Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI2 E1 > segers meds > Flashcards

segers meds Flashcards

antacids antiulcer N/V IBD Diarrhea, Abd pain, Constipation

1
Q

indications for antacids

A

SHORT term use, temporary relief of PUD and GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

low systemic antacids

A

aluminum based agents
Ca based agents
Mg based agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

high systemic antacids

A

Na based agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do antacids work

A

combine chemically with H+ to make H2O, CO2, Cl- salts

–>increease LES tone in high doses

not any reduction in acid production, in fact rebound increase in acid production can happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which antacids work fastest and longest, and have the best neutralizing ability

A

Ca based agents

Mg based agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the clinical use of simethicone

A

= an antacid

= pro-fart+burp to get rid of gas thats already been made in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

side effects of Al based antacids

A

constipation, HYPOphosphatamia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

side effects of Mg based antacids

A

dose related diarrhea, increased Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

side effects of Ca based antacids

A

constipation, increase Ca (leading to stones), nephropathy, met alk, HYPOphosphatemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

side effects of Mg based antacids

A

dose related diarrhea, increased Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

side effects of Na based antacids

A

bicarb burps, increased Na, met alk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what important considerations should be taken when considering prescribing antacids

A

dosage
hx of renal/heart ds
electrolyte status
hx of diarrhea/constipation

lots of drug interactions- take all antacids 1-2 hours before, or 2-4 hours after any other med

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which drugs work on the H+ leaving parietal cells into the extracellular gastric content

A

antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which drugs inhibit the luminal H/K+ ATPase on parietal cells membranes

A

PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which drugs inhibit H2 receptors on the basolateral membrane of parietal cells

A

H2 receptor antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which drug is a PGE1 analog, working on EP3 receptors on the basolateral membrane of parietal cells and superficial epithelial cells

A

misprostol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

which drugs directly inhibits H Pylori

A 
bismuth
clonthromycin
metronidazole
tetracycline
amoxicillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what drug enhances mucus and bicarb transport on the luminal membrane of superficial epithelial cells

A

sucralfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

“__-tidine”

group
special drug notes
method of action
side effect
contraindications
A

h2 receptor antagonist= antiulcer

cimetidine= decreased T binding= gynecomastia/galactorrhea, neutropenia, thrombocytopenia, DRUG INTERACTIONS SO REPLACE WITH RANITIDINE

partially inhibits acid production –> ulcer will heal in 4-8 weeks if H pylori is not present

side effects= mild and transient if at all, GI and HA

PREGNANCY= use ranitidine or famotidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

rate the speed of action of dif antiulcer+antacids

A

antacids > H2 block > PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

drugs that have a lot of drug drug interactions usually affect what pathway

A

CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

with what anti-ulcer drug classes do you need to use an NSAID

A

PPI and PGE1 analog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

“__-prazole”

group
special drug notes
method of action
side effect
contraindications
A

PPIs= antiulcer

takes days to create a new steady state by binding sulfhydryl group of H/K ATPase
short have life but effect lasts days, ulcers heal in 4-8 weeks if H Pylori not present

omeprazole= increased drug interactions

sideeffects= dyspepsia, myalgia, life threatening C. Dif fiarrhea (CDAD)= watery and smelly

pregnancy= only if necessary, use lansoprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

sucralfate

group
method of action
indications
side effect
contraindications
A

surface acting =antiulcer

=sucrose + Al(OH)3 create viscous polymer when adheres to epithelial cells around ulcer –> stimulate PGE + mucus production
NO effect on pH

can also use for mucositis, enema, bile acid reflex

side effect= constipation

relative contra= severe renal failure
possible drug interactions->take 2 hours after any other male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

misprostol

group
method of action
indications
side effect
contraindications
A

PGE1 analog = antiulcer

protect prostoglandin + decreased gastric acid release from parietal cell
+increased mucous+bicarb production

used to prevent NSAID-induced ulceration in pts who can’t stop taking NSAIDs
also for pregnancy termination, cervical ripening, post partum hemorrhage

side effects= diarrhea, HA, dizzy

contra= pregnancy, IBD (r)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

“bismuth”, peptobismol, kaopectate

group
method of action
indications
side effect
contraindications
A

bismuth compounds, anti-ulcer

prevent attachment to mucosa, disrupt cell wall

use for heartburn, diarrhea
antidiarrheal and antimicrobial = can work against H Pylori (in combo w abx+acid suppressant)

side effect= constipation, black stool (norm shape)
drug interactions, take 2 hrs after other meds

relative CI= anticoag use, severe renal failure
abs CI= GI bleed, hypersensitivity to salicytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

trx for H pylori

A

at least 2 abs + PPI

  • clorythromycin/amoxicillin
  • if can’t use PPI, give H2 blocker

if failed regimen, then do triple therapy:
BID PPI+ clarythromycin + amoxicillin/metronidazole

if failed then do quadriple
BID PPI+ QID metronidazole +tetracycline + bismuth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

receptors responsible for N/V

A 
5-HT3 (seratonin)
HI (histamine)
MI (muscurinic)
D2 (dopamine)
NKI (neurokinin/substance P)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the vomiting center of the brain and what receptors are there

