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Master PA Deck > Pharm GERD IBD Motility > Flashcards

Pharm GERD IBD Motility Flashcards

1
Q

Hydrocortisone

A

Topical corticosteriod or enema

IBD management

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2
Q

Budesonide

A

Topical foam or oral corticosteroid

IBD management

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3
Q

Prednisone

A

Oral corticosteriod

IBD management

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4
Q

Sulfasalazine

A

Class: Aminosalicylate

IBD Management

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5
Q

Mesalamine

A

Class: Aminosalicylate

IBD Management

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6
Q

Olsalazine

A

Class: Aminosalicylate

IBD management

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7
Q

Balsalazide

A

Class: Aminosalicylate

IBD management

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8
Q

IBD Management Sequence

A 
Aminosalicylates
Corticosteriods
Immunomodulators
TNF alpha inhibitors
Antibiotics
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9
Q

Immunomodulators for IBD

A

Azathioprine
Mercaptopurine
Cyclosporine
Methotrexate

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10
Q

Sodium Bicarbonate

A

Antacid

GERD Management

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11
Q

Calcium Carbonate

A

Antacid

GERD Management

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12
Q

Magnesium hydroxide + Aluminum hydroxide

A

Antacid

GERD Management

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13
Q

Cimetidine

A

H2 Blocker

GERD Management

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14
Q

Famotidine

A

H2 Blocker

GERD Management

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15
Q

Ranitidine

A

H2 Blocker

GERD Management

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16
Q

Nizatidine

A

H2 Blocker

GERD Management

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17
Q

Omeprazole

A

PPI

GERD Management (1x day)
PUD/H. Pylori (Multiple times a day)
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18
Q

Esomeprazole

A

PPI

GERD Management (1x day)
PUD/H. Pylori (Multiple times a day)
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19
Q

Pantoprazole

A

PPI

GERD Management (1x day)
PUD/H. Pylori (Multiple times a day)
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20
Q

Lansoprazole

A

PPI

GERD Management (1x day)
PUD/H. Pylori (Multiple times a day)
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21
Q

Dexlansoprazole

A

PPI

GERD Management (1x day)
PUD/H. Pylori (Multiple times a day)
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22
Q

Rabeprazole

A

PPI

GERD Management (1x day)
PUD/H. Pylori (Multiple times a day)
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23
Q

Misoprostol

A

Analogue of PGE, stimulates secretion of mucus and bicarbonate

GERD Management of patients on NSAIDs

Contraindicated in pregnancy

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24
Q

Sucralafate

A

Salt of sucrose complexed to aluminum hydroxide which forms viscous paste that binds selectively on ulcers or erosions

GERD Management

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25
Q

Triple therapy

A

H. Pylori Management

High dose PPI plus
Antibiotics (Clarithromycin and [Amoxicillin or Metronidazole])

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26
Q

Prevpac

A

Triple therapy combination product for H. Pylori

Lansoprazole, amoxicillin, clarithromycin

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27
Q

Pylera

A

Triple therapy combination product for H. Pylori

Bismuth subcitrate potassium, metronidazole, tetracycline

28
Q

Quadruple Therapy

A

H. Pylori management

High dose PPI plus
Bismuth subsalicylate plus
Metronidazole and [tetracycline or doxycycline]

29
Q

Bethanechol

A

Cholinomimetic agent (stimulates muscarinic receptors and increases smooth muscle tone)

Motility Disorders

30
Q

Neostigmine

A 
Cholinomimetic agent 
(Acetylcholinesterase inhibitor and blocks destruction of ACh)

Motility Disorders

31
Q

Metoclopramide

A

D2 receptor blocker

Requires renal adjustment

Motility Disorders

32
Q

Domperidone

A

D2 receptor blocker

NOT FDA approved

Motility Disorders

33
Q

Erythromycin

A

Macrolides (antibiotic)

Motility Disorders

34
Q

Erythromycin (side effects)

A
  • QTc prolongation, ventricular arrhythmias
  • Abdominal pain/cramping, diarrhea
  • Decreased efficacy with long term use (4+ weeks)
35
Q

Erythromycin (Drug interactions)

A

Numerous, major CYP3A4 inhibitor

36
Q

Macrolides (MOA)

A
  • Mimics motilin, a potent contractile agent

- Cholinergic facilitation

37
Q

Domperidone (Side effects)

