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Gastroenterology > Pharm > Flashcards

Pharm Flashcards

1
Q

Hep B Tx

A

First line: pegylated interferon alpha, entecavir, tenofovir disoproxil fumarate (TDF)*

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2
Q

C. diff colitis Tx

A

metronidazole (PO, IV)

vancomycin (PO only! IV doesn’t penetrate gut)*

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3
Q

Hep C Tx

A

protease inhibitor (eg sofosbuvir/simeprevir)

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4
Q

H. pylori Tx

A

1st line: Triple therapy regimen (10-14 days)
Clarithromycin: 500mg PO BID
Amoxicillin: 1g PO BID
Metronidazole: 500mg PO BID
PPI PO BID (eg esomeprazole, lansoprazole)

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5
Q

Gastroparesis Tx**

A

Metoclopramide (Reglan) – acts on dopamine receptors in stomach/intestines/brain
**watch for tardive dyskinesias

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6
Q

Giardia Tx

A

Metronidazole

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7
Q

Tx Cryptosporidiosis

A

Nitazoxanide

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8
Q

Pancreatitis Tx

A 
DO NOT SEND PTS HOME (acute)
Maintain pt NPO
IV fluids* (helps)
Pain control – Meperidine standard but shifting now to Dilaudid (concern that morphine and its derivatives can cause spasm at sphincter of Oddi and increased biliary pressure, can make ab pain/Sx worst)
Anti-emetic – IV zofran, phenergan
Parenteral antacid (H2 blocker or PPI)
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9
Q

1st line Tx of hypertriglyceridemia

A

Fibrates

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10
Q

Spontaneous Bacterial Peritonitis tx**

A

Cefotaxime x 5 days

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11
Q

Medications that can cause chronic liver dz and cirrhosis**

A

Amiodarone

Methotrexate

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12
Q

Hepatotoxic meds

A

NSAIDs, isoniazid, valproic acid, erythromycin, amoxicillin-clavulanate, ketoconazole, chlorpromazine, ezetimibe
Limit acetaminophen <2g/day

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13
Q

Crohn’s Dz Tx

A

mild to mod: salicylate (5 ASA), maintenance mesalamine
mod to sev: systemic corticosteroids (prednisone or Budesonide), consider immunosup maintenance (azathioprine)
Humira, Infliximab, methotrexate, tacrolimus f refractory
no immunosuppressants if infectious colitis on DDx

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14
Q

Examples of 5-ASA (5-aminosalicylates)

A

Rowasa, Pentasa, Asacol

1st step Tx in IBD

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15
Q

Entocort

A

Budesonide, used in IBD

Steroid whose systemic effects are reduced due to first pass in the liver.

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16
Q

glucagon in acute dysphagia

A

glucagon 1 mg IV to relax lower esophagus first - let blous pass on its own

17
Q

Eosinophilic esophagitis tx

A

First line – inhaled corticosteroid (spray during breath hold then swallow) x 8 wks
Candida esophagitis – most common adverse reaction

18
Q

Esophageal Motility Disorders Tx

A

CCB or TCA (EG IMIPRAMINE)

19
Q

GERD Tx

A

H2 receptor antagonist: pepcid

then PPI instead

20
Q

Over-the-counter Anti-emetics

A

sodium citrate/dextrose/fructose (Nauzene)
phosphoric acid (Emitrol)
bismuth subsalicylate (Pepto-Bismol)
Ginger (available in candies, drinks, and teas)

21
Q

Tx acute vomitting

A

Anticholinergics – hyoscyamine (Levsin), dicyclomine (Bentyl), transdermal scopolamine (Transderm Scop)
H1 antihistaminics – promethazine (Phenergan), Diphenhydramine (Benadryl), doxylamine (Unisom), meclizine (Bonine, Antivert), dimenhydrinate (Dramamine)
Dopamine receptor antagonists – metoclopramide (Reglan), domperidone, prochlorperazine (Compazine), chlorpromazine (Thorazine), haloperidol (Haldol)
5HT3-Antagonists – ondansetron (Zofran), granisetron (Kytril), dolasetron (Anzemet)
Adjuvant antiemetics – corticosteroids, benzodiazepines, cannabinoids, trimethobenzamide (Tigan), aprepitant (Emend)

22
Q

Dopamine receptor antagonist SE

A 
Extrapyramidal effects (dyskinesia, dystonia)
eg metoclopramide (Reglan), prochlorperazine (Compazine), chlorpromazine (Thorazine), haloperidol (Haldol)
23
Q

Functional chronic nausea and vomiting (after ruling out everything else) Tx

A

reassurance, low-dose Tricyclic antidepressants (Amitriptyline, Nortriptyline)

24
Q

Antidiarrheals

A 
Loperimide (Imodium)
Diphenoxylate atropine (Lomotil)
25
Q

Laxatives

A

Metamucil, colace, dulcolax, senekot, polyethylene glycol

26
Q

Elavil

A

Amitriptyline (TCA)

27
Q

IBS Symptomatic Tx

A

Imipramine (Tofranil), Amitriptyline (Elavil)
provide a visceral analgesic effect by increasing pain threshold in the gut. It prolongs oral-cecal transit time, reduces abdominal pain, mucorrhea, and stool frequency

28
Q

IBS specific Tx

A

Alosetron (Lotronex)- very limited for diarrhea
Lubiprostone (Amitiza)- constipation dominant
Linaclotide (Linzess)- Constipation dominant

Gastroenterology (2 decks)

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