Pharm

Question 1

What medication side effect is being described? Crosses BBB, confusion, dizziness, HA, anti-androgen effects, and decreases renal clearance of creatinine?

Answer 1

H2-blockers

Cimetidine and ranitidine

Question 2

What medication side effect is being described? Increased risk of C. Difficile, pneumonia, hip fractures, and decreased Mg2+

Answer 2

PPIs

Question 3

This medication MOA is to slow things down. It is a long acting analog, and SE includes nausea, cramps, and steatorrhea.

Answer 3

Octreotide - MOA is that it reduces splanchnic blood flow, thus slows down everything

Question 4

Fibrates, rifampin, prednisone, Statins, INH, all cause what?

Answer 4

Rhabdomyolysis

Question 5

Cholestyramine, Colestipol, and cholesevelam are all what? What is their MOA?

Answer 5

Bile acid resins - they block intestinal reabsorption of bile resins. These drugs also help lower cholesterol

Question 6

What is the MOA of Azitamide?

Answer 6

Blocks the reabsorption of cholesterol at the intestinal brush border, thus decreasing systemic cholesterol

Question 7

What is the treatment for hepatic encephalopathy, and why?

Answer 7

Lactulose (increase NH4+ generation) + rifaximin or neomycin (to decrease NH3 producing gut bacteria)

Question 8

What is the MOA of PPIs?

Answer 8

Irreversibly inhibit H/K+ ATPase in stomach parietal cells.

Question 9

Biggest side effect of Aluminum OH?

Answer 9

Constipation and hypophosphatemia (muscle weakness, osteodystrophy, seizures).

Question 10

Most common side effect of Calcium Carbonate?

Answer 10

Hypercalcemia which can cause rebound acid increase.

-Can chelate and decrease the effectiveness of other drugs like tetracyclines.

Question 11

What is the most common side effect of MgOH?

Answer 11

Diarrhea, hyporeflexia, hypotension, and cardiac arrest.

Question 12

What is the MOA of Misoprostol?? What is the side effect??

Answer 12

PGE1 analog - increases the production and secretion of gastric mucous barrier, and decreases acid production.

SE: diarrhea + abortifacient (increases uterine contractions)

Question 13

What is the MOA of ondansetron?

Answer 13

It is a 5-HT3 antagonist, thus decreasing vagal stimulation. Used mainly as an anti-emetic.

Question 14

What is the MOA of metoclopramide? When is it used?

Answer 14

D2 receptor antagonist - increasing the resting tone, contractility, LES tone, promotes gastric emptying (but does not increase colon transport time).

Uses: diabetic gastroparesis, post Qx, anti-emetic, and persistent GERD.

Question 15

What is the MOA of Orlistat?

Answer 15

Inhibits gastric and pancreatic lipase —> can’t absorb dietary fats.

Question 16

What is the MOA of polyethylene glycol?

Answer 16

Provides osmotic load to draw water to GI lumen.

SE: diarrhea and dehydration

Question 17

What is the MOA of Aprepitant? What is it’s clinical use?

Answer 17

Substance P antagonist. Blocks NK1 (neurokinin-1) receptors in brain.

Clinical use: Antiemetic for chemotherapy-induced nausea and vomiting.

Question 18

A patient presents with tinnitus, dizziness, headache, and GI distress. What is this called and what medication did this Px take?

Answer 18

Cinchonism caused by Quinine or Quinidine.

Question 19

What is the MOA of lactulose?

Answer 19

It is digested by bacteria in the colon creating an acidic environment. Ammonia is converted to ammonium—> ammonium is trapped in the colon and excreted in the stool.

Question 20

What medications inhibit Cytochrome P450?

Answer 20

CRACK AMIGOS:
Ciprofloxacin
Ritonavir
Amiodarone
Cimetidine
Ketoconazole
Acute -OH use
Macrolides 
Isoniazid 
Grapefruit juice 
Omeprazole
Sulfonamides