A
  • QTc prolongation, cardiac arrest

- Abdominal cramps

38
Q

Domperidone (Drug interactions)

A
  • CYP3A4 inhibitors

- QTc prolonging medications

39
Q

Metoclopramide (Side effects)

A

Drowsiness, dystonic reaction, restlessness, bronchospasms, prolactin elevation

40
Q

Metoclopramide (Drug interactions)

A

Antipsychotic agents
Atovaquone (antimalarial)
Droperidol

41
Q

D2 Receptor Blockers (MOA)

A

Blockade of D2 receptors which leads to increased smooth muscle stimulation

  • increased esophageal peristalsis
  • increased lower esophageal sphincter pressure
  • increased gastric emptying
42
Q

D2 Receptor Blockers

A

Common for diabetic gastroparesis

Metoclopramide
Domperidone

43
Q

Neostigmine (Drug Interactions)

A

Beta blockers
Corticosteroids
Succinylcholine

44
Q

Neostigmine (Side Effects)

A

AV block, bradycardia
Dizziness
Diaphoresis
Bronchospasms

45
Q

Bethanechol (Side Effects)

A

Abdominal pain, diarrhea
Urinary urgency
Asthma, bronchoconstriction
Flushing, headache, bradycardia

46
Q

Bethanechol (Drug interactions)

A

Acetylcholinesterase inhibitors

Beta blockers

47
Q

Misoprostol (Side Effects)

A

Diarrhea, abdominal pain

Detrimental to pregnancy

48
Q

Misoprostol (Drug Interactions)

A

Antacids, magnesium containing

49
Q

Sucralafate (Side Effects)

A

Constipation, aluminum toxicity (CKD patients)

50
Q

Sucralafate (Drug Interactions)

A

Binds to multiple medications

51
Q

PPIs (MOA)

A

Travel systemically to form irreversible disulfide bonds with proton pumps inactivating them

Taken on empty stomach

52
Q

PPIs (Side Effects)

A
  • Decreased B12, Ca and magnesium absorption
  • Increased risk of bone fractures
  • Increased risk of C. diff and pneumonia
  • Increased risk of dementia and CKD
  • Rebound acid hypersecretion with discontinuation
53
Q

PPIs (Drug Interactions)

A

Drugs process via CYP2C19

Clopidogrel (Plavix): decreased antiplatelet activity

54
Q

H2 Blockers (MOA)

A

Acid inhibition via reversible H2 receptor blockade on parietal cells

55
Q

H2 Blockers (Side Effects)

A

Diarrhea, headache, fatigue, constipation, CNS effects (confusion, hallucinations, delirium)
Gynecomastia/impotence (cimetidine only)

56
Q

H2 Blockers (Drug interactions)

A

Cimetidine (CYP2C9, CYP2D6, CYP1A2, CYP3A4 inhibitor)

57
Q

Antacids (MOA)

A

Neutralize gastric acid by reacting with HCl

58
Q

Sodium bicarbonate (Side effects)

A

Belching, metabolic alkalosis, fluid retention

59
Q

Calcium carbonate (Side effects)

A

Belching, hypercalcemia, metabolic alkalosis

60
Q

Magnesium hydroxide + Aluminum hydroxide (Side effects)

A

Diarrhea, constipation, aluminum accumulation in CKD

61
Q

Sodium bicarbonate (Drug Interactions)

A

Elvitegravir (v)
Amphetamines (^)
Calcium-containing dairy products (v)

62
Q

Calcium carbonate and Magnesium hydroxide + Aluminum hydroxide (Drug interactions)

A 
Tetracyclines (v)
Fluoroquinolones (v)
Itraconazole (v)
Iron (v)
Calcium-containing dairy (^)
Elvitegravir (v)
63
Q

TNF alpha inhibitors

A

Adalimumab
Infliximab
Golimumab (ulcerative colitis only)
Certolizumab (Crohn’s only)

64
Q

TNF alpha inhibitors (side effects)

A

Infections, injection site reactions, headache, nausea, hepatotoxicity

65
Q

Immunomodulators

A

Azathioprine
Mercaptopurine
Methotrexate

66
Q

Immunomodulators (side effects)

A

NVD, myelosuppression, hepatotoxicity

alopecia, photosensitivity, mucositis with methotrexate

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