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Kol- Pharm 323 Spring > PUD > Flashcards

PUD Flashcards

1
Q

Classes of drugs to treat PUD (5)

A
  • Antibiotics for H.Pylori
  • Anti Secretory:
  • Mucosal Protectant:
  • Prostaglandin Agent
  • Antacid
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2
Q

3 ways drugs work to treat ulcers

A
  • erradicate H pylori
  • reduce gastric acidity
  • enhance mucosal defenses
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3
Q

Anti ulcer drugs only treat ulcers: true or false

A

FALSE- also treat gastritis and GERD

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4
Q

What is the regiment for treating H pylori w/ ABX ? how long?

A

At least 2 antibiotics, preferably 3 abx + PPI or H2 blocker
->14 days

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5
Q

do we give ABX to someone who is asxs but has h pylori ?

A

nope!

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6
Q

issues w/ treating h pylori?

A

patient complianc: cost, pill count, SE

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7
Q

3 types of anti secretory agents:

A
  • H2Blockers
  • Proton Pump Inhibitors
  • Muscarinic antagonist ???
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8
Q

prototype of H2 blockers

A
  • Prototype: cimetidine (Tagamet) –> in the drug book, original H2 blocker
  • Also Know: famotidine (Pepcid) –> more commonly used
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9
Q

how fo H2 blockers work?

A
  • Act on H2 receptors on parietal cells

- ->Suppress acid secretion

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10
Q

indication for using H2 blockers

A

ulcers, GERD, heartburn, aspiration pneumonitis, Zollinger-Ellison syndrome (acid hypersecretion)

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11
Q

Duration of treatment on H2 blockers

A

4-6 weeks, up to 12

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12
Q

side effects of cimetidine

A

LOW
◦ Androgen blockade :Gynecomastia, reduced libido, impotence
◦ CNS Effects b/c crosses BB : Elderly (somnolence, seizure)
◦ Pneumonia (all H2 blockers)
‣ Bacterial colonization in the stomach increases with less acid present
• increase risk of aspiration pneumonia

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13
Q

drug drug interactions w/ cimetidine

A

◦ Warfarin, phenytoin, metformin, glipizide

◦ separate antacids by 1 hr.

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14
Q

route for cimetidine

A

IV, oral 2x day

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15
Q

side effects of famotidine?

A

pneumonia risk

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16
Q

prototype for anti secretory: proton pump inhibitor

A

omeprazole (Prilosec)

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17
Q

how does omeprazole (Prilosec) fxn

A

Irreversible inhibition of H+,K+ ATPase

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18
Q

most effective drug for acid suppresiion?

A

omeprazole (Prilosec)

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19
Q

how long does omeprazole (Prilosec) work and when do see effects?

A

-life of enzyme (1 day) and results w/in 2 hours

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20
Q

indication for using omeprazole (Prilosec)

A

ulcers, erosive esophagitis, GERD Zollinger-Ellison, stress ulcer prevention–> ICU/Trauma

21
Q

how long to be on omeprazole (Prilosec)

A

4-8 weeks

22
Q

short term vs long term side efffects of omeprazole (Prilosec)

A

Side Effects: headache, diarrhea, N/V (<1%)
long term side effects: osteoporosis and hip fractures, Cdiff, pneumonia, acid rebound (difficult to come off drug), kidney disease, Mg deficiency
◦ Possible: B12 deficiency, dementia

23
Q

patient education for omeprazole (Prilosec)

A

• only want patients on these short term!

–> wean off and put on H2 blocker

24
Q

ending for ppi’s

A

prazole

25
Q

prototype for mucosal protectant

A

Sucralfate

26
Q

how does Sucralfate fxn

A

Creates a protective coating on the gastric and esophageal surface
–>protects the ulcer from acid and pepsin

*Not absorbed -> does not reduce acid secretion

27
Q

side effects of Sucralfate

A

constipation

28
Q

admin for Sucralfate

A

Take 1 hr before meals and at HS
>Interfere with absorption of other meds
• Separate by 2 hrs.

29
Q

admin considerations giving sucralfate for gi vs esophagus ulcer

A
  • Ulcers in esophagus: make a slurry w/ the pill

- Ulcers in stomach: take pill as regular

30
Q

Prostaglandin Agent prototype

A

misoprostol (Cytotec)

31
Q

how does misoprostol (Cytotec) fxn?

A

Synthetic prostaglandins (stimulate secretion of mucous/bicarbonate, cause vasodilation

32
Q

how do NSAID cause ulceration?

A

NSAID inhibits prostaglandin –> suppresses mucous/bicarb, promote gastric acid

33
Q

indication for using misoprostol (Cytotec)

A

Used only for NSAID gastric ulcers

34
Q

misoprostol (Cytotec) safe for preggos?

A

Pregnancy Category X –> prostaglandins stimulate uterine contractions

35
Q

side effects of misoprostol (Cytotec)

A

diarrhea, abdominal pain, spotting, dysmenorrhea

36
Q

fxn of antacids

A

Alkaline compounds that neutralize stomach acid

37
Q

indication for using antacids

A

PUD, GERD symptom control

38
Q

admin of antacids

A

Separate 1 hour from other drugs –> drug needing acidic enviro for absorb will be diminished

39
Q

different kinds of antacid compounds

A

aluminum
magnesium
calcium
sodium

40
Q

antacid compounds that cause constipation?

A

aluminum

calcium

41
Q

anatacid compound not safe for renal disease?

A

magnesium

42
Q

magnesium + kidney disease = hypo or hyper magnesium?

A

hyper

43
Q

antacid of choice? why?

A

milk of magnesia is antacid of choice: high acid neutralizing effects, rapid acting, long lasting effects

44
Q

antacid compound that causes diarrhea

A

magnesium

45
Q

antacid compound that causes gas

A

sodium and calcium

46
Q

anatacid compound that causes fluid retention

A

sodium

47
Q

avoid sodium antacids in which patient popilation

A

HTN, heart failure

48
Q

antacid compound that causes acid rebound and need repeat dosing

A

calcium (tums)

49
Q

what is simethicone

A

decreases gas (not a PUD or laxative)

Kol- Pharm 323 Spring (41 decks)

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