A

nucleus of tractus solitaris

5HT3
HI
NK1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the chemoreceptor trigger zone in the brain and what receptors are there

A

area postrema

5HT3
D2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

indication for glucocorticosteroids + benzodiazepines

A

for N/V

32
Q

“__setron”

group
method of action
indications
side effect
special drug notes
contraindications
A

5 HT3 serotonin antagonists- strong drug for N/V

block 5ht3 receptor at vagal N terminal and block transmission to CTZ in medulla,

used in chemo and N/V of pregnancy
bc have short half life

adverse effects= serotonin syndrome [met instable, dec mood, life threatening]
QT PROLONGATION= torades des pointe

alosetron= IBS is the only indication
palonesetron= longer half life
33
Q

“___pitant”

group
method of action
indications
side effect
special drug notes
contraindications
A

NKI receptor antagonist= moderate drug for N/V

block neurokinin/substance P in the medulla, vomiting center/vagal terminals in gut

used in PROPHYLAXIS of chemo induced N/V w glucosteroids+ 5HT3 antagonist

adverse effect= somnolence, drug interactions

34
Q

diphenhydramine, dimenhydrinate,

group
method of action
indications
side effect

A

H1 histamine receptor antagonist= weak drug for N/V

mostly for allergies or motion sickness, work in medulla and vestibular system

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol

35
Q

hydroxyzine

group
method of action
indications
side effect

A

H1 histamine receptor antagonist= weak drug for N/V

mostly for allergies or motion sickness, work in medulla and vestibular system

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol

36
Q

promethazine

group
method of action
indications
side effect

A

H1 histamine receptor antagonist= weak drug for N/V

mostly for allergies or motion sickness, work in medulla and vestibular system

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol

37
Q

meclizine, cyclizine

group
method of action
indications
side effect

A

only indication is motion sickness

H1 histamine receptor antagonist= weak drug for N/V

mostly for allergies or motion sickness, work in medulla and vestibular system

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol

38
Q

doxylamine

group
method of action
indications
side effect

A

used in N/V of pregnancy

H1 histamine receptor antagonist= weak drug for N/V

mostly for allergies or motion sickness, work in medulla and vestibular system

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol

39
Q

metoclopramide
phenothiazines (prochloroperazine, perphenazine, chlorpromazine)

group
method of action
indications
side effect
special drug notes
contraindications
A

D2 receptor antagonist= weak-mod drug for N/V

block D2 receptor in CTZ/medulla

metoclopramide= stimulate Ach actions in GI, enhance motility, inc LES tone

used in N/V of preg, not used alone bc is weak

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol
+arrhythmia, parkinsons,

40
Q

scopolamine

group
method of action
indications
side effect
special drug notes
contraindications
A

M1 receptor antagonist= weak

a patch worn for 72 hours, mostly used for motion sickness

block Ach from vestibular nuclei in inner ear –> brainstem and reticular formation –> vomiting center

mostly palliative and end of life care

adverse= drowsy, dry mouth, urinary retention, blurred vision, hypotension, antii-chol
+drug interactions

41
Q

dronabinol and nabilone

group
method of action
indications
side effect
special drug notes
contraindications
A

cannabinoid receptor agonist

synthetic THC= v strong+effective in trx resistant N/V
stimulate CB1+CB2 receptors in vomiting center/CTZ medulla

reserved for trx-resistant chemo induced N/V +appetite stimulation in anorexic pts

adverse= emotional lability, vertigo, sedation, impaired cogn, hallucinations, dry mouth, inc HR/BP

42
Q

what is the high emetogenic chemo regimen

A

NKI receptor ant + 5-HT3 receptor antagonist + dexamethasone

regimen on day of chemo + 3 days after

if hx of N/V with chemo–> add olanzipine
in trx resistance –> add cannaboid

43
Q

what is the moderate ematogenic chemo regimen

A

5-HT3 receptor antagonist + dexamethasone

give regimen of day of chemo + 2 days after

if hx of N/V with chemo–> add NKI receptor or olanzipine
in trx resistance –> add cannaboid

