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Paige: GI > Pharm Blessings for my favs (you) > Flashcards

Pharm Blessings for my favs (you) Flashcards

1
Q

well.

this is about to be shitty

A

but it doesn’t have to be T-PAINful….

https://www.youtube.com/watch?v=SyVcyT-fOao

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2
Q

But first, quick shoutout to sasha for being a BALLER and posting notes from all the cases

A

xoxoxoxoxoxoxo

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3
Q

What are 3 drug options for a person having an acute attack of diarrhea?

A
  1. Fiber
  2. Kaolin-pectin [kaopectolin]
  3. Loperinide [imodium]
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4
Q

What is the non-pharm diet treament for acute diarrhea?

A

BRAT diet

bananas, rice, applesauce, toast

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5
Q

what’s worse for diarrhea: high sugar content or low sugar content?

A

high

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6
Q

loperinide [imodium] is an opioid.

does it have analgesic effects?

A

nope

no numb nuggets for you

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7
Q

do opioids increase or decrease bowel motility?

A

decrease

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8
Q

you can use fiber [metamucil] for constipation or diarrhea.

how do you prescribe it differently?

A

for diarrhea: lots of fiber w/ little water

for constipation: lots of fiber w/ lots of water

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9
Q

your patient has chronic diarrhea secondary to a gastrectomy. what is the DOC?

A

octreotide [sandostatin] depo injection

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10
Q

in this post-gastrectomy pt with diarrhea, why can’t we give him kaolin-pectin [kaopectolin]?

A

this is absorbed in the stomach

which you took out

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11
Q

what should you supplement ocreotide [sandostatin] with

A

B12 and folate

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12
Q

your patient has ulcerative colitis. what drug is this patient likely going to be on to manage it?

A

5-ASA/mesalamine [asacol]

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13
Q

ok so she’s on this 5-ASA/mesalamine [asacol] for her ulcerative colitis. but now she’s got macrocytic anemia.

what’s going on?

A

5ASA/mesalamine [asacol] has decreased her B12/folate so supplement!

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14
Q

which drug for chron’s disease is steroid-sparing?

A

azathioprine [imuran]

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15
Q

what are the side effects of azathioprine [imuran]?

A

pancreatitis (pain, steatorrhea)

hepatitis (jaundice, itching, pain)

marrow toxicity (easy bruising, bleeding)

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16
Q

what are you at an increased risk for when you mix azathioprine [imuran] with sulfasalazine [azulfadine]?

A

myelosuppression

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17
Q

how long does it take for azathioprine [imuran] to take full effect?

A

3-6 months

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18
Q

an old man is constipated…. shocker.

what are you going to give him?

A

miralax

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19
Q

what’s the ratio of miralax:water for constipation?

A

one tbsp : 240ml

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20
Q

after taking miralax, within how many days should you have a BM?

A

1 to 3

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21
Q

what makes people with constipation lazy?

A

they just don’t give a shit

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22
Q

OBVIOUSLY what do you r/o in a patient with constipation?

A

obstruction or impaction

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23
Q

what is the DOC for esophageal varices?

A

octreotide [sandostatin]

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24
Q

Tommy went on a tangent about how octreotide [sandostatin] treats esophageal varices…

so why does that work?

A

it constricts the stomach vessels which then decreases hepatic/portal blood flow which then decreases the pressure in the esophagus

in a nutshell

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25
Q

regardless of what the drug table says, what is used all the time for people who are nauseous and vomming?

A

odansetron [zofran]

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26
Q

what is the typical regimen for HCV?

A

PEG interferon + ribavirin [virazole] + sofosbuvir [sovaldi]

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27
Q

what is the alternative regimen for HCV that costs like 40,000 dolla dolla bill ya’lls?

A

Ledapisvir + Sofosbuvir [Harvoni]

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28
Q

which HCV regimen has less s/e?

A

harvoni

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29
Q

pick the correct word in parentheses:

a) ribavirin [virazole] is for (eradication, suppression) of HCV
b) lamivudine [epivir] is for (eradication, suppression) of HBV

A

a) eradication
b) suppression

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30
Q

what is the DOC for hepatic encephalopathy?

and why?

A

lactulose [enulose]

induces BM to get rid of wastes

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31
Q

what is the secondary agent for hepatic encephalopathy if lactulose [enulose] doesn’t work?

