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Clin Med- P > Toxic Substances and GI meds > Flashcards

Toxic Substances and GI meds Flashcards

1
Q

MOA of proton pump inhibitors + med names

A

lansoprazole, omeprazole, pantoprazole, esomeprazole
MOA = IRREVERSIBLE inhibition of parietal cell proton pump, which reduces acid secretion (promotes peptic ulcer healing and prevents reoccurance)

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2
Q

5 indications for PPIs

A

1) . #1 PUD (very important)
2) . GERD
3) . Zollinger-ellison syndrome
4) . H. pylori tx/Gastritis
5) . OTC for acid indigestion/heartburn

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3
Q

4 side effects of PPIs

A

diarrhea, headache, b12 deficiency (stopping of parietal cell fxn eventually causes B12 malabsorption probs), hypomagnesemia

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4
Q

when are PPIs normally taken?

A

30 mins before meal in AM

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5
Q

MOA of H2 blockers and medications

A

cimetidine, famotidine, ranitidine

MOA = binds to H2 receptor on parietal cells and inhibits gastric acid secretion

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6
Q

4 indications for H2 blockers

A

PUD, GERD, Zollinger-Ellison, OTC acid indigestion/heartburn

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7
Q

2 ADRs for cimetidine and 2 for Famotidine

A 
C = gynecomastia, impotence
F  = blood dyscrasias, QT prolongation
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8
Q

when should pts take H2 blockers? which H2 blocker is most potent?

A

usually at night

famotidine

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9
Q

MOA for antacids and medications

A

aluminum hydroxide, calcium carbonate (tums), magnesium hydroxide (milk of magnesia)
MOA: neutralizes gastric acid (which raises pH)

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10
Q

3 indications for antacids

A

1) . sxs relief of heartburn
2) . acid indigestion
3) . GERD

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11
Q

side effects of antacics

A

Mg: diarrhea

Ca/Al: constipation

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12
Q

MOA of sulcralfate

A

forms adhesive coating on ulcer surface that promotes healing

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13
Q

2 indications for sulcralfate

A

1) . treats active ulcers (esp duodenal)

2) prevents recurrent ulcers (used as prophylaxis)

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14
Q

3 side effects for sucralfate

A

metallic taste, constipation, nausea

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15
Q

what medications should you not take with sucralfate?

A

any meds that increase stomach pH (take away stomach acid) like PPIs, H2 blockers
*needs acidic pH for activation

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16
Q

MOA of misoprostol

A

MOA = prostaglandin analogue that inhibits gastrin secretion and INCREASES bicarb/mucus secretion

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17
Q

GI indication for misoprostol

A

preventing NSAID-induced ulcers (can’t heal existing ulcers)

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18
Q

3 side effects for misoprostol

A

abdominal cramps, diarrhea, vaginal bleeding

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19
Q

MOA for bismuth subsalicylate compounds and 2 drugs

A

MOA = antibacterial and binds to ulcer to protect mucosa from acid
Pepto bismol and kaopectate

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20
Q

three indications for bismuth subsalicylate agents

A

GERD, diarrhea, H. pylori

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21
Q

3 side effects of bismuth products

A

BLACK stool, constipation, salicylate and neuro toxicity in high doses

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22
Q

what are four classes of medications that can be used for nausea/vomiting

A

dopamine blockers, serotonin antagonists, antihistamines, anticholinergics

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23
Q

MOA of dopamine blockers and 3 medications

A

Metoclopramide, prochlorperazine, promethazine

MOA = blocks CNS dopamine receptors in vomiting center (metoclopramide also increase GI motility)

24
Q

2 GI indications for dopamine blockers (and one specific for metoclopramide)

A

N/V, motion sickness, metoclopramide = GERD, gastroparesis

25
Q

4 side effects for dopamine blockers

A

QT prolongation, constipation (anticholinergic), sedation (antihistamine), Parkinsonian effects (rigidity, bradykinesia, tremor, akathisia)

26
Q

how to treat acute dystonic reaction?

