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25 Cards in this Set

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  • Back
Antacids
a)mechanism of action
Antacids
a)mechanism of action: neutralize gastric acid; INCREASE LES PRESSURE
Antacid
b)dosage and administration (oral therapy)
Antacid
b)dosage and administration (oral therapy):
1. for acute mgmt of moderate to severe GERD: administer every hour; can administer every 30 min. for persistent symptoms
2. for long-term therapy: 1 to 3 hours after meals and at bedtime and whenever symptoms occur
3. for infrequent symptoms: administer as needed
Alginic Acid-Antacid Combination (Gaviscon)
a)mechanism of action
Alginic Acid-Antacid Combination (Gaviscon)
a)mechanism of action: mechanical BARRIER to reflux; coats esophagus thereby protecting the mucosa from irritants in the refluxed material; weak neutralizer of acid
Alginic Acid-Antacid Combination (Gaviscon)
b)dosage
Alginic Acid-Antacid Combination (Gaviscon)
b)dosage: oral, 1 tablet or 15 ml QID
Bethanechol (Urecholine)
a)mechanism of action
Bethanechol (Urecholine)
a)mechanism of action: increases LES pressure; increases esophageal clearance
Bethanechol (Urecholine)
b)dosage and administration
Bethanechol (Urecholine)
b)dosage and administration (oral therapy)
Bethanechol (Urecholine)
c)adverse effects
Bethanechol (Urecholine)
c)adverse effects: n/v/d, abdominal cramps, urinary frequency, malaise, blurred vision, orthostatic hypotension, flushing of the skin
Bethanechol (Urecholine)
d)consideration
Bethanechol (Urecholine)
d)consideration: bethanechol may increase gastric acid secretion, therefore, may not be considered appropriate to treat GERD in a patient with PUD
Bethanechol (Urecholine)
e)drug interactions
Bethanechol (Urecholine)
e)drug interactions: quinidine, procainamide
Metoclopramide (Reglan)
a)mechanism of action
Metoclopramide (Reglan)
a)mechanism of action: accelerates gastric emptying; increases LES pressure
Metoclopramide (Reglan)
b)dosage and administration
Metoclopramide (Reglan)
b)dosage and administration (oral therapy)
Metoclopramide (Reglan)
c)adverse effects
Metoclopramide (Reglan)
c)adverse effects:
1. CNS: drowsiness, restlessness, nervousness, fatigue, dizziness, depression, anxiety, insomnia, extrapyramidal reactions
2. GI: diarrhea
3. allergic: rash
Metoclopramide (Reglan)
d)cautions and considerations
Metoclopramide (Reglan)
d)cautions and considerations:
1. contraindications: EPILEPSY (severity/freq. may be increased); GI obstruction/hemorrhage (stimulation of GI motility can aggravate condition); Pheochromocytoma (may cause hypertensive crisis)
2. caution: asthma (may increase risk of bronchospasm); Parkinson's disease (may exacerbate symptoms)
Metoclopramide (Reglan)
e)drug interactions
Metoclopramide (Reglan)
e)drug interactions:
1. alcohol or other CNS depressants: increased CNS depressants effects
2. anticholinergics or opioid-containing medication: may antagonize effects of metoclopramide on GI motility
3. digoxin: may decrease absorption of digoxin from stomach
Cisapride (Propulsid)
a)mechanism of action
Cisapride (Propulsid)
a)mechanism of action: increases LES pressure; increases lower esophageal persistalsis and clearance; accelerates gastric