A

rifaximin [xifaxan]

*side note: white is weirdly obsessed with this drug because it’s new so i would take a look at it*

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32
Q

chemically, what does lactulose [enulose] do?

A

prevents the conversion from ammonia to ammonium

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33
Q

chemically, what does rifaximin [xifaxan] do?

A

alternates the bacteria flora to have the safe effect as lactulose [enulin]

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34
Q

what are the MC s/e of lactulose [enulin]?

A

gas and diarrhea

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35
Q

what is the DOC for steatorrhea secondary to chronic pancreatitis?

A

pancrelipase [viokace]

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36
Q

what could make someone’s pancrelipase [viokace] be less effective?

A

increased stomach acids

the drug might get partially broken down by the time it gets to the duodenum

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37
Q

what other disease is steatorhhea seen in?

A

cystic fibrosis

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38
Q

oh my good god this is only case 9

A

oh baby i got what you need

https://www.youtube.com/watch?v=EPFGUHDIHwQ

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39
Q

what is a pancreatic analgesic that is to be taken after surgery?

A

Meperidine [demerol]

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40
Q

can elderly take Meperidine [demerol]?

A

nope - confusion, seizures

41
Q

when do we make the most acid?

when should we take an H2 blocker?

A

7pm

take at 6pm

42
Q

what is the DOC for GERD with nocturnal sx?

A

ranitidine [zantac]

43
Q

how long does it take PPIs to have max effect?

A

3-5 days

44
Q

how long are PPIs FDA approved to take for?

A

12 weeks

(but like literally everyone I know that’s on them takes them forever)

45
Q

what can happen if you take PPIs for 1-2 years?

A

inc risk for:

CVD

hip fracture

gastric atrophy

decreased B12 absorption

pneumonia

cdiff

46
Q

what is the ONLY PPI you can go on while on clopidogrel?

A

pantoprazole [protonix]

47
Q

what enzyme metabolizes both PPIs and clopidogrel?

A

QRN83X3

lol just kidding that’s nonsense it’s CYP

48
Q

i’m literally fresh outta good jokes

A

usually they just ooze right out of me like mucopurulent discharge oozes out of a pilonidal cyst

like diarrhea oozes out of a butthole

like vomit oozes out of you after reading that

49
Q

how do you tell a patient to take pantoprazole [protonix]?

A

one hour prior to breakfast and other drugs

50
Q

which drug is used as a surfactant to treat ulcers?

A

sulcrafate [carafate]

51
Q

which drug is used to treat NSAID ulcers?

A

misoprostol [cytotec]

52
Q

what is the DOC for diverticulitis?

A

cipro and metronidazole

(AKA flagyl for your vagyl)

(but now it’s metronid for your divertic)

for 10-14 days

53
Q

what are the 2 MC side effects of cipro?

A

diarrhea oozes from your butthole

tendon rupture

54
Q

what’s the DOC for cdiff?

and then what if that doesn’t work?

and then what’s your 3rd line?

A

metronidazole [flagyl]

IV vanco

rifaximin [xifaxan]

(see! white never talks about 3rd line agents. he loves rifaximin)

55
Q

So Primaxin is what gave flash card #54 cdiff. What is primaxin used for?

A

anti-pseudomonas

56
Q

what’s the triple drug regimen for H pylori duodenal ulcers?

A
  1. omeprazole 2x daily
  2. amox or metronidazole [flagyl]
  3. clarithromycin
57
Q

what’s the quad drug regimen for H pylori ulcers?

A
  1. omeprazole 2x daily
  2. tetracycline
  3. metronidazole
  4. bismuth
58
Q

when should you take omeprazole?

A

on empty stomach one hour before breakfast

59
Q

DOC for IBS-D?

A

loperimide [imodium]

60
Q

DOCs for IBS-C?

A

senokot [senna]

fiber

61
Q

why are men like laxatives?

A

they irritate the shit out of you

62
Q

how are women like anti-diarrheals?

A

they help make things get hard

WOAH THIS JOKE IS RATED NC-17

63
Q

what if IBS cramping doesn’t go away?

A

put on antispasmodic

64
Q

your patient has a history of gout and NSAID GI bleeds.

what could you give for ppx of GI bleeds?

A

PPI like omeprazole

65
Q

this is just a weird case but

same dude. same hx of gout. STILL had a GI bleed on a PPI. He still wants to continue the NSAID, so what do you do?