44
Q

what is the low ematogenic regimen

A

dexamethasone OR 5-HT3 receptor antagonist OR metoclopramide OR prochlorperazine

give med on daily chemo

45
Q

what is the minimal ematogenic chemo regimen

A

no prophylaxis recommended

46
Q

define acute N/V

A

less than 24 hours after chemo

47
Q

trx for motion sickness

A

scopalimine or dymenhydrinate or meclizine

48
Q

trx for vertigo

A

meclizine or cyclizine

49
Q

trx for diabetic gatroparesis

A

metaclopramide

50
Q

trx of pregnancy induced N/V

A

step 1–> vit B6 or H1 antagonist or 5-HT3 antagonist

step 2–> D2 antagonist

step 3–> steroid or dif dopamine antagonist

51
Q

5 ASA Agents

names
indication
method
special drug notes
side effects
A

“__sala__”= for mid to moderate ulcerative colitis

inhibit PG+LT production via AA pathway= xCOX+ xLTE4
decreased Mø = xNF-kB activation

sulfasalazine= no give with sulfa allergy
olsalazine= maintain remission only
balsalazide- active ds only
mesalamine= pH dependent, time dependent, rectal enema, rectal suppositary

avoid in pts w ASA allergy

52
Q

TNF inhibitors

names
indication
method
special drug notes
side effects
A

” ___mab”= mod to severe UC or crohn

upregulate VCAM, E selectin, MADCAM-1 for leukocyte adhesion

adallmumab+ infliximab= UC+Crohn
IgG1 recomb,
a= SQ every 2 weeks, i= IV every 8 weeks

Gollmumab= UC only
IgG4 recomb, SQ every 4 weeks

certolizumab= Crohn only
Fab recomb, SQ every 4 weeks

53
Q

integrin inhibitors

names
indication
method
special drug notes
side effects
A

___lizumab= mod to severe active and maintain remission UC or CD

prevent leukocyte-endothelium adhesion by xα4B1, VCAM1, MadCAM1

Natalazumab= Crohn only
α4B1/7 blocker, IgG4 recomb
IV every 4 weeks

Vedolizumab= α4B7 blocker, IgG1 recomb
IV every 8 weeks

side effects= increased risk of PML (infection) w trx > 2 years, prior immunosuppression, JCV Ab present

54
Q

IL12/23 inhibitors

names
indication
method
special drug notes
side effects
A

Ustekinumab= mod to severe, active + maintain remission of Crohn
give to pts resistant/intolerant to steroids/TNF therapy

bind and block P450 subunit of IL-12/23 –> x naive T cell activation and NK activation

IgG1 Ab, SQ every 8 weeks

side effect= occur w infection so get TB test before use

55
Q

JAK inhibitor

names
indication
method
special drug notes
side effects
A

tofacitinib= mod-severe, active and maintain remission of UC

no use unless HAVE to

intracellularly inhibit pro-inflammatory gene via JAK 1+3 –> x cytokine release
taken orally

side effects= lymphopenia lymphocytosis: neutropenia:

56
Q

describe the use of steroids in IBD

A

give in active IBD if absolutely need to

lowest dose, shortest duration possible

57
Q

Loperamide

group, indication
MOA
special facts
side effects/contraI

A

opioid agonist= for diarrhea

slow peristalsis+motility, increase fluid absorb

no analgesic effect, no dependence

side effect= cardiact toxicity

58
Q

diphenoxylate

group, indication
MOA
special facts
side effects/contraI

A

opioid agonist= for diarrhea

slow peristalsis+motility, increase fluid absorb

synthetic opiate
analgesic at HIGH doses
give with atropine to decrease dependence

59
Q

eluxadoline

group, indication
MOA
special facts
side effects/contraI

A

opioid agonist= for diarrhea
use in IBS

slow peristalsis+motility, increase fluid absorb

opioid mu and kappa agonist
delta antagonist–> decrease secretions

side effects- hepatic and pancreatic toxicity

CONTRA- biliary duct obstruction, alc abuse, STOP IF HAVE CONSTIPATION FOR MORE THAN 4 DAYS

60
Q

PG inhibitors indication?

