (Viokase) Indication
chronic pancreatitis
PANCRELIPASE (Viokase) MOA
supplemental enzymes (lipase, amylase, protease)
What’s the dosing of PANCRELIPASE (Viokase)?
~30,000units/meal
What allergy do we need to consider when giving PANCRELIPASE (Viokase)?
Pork!
MEPERIDINE (Demerol) Class
opioid analgesic (synthetic)
MEPERIDINE (Demerol) Indication
short-term use peri-op and acute pancreatitis (less sphincter of Oddi spasm?)
MEPERIDINE (Demerol) MOA
binds to mu opioid receptors in CNS and inhibits ascending pain pathways
RANITIDINE (Zantac) Class
H2 receptor antagonist
RANITIDINE (Zantac) Indication
peptic ulcer disease, GERD
RANITIDINE (Zantac) MOA
competitive inhibition of H2-receptors of gastric parietal cells reduce basal and stimulated acid production
Is Meperidine a good choice for an elderly patient?
NO! It can cause seizures!! BLACK BOX WARNING
Can only be used acutely
What type of symptoms do we typically prescribe ranitidine for?
GERD with nocturnal symptoms
What is the best time to take ranitidine? Why?
between 6PM
Because the highest production of acid occurs at 7PM
Where do PPI’s work?
On the parietal cells, binding to H, K+ATPase, inactivating the enzyme.
How do we administer a PPI?
On an empty stomach
How long does a PPI work for?
24 hours
How long does it take to see full effects of a PPI?
3-4 days; can also take 3-4 days to come off the medication
OMEPRAZOLE (Prilosec) Class
proton pump inhibitor (PPI)
OMEPRAZOLE (Prilosec) Indicaiton
peptic ulcer disease, GERD; prevention of NSAID ulcers; stress ulcer prophylaxis in critically ill
OMEPRAZOLE (Prilosec) MOA
inhibits basal and stimulated parietal cell proton pump acid secretion
What medication can you not take with Omeprazole (prilosec)?
Clopidogrel!
If a patient is on clopidogrel and has GERD, what other PPI can you prescribe?
PANTOPRAZOLE (Protonix)
PANTOPRAZOLE (Protonix) Indicaitons
PUD, GERD; prevention of NSAID ulcers; stress ulcer prophylaxis in critically ill
PANTOPRAZOLE (Protonix) MOA
inhibits basal and stimulated parietal cell proton pump acid secretion
So, can we stop a PPI abruptly?
No
How long before a meal should we tell our patients to take their PPI?
0.5-1 hour before
What antibiotic can we use to treat resistant gram negative psudeomonas and enterobacter infections?
IMIPENEM-CILASTIN (Primaxim)
IMIPENEM-CILASTIN (Primaxim) indication
intra-abdominal infections, liver abscess, lower respiratory tract and GYN organ infections
IMIPENEM-CILASTIN (Primaxim) MOA
inhibits bacterial cell wall synthesis with lyses of bacterial cells
CIPROFLOXACIN (Cipro) Class
Fluoroquinolone
CIPROFLOXACIN (Cipro) Indications
diverticulitis, mild; traveler’s diarrhea; UTIs, anthrax (inhalation, cutaneous, GI), chlamydial infections, cholera, salmonosis, shigella
What must we always remember is a S/E of cipro?
tendon rupture!
And QT prolongation, rash, and photosensativity
METRONIDAZOLE (Flagyl) indicaiton
anaerobic bacterial and protozoal infections: diverticulitis; c diff colitis; vaginitis; brain abscess; rosacea, amebiasis, giardiasis, trichomonas
METRONIDAZOLE (Flagyl) MOA
disrupts DNA structure inhibiting protein synthesis producing cell death
VANCOMYCIN (Vancocin) indicaiton
PO treatment of staph enterocolitis or antibiotic-associated pseudomonas (c. diff) colitis: IV MRSA, HAP meningitis, pre-op Px infective endocarditis
VANCOMYCIN (Vancocin) Class
glycopeptide antibiotic
VANCOMYCIN (Vancocin) MOA
inhibits bacterial cell wall synthesis by blocking polypeptide polymerization
