Pharm exam 4

Question 1

Cytotec

Answer 1

Drug class: Prostaglandin E analog
prototype: Misoprostol
MOA: Decreases acid secretion, increased sodium bicarbonate and protective mucus to prevent gastric ulcers
Use: Long-term NSAID treatment and promotes cervical ripening in pregnant people or medical induced termination of pregnancy
A/E: Diarrhea and dysmenorrhea, spotting
Administration: Take with meals and at bed time

Question 2

Loperamide and Lomotil

Answer 2

Drug Class: opioids for lomotil// loperamide is antidiarrheal
Prototype: lomoril: diphenoxylate with atropine or loperamide (imodium)
MOA: Decrease intestinal peristalsis, increased absorption of water in feces
A/e: Cardiac arrest/dysthymias, anti-cholinergic effects, dizziness, light headedness
Interventions: monitor I&O for urinary retention, suck on candy
Administration: naloxone for OD, orthostatic hypotension (slow position changes), urinate Q4 hours
Contraindications: glaucoma, Gi bleed, Hepatic disease, IBD

Question 3

Antacid

Answer 3

Treats: Peptic ulcers disease and Gerd
Prototype: Aluminum Hydroxide (Amphojel)
-also calcium-base: calcium carbonate (tums)
-also Magnesium-based: Milk of meg (diuretic effect)
MAO: Neutralize gastric acid
A/E: constipation for Al+ and Ca+ antacids and diarrhea with Mag+ antacids
- hypophosphatemia with Al+ antacids
Interventions: Monitor for bowl function
Administration: Up to four days per day, follow with a full glass of water, do not give within 1-2 hours with interacting drugs
Contraindications: Severe unknown abdominal pain, caution with hypercalcemia and hypophosphatemia

Question 4

H2 blockers

Answer 4

Treats: Gastric and duodenal ulcer, heartburn, dyspepsia, GERD, Zollinger-Ellison syndrome, and aspiration pneumonitis
Prototype: Cimetidine (Tagamet) **TIDINES
-Famotidine (pepcid), nizatidine (Axid)
MOA: block histamine in stomach
A/E Impotence, gynecomastia, decreased libido
Intervention: Assess adults for confusion
Administration:
-with or without food / does not affect absorption
- do not give with antacids with 1H of admin due to decreased absorption oh H2 blocker
-No NSAIDs or alcohol for GI upset
- No smoking
Contraindications: Can increase warfarin levels

Question 5

PPI

Answer 5

Treats: Gastric and duodenal ulcer, GERD, erosive esophagitis, mastocytosis
Prototype: Omeprazole **PRAZOLE
MOA: Inhibit H+ K+ ATPase enzyme system in the parietal cells of stomach. Suppresses gastric acid production
● A/E: Bone loss, headache, abd pain, N/V/D, hypomagnesemia, C. Diff
● Interventions: Monitor bone density and Mg+ levels
● Administration: In the morning before first meal of the day
● Instructions: Do weight bearing activities daily, increased calcium and vitamin D intake, and report N/V/D
● Contraindications: Use with caution on pregnant people and liver dysfunction. Rilpirivine. Can increase levels of warfarin.

Question 6

Sucralfate

Answer 6

● Mucosal Protectants: treat acute duodenal ulcer
● MOA: Gel coats ulcer and creates a barrier in the stomach
● A/E: Constipation
● Interventions: Admin stool softener as prescribed, increase fiber and water intake
● Administration: Administer on an empty stomach, give 4x daily one hour before meals and at bedtime. Space antacids out by 30 minutes. Can decrease absorption of some drugs, space out other drugs by 2H.
● Contraindications: Renal failure, diabetes, dysphagia

Question 7

Sulfasalazine

Answer 7

● Drug Class: 5-Aminosalicylates
● MOA: Sulfonamide antibiotic, decrease inflammation in the intestines. No therapeutic effect for IBD
● A/E: N, fever, rash, headache, agranulocytosis
● Interventions: Monitor for N/V/D, monitor for infection and rash.
● Administration: Oral only, expect a change in urine and skin color

Question 8

Reglan

Answer 8

● Prototype: metoclopramide
● Class: Dopamine antagonist
● Use: anti-emetic related to chemo, toxins, and postop recovery and anti-diarrheal
● MOA: block of dopamine receptor in the CTZ.
● A/E: EPS: tardive dyskinesia (administer and anti-cholinergic med to stop EPS), hypotension, sedation, anticholinergic effects

Question 9

Corticosteroids

Answer 9

Prototype: Dexamethasone
● Use: anti-emetic, typically in combo to treat chemo-induced N/V
● A/E Adrenal insufficiency, osteoporosis, peptic ulcer disease, hypokalemia, hyperglycemia, increase risk for infection