A

diphenhydramine IV (side effect of dopamine blocker)

27
Q

MOA of serotonin antagonists and 3 meds

A

Dolasetron, granisetron, ondansetron

MOA = blocks serotonin receptors in medulla to suppress vomiting center

28
Q

3 GI indications for serotonin antagonists

A

1) . #1 for chemotherapy induced vomiting
2) . nausea
3) . vomiting

29
Q

3 side effects for serotonin antagonists

A

1) . Neuro: HA, fatigue, sedation
2) . GI: constipation, bloating, diarrhea
3) . Cardiac: prolonged QT, arrhythmias

30
Q

MOA and 2 medications for antihistamines used for GI

A

Diphenhydramine, Meclizine

MOA = acts at CNS centers for nausea, vomiting

31
Q

main side effect for antihistamines used for GI? uses for antihistmaines

A

ANTICHOLINERGIC (dry mouth, blurry vision, sedation, urinary retention etc)
-N/V, motion sickness, vertigo

32
Q

GI antimuscarinic drug and MOA

A

Scopolamine

MOA = central muscarinic receptor blocker

33
Q

3 indications for scopolamine and side effects

A

Indications = motion sickness, vomiting, anti-GI motility (anti-diarrheal)
Side effects = anticholinergic (anti-sludgeM)

34
Q

2 drug classes to use to treat diarrhea

A

1) . Bismuth subsalicylate compounds

2) . opioid agonists

35
Q

MOA of opioid agonists used to tx diarrhea and 2 meds

A

atropine and loperamide

MOA = binds to gut wall opioid receptors to disrupt peristalsis/GI motility and intestinal transit time

36
Q

2 indications for opioid agonists in diarrhea

A

1) . noninvasive acute diarrhea

2) . chronic diarrhea associated with bowel disease

37
Q

treatment for TCA toxicity

A

sodium bicarbonate (used for cardiotoxicity of TCA)

38
Q

treatment of cocaine toxicity

A

ammonium chloride

39
Q

treatment of severe respiratory depression of Opioids

A

Naloxone, naltrexone (maintain over 12 breaths per minute)

40
Q

treatment of severe benzo toxicity

A

flumazenil

41
Q

treatment of BB toxicity

A

glucagon

42
Q

treatment to theophylline toxicity

A

BB

43
Q

treatment of digitalis toxicty

A

digibind

44
Q

treatment for warfarin toxicity

A

vitamin K and fresh frozen plasma (esp if INR > 10)

45
Q

treatment for heparin toxicity

A

protamine sulfate

46
Q

treatment for antifreeze toxicity

A

iv ethanol infusion

47
Q

what is the main complication of tylenol toxicity? how to manage it?

A

hepatic necrosis

Tx = n-acetyl-cysteine and activated charcoal

48
Q

what happens physiologically in a salicylate toxicity?

A 
respiratory alkalosis (respiratory stimulation) leads to high anion gap metabolic acidosis 
*can also get CNS signs of seizures, coma
49
Q

how to treat salicylate toxicity?

A

1) . ABCs/resuscitation/IV fluids
2) . GI decontamination with activated charcoal
3) . Sodium bicarbonate

50
Q

Base toxicity: substances and how it damages the body

A

i. e. Oven cleaner, drain cleaner,
* LIQUEFACTIVE NECROSIS = sloughs off tissue which leads to esophageal or gastric perforation (more esophagus), respiratory distress, irritated mucous membranes

51
Q

how to treat base toxicity?

A

supportive care and ABCs
*DON’T try to neutralize
(worse than acids)

52
Q

acid toxicity: substances and how it damages the body

A

toilet cleaner and battery acid

*causes coagulative necrosis mostly in the stomach, which turns into an eschar

53
Q

anticholinergic toxicity: what three classes of drugs and how does it affect the body?

A

i.e. antihistamines, atropine, TCAs

Sympathetic stimulation: hyperthermia, tachy, HTN, hot flushed skin, dry mucous membranes, mydriasis

54
Q

treatment of anticholinergic toxicity

A

activated charcoal, physostigmine

55
Q

cholinergic toxicity: substances and how it damages he body

A

i. e. organophosphates, insecticides, pesticides

* SLUDGE-M side effects, children usually present with nicotinic sxs (tachy, weakness, HTN, mydriasis, fasciculations)

56
Q

treatment for cholinergic toxicity

A

atropine + pralidoxime (reactivates cholinesterase enzyme)

*remove contaminated clothes

57
Q

what are some side effects of salicylate toxicity?

A

tinnitus, nausea, vomiting, abdominal pain

*often start with respiratory alkalosis and hyperventilation

Clin Med- P (124 decks)

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