Pharm 2 exam 5 Flashcards
albumin indications
> 5L paracentesis, SBP, hepatorenal syndrome
ascites treatments
spironolactone +/- furosemide
2g Na+ diet
variceal bleeding treatments
octreotide and band ligation
ceftriaxone
prophylaxis with non-selective BB
hepatic encephalopathy treatments
lactulose
rifaximin
hepatorenal syndrome treatments
albumin
octreotide
midodrine
SBP treatments
IV 3rd gen ceph or fluoroquinolones
prophylaxis with fluoro or bactrim
albumin
jaundice treatment
1st gen antihistamines
BAS- cholestyramine
TCAs- doxepin
octreotide MOA
somatostatin analog that decreases splanchnic blood flow
octreotide ADRs
decreased glucose regulation
pancreatitis
diarrhea
lactulose MOA
acidifies gut and facilitations ammonia –> ammonium
*give q 30 min until BM and titrate until 2-3 BM/day
rifaximin use and MOA
used for recurrent encephalopathy NOT monotherapy
non-absorbable abx that decreases bacterial RNA synthesis and decreases ammonia secreting bacteria
rifaximin ADRs
peripheral edema
ascites
c diff
midodrine MOA
alpha 1 agonist–> increases vascoconstriction and increases renal perfusion
midodrine ADRs
supine HTN
paresthesias
calcium containing antacid ADR
milk alkali syndrome (metabolic acidosis, increased Ca2+, renal impairment)
Mg antacid ADR
diarrhea
Al antacid ADR
constipation
Mg and Al containing antacids should be avoided in _____ impairment pts
renal
H2 receptor blocker MOA
decreases histamine receptors on parietal cells which decreases H+ secretion and decreases gastrin and pepsin
ADRs of H2 receptor blockers
HA, diarrhea, B12 def if > 2 yrs
QTc prolongation in renal
rare- gynecomastia, AMS, thrombocytopenia
DI of H2 receptor blockers
CYP inhibition
PPI MOA
irreversibly inhibits H/K ATPase proton pump in parietal cells
use/ education of PPIs
take on empty stomach 1 hr before meal
full inhibition 3-4 days after 1st dose
PPI DIs
metabolized by 3A4 and 2C19
DI- inhibits 2C9 and 2C19 *do not take clopidogrel
