Seegars - Antacids & Anti-Ulcer Drugs

Question 1

used for short-term, temporary releif of pild pain and symptoms ass’d with PUD/GERD

Answer 1

antacids

Question 2

low-systemic antacids

Answer 2

• aluminum-salts
• calcium-salts
• Mg-salts

Question 3

high-systemic antacids

Answer 3

Na-salts

Question 4

supplemental agents - antacids

Answer 4

simethicone

Question 5

good rule of thumb to use to avoid the drug interactions seen w/ antacid use (and for all these other drugs!)

Answer 5

• take 1-2 hr before other meds OR

- 2-4 hr after other meds

Question 6

ending of anti-ulcer Histamine type-2 blocker

Answer 6

-tidine

Question 7

histamine type 2- blocker that inhibits several CYP450 isoenzymes and therefore causes many drug-drug interactions

Answer 7

cimetidine

Question 8

ending of PPI anti-ulcer drugs

Answer 8

-prazole

Question 9

prototypical PPI that inhibits CYP450 and causes lots of drug-drug interactions

Answer 9

omeprazole

Question 10

PPI used if needed during pregnanacy

Answer 10

lansoprazole (make sure you don’t sure omeprazole!)

Question 11

sticky polymer what adheres to epithelial cells around ulcer crater

Answer 11

sucralfate

Question 12

used in prevention of NSAID-induced gastric ulceration in pts at high risk of ulcerations and complications

Answer 12

Misoprostol

Question 13

MOA: misoprostol

Answer 13

PGE1 analog > reduces gastric acid release from parietal cells

Question 14

black/dark stools

Answer 14

Bismuth cmpds

Question 15

absolute CIs: bismuth compounds

Answer 15

• GI bleeding

- salicylate HSN

Question 16

combo therapy for H. pylori

Answer 16

• antibiotics & acid reducer

- need to use 2 abs

Question 17

BID triple therapy for H. pylori

Answer 17

• PPI
• clarithromycin
• ammox or metronidazole

Question 18

H. pylori with PNC allergy

Answer 18

-sub metrnidazole for ammox

Question 19

H. pylori with metronisdazole resistance

Answer 19

• sub tetracycline

- consider quadruple therapy

Question 20

H. pylori with clarithromycin resistance

Answer 20

• sub ammox or tetracycline

- consider quadruple therapy

Question 21

quadruple therapy for H. pylori

Answer 21

• PPI or H2 blocker
• metrnidazole or clarithromycin
• ammox or tetracyclin
• bismuth subsalicylate

Question 22

-PUD in pregnant pt w/out H. pylori

Answer 22

• short antacid course or sucalfate
• add ranitidine for moderate persistence
• add lansoprazole for severe persistence

Question 23

PUD in pt with NSAID use

Answer 23

• NSAID not needed = d/c and use acetaminophen

- NSAID needed = COX-2 NSAID or PPI or Misoprostol

Question 24

2 rapid onset antacids with good acid neutralizing capacity

Answer 24

Ca and Mg compounds

Question 25

antacid cmpds that cause consipation

Answer 25

Al and Ca

Question 26

antacid cmpds that casue diarrhea

Answer 26

Mg

Question 27

antacid cmpds that cause gas

Answer 27

Na

Question 28

AEs: histamine type-2 blockers

Answer 28

• GI related: N/V/const

- CNS related: drowsiness/HA

Question 29

histamine type-2 blocker that can cuase gynecomastia

Answer 29

rimetidine

Question 30

how often are PPIs dosed?

Answer 30

daily! DOA = 24h

Question 31

pt on PPI presents with fever and diarrhea thats lasted 24+ hrs

Answer 31

CDAD: clostridium difficile ass’d diarrhea

Question 32

AE: sucralfate

Answer 32

const