A

change to cox-2 inhibitor for NSAID (like celcoxib)

increase PPI dosage

give misoprostol [cytotec] to protect

give sucralfate [carafate] to protect

66
Q

which drug is a synthetic prostaglandin?

a) sucralfate [carafate]
b) misoprostol [cytotec]

A

misoprostol [cytotec]

67
Q

what are your two drug options for motion sickness?

A

meclizine

scopolamine

68
Q

which motion sickness drug is a patch?

A

scopolamine

69
Q

how early do you have to apply the scopolamine patch, and how often do you change it?

A

apply 4 hours before

change every 72h

70
Q

what is the biggest s/e of meclizine?

A

sedation

71
Q

what might the elderly experience as a s/e to either meclizine or scopolamine?

A

urinary retention

72
Q

what are the s/e of anticholinergic drugs like scopolamine?

A

no pee

no see

no spit

no shit

73
Q

which anti-emetic drug do you give pre-op and post-op?

A

ondansetron [zofran]

74
Q

which 3 drugs together are 90% effective for n/v from chemo/rad?

A

ondansetron [zofran]

aprepitant [emend]

dexamethasone [maxidex]

75
Q

which post-chemo drug is dissolved under the tongue?

A

ondansetron [zofram]

76
Q

which post-chemo drug is short-term use?

A

aprepitant [emend]

77
Q

UGH IS THIS OVER YET

what 2 drugs do you give as PRE-chemo treatment, one hour before?

A

dexamethasone [maxidex]

aprepitent [emend]

78
Q

what are the indications for meclizine [antivert]?

A

vertigo

motion sickness prev + tx

79
Q

what are the indications for ondansetron [zofran]?

A

postop n/v

(but like Tdubs said.. it’s used all the time)

80
Q

what’s the MOA of meclizine [antivert]?

A

anticholinergic

antihistamine

H1 agonist

works at vestibular-cerebellar pathways

81
Q

what’s the MOA of ondansetron [zofran]?

A

serotonin antagonist

82
Q

what’s the MOA of dexamethasone [maxidex]?

A

corticosteroid

but works on serotonin receptors too

83
Q

which drug decreases the effectiveness of progestin?

A

aprepitant [emend]

84
Q

what is a great medicine, but should not be prescribed for diarrhea?

A

laughter

85
Q

what is the DOC for diabetic gastroparesis?

A

metoproclomide [reglan]

86
Q

what type of drug is metoproclomide [reglan]?

A

prokinetic agent

87
Q

how long are prokinetic agents FDA approved for?

why is this an issue with gastroparesis?

A

12 weeks

an issue because gastroparesis never really goes away

88
Q

what does metoproclimide [reglan] have a black box warning for?

A

extrapyrimidal sx like tardive dyskinesia

89
Q

did i make this card already?

when do we tell a pt to take a PPI?

A

30-60 minutes before breakfast

yes i think i made this card already

if you were wondering @ which card you start to get forgetful the answer is card 89

90
Q

what are alarming sx with PUD or GERD?

A

coffee ground emesis

dysphagia

black tarry stool

(get endoscopy)

91
Q

what happens if you don’t titrate down a PPI?

A

rebound acid effect

92
Q

what is the treatment for chronic HCV genotype 2?

A

Sofosbuvir + Ribavarin for 12 weeks

93
Q

you’re putting a male on ribavarin [virazole]. What do you have to tell him if he has a partner?

A

that this drug is some alien shit and it turns his sperm into hitmen ninjas that can abort another woman’s baby just because he’s on the drug

like whaaaaaat

94
Q

how many hepatitis cases did we have?

A

“3.”

“know them.”

-blessington

95
Q

what 2 drugs can you rx for IBS-C that is non-responsive to OTC shizzz?

A

lubiprostone [amitiza] or linclotide [linzess]

96
Q

for what age group of women can you not rx lubiprostone [amitiza]?

A

less than 18y

97
Q

what drug class is lubiprostone [amitiza]?

A

laxative

calcium channel activator

98
Q

what is the name of the colonoscopy prep and what do you need to know about it?

A

it’s called GoLytely

it’s an osmotic electrolyte laxative

GI practices use different variations of this

watch dehydration with this!

99
Q

OMG YOU DID IT

I DID IT

I DIDN’T THINK I WAS GOING TO MAKE IT

A

good luck and happy pooping!

Paige: GI (3 decks)

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