A

diarrhea

61
Q

alosetron

group, indication
MOA
special facts
side effects/contraI

A

serotonin antagonist= use in refractory IBS

block GI 5HT3 receptor
x pain, transit, secretion

side effect= ischemic colitis, no refill without f/u w PCP

CONTRAI= GI obstruct, perforation, stricture, diverticulitis, impaired intestinal circulation, constipation

62
Q

crofetemer

group, indication
MOA
special facts
side effects/contraI

A

chloride ch blocker,
non-infectious diarrhea in HIV/AIDS

inhibit CFTR+ CaCC channel, regulate fluid secretion

CONTRA in respiratory/urinary ds

63
Q

antimuscurinics

group, indication
MOA
special facts
side effects/contraI

A

Hyoscyamine, Dicyclomine, Clinium/chlordiazepoxide

abdominal pain

competitive inhibitors of post ganglionic cholinergic receptors

side effects= dry mouth, urinary retention, blurry vision, constipation (the effects with anti-chol)

64
Q

methylnaltrexone + alvimopan

group, indication
MOA
special facts
side effects/contraI

A

peripheral opioid antagonist, trx constipation

work together: peripheral mu opioid receptor antagonist
prevent post op ileus after bowel resection

side effects: increased risk of MI, REMS program= use on in institutions for max 15 dose

65
Q

Linoditide

group, indication
MOA
special facts
side effects/contraI

A

guanylate cyclase ch agonist- constipation

increase intra/extracellular cGMP
increase Cl-/HCO3 secretion via CFTR
increase intestinal fluids
*use with IBS-C + chronic idiopathic constipation

66
Q

lubiprostone

group, indication
MOA
special facts
side effects/contraI

A

selective C2 ch activator- constipation

increased fluid secretion secondary to increased Cl in lumen
use in IBS-women, chronic idiopathic and opioid induced constipation

67
Q

fiber/bran: psyllum: cellulose : Ca polycarbophil

group, indication
MOA
special facts
side effects/contraI

A

bulk forming laxative/cathartic agent= works in 2-4 days

increase bulk volume and water support, bacterial fermentation

side effects-
bloating, obstruction (

68
Q

surfactant, emollient

group, indication
MOA
special facts
side effects/contraI

A

stool softener laxative/cathartic agent= works in 1-3 days

=decusate salts and mineral oils

surfactant lubricates feces, increase fluid secretion, H2O resorption, oil will penetrate the stool

69
Q

senna

group, indication
MOA
special facts
side effects/contraI

A

stimulant- laxative/cathartic agent works in 12-36 hrs

irritate enterocyte till they make prostoglandins

side effects= pass into breast milk
urine discoloration either yellow-brown or red-pink

70
Q

bisacodyl and glycerin

group, indication
MOA
special facts
side effects/contraI

A

stimulant- laxative/cathartic agent works in 12-36 hrs

irritate enterocyte till they make prostoglandins

only taken PR

side effects= pass into breast milk

71
Q

caotoroil

group, indication
MOA
special facts
side effects/contraI

A

stimulant- laxative/cathartic agent works in 12-36 hrs

irritate enterocyte till they make prostoglandins

hydrolysed into rucinoleic acid

side effects= pass into breast milk

72
Q

Na picosulfate

group, indication
MOA
special facts
side effects/contraI

A

stimulant- laxative/cathartic agent works in 12-36 hrs

irritate enterocyte till they make prostoglandins

precolonoscopy bowel prep –> lead to osmotic diarrhea

side effects= pass into breast milk

73
Q

Mg salt, Na phosphate

group, indication
MOA
special facts
side effects/contraI

A

saline agents= laxative/cathartic agent

hyperosmolar solutions, osmotically retain water in GI
with increase volume, decrease transit time

side effect= interact with diuretics–> electrolyte imbalance

contraindications= (relative) renal ds/CHF/HTN

74
Q

lactulose

group, indication
MOA
special facts
side effects/contraI

A

osmotic agents, laxative/cathartic agent= work in 1-3 hours but take small doses so that it takes 1-2 days?

osmotically attract and retain water in the colon
increased moisture, softness, volume

also used in liver ds (with increase ammonia)

side effect= electrolyte imbalance

75
Q

PEG-3350

group, indication
MOA
special facts
side effects/contraI

A

osmotic agents, laxative/cathartic agent= work in 1-3 hours but take small doses so that it takes 1-2 days?

osmotically attract and retain water in the colon
increased moisture, softness, volume

increase dose for bowel prep prior to scope

side effect= electrolyte imbalance

76
Q

Mg citrate, sorbitol

group, indication
MOA
special facts
side effects/contraI

A

osmotic agents, laxative/cathartic agent= work in 1-3 hours but take small doses so that it takes 1-2 days?

osmotically attract and retain water in the colon
increased moisture, softness, volume

side effect= electrolyte imbalance

GI2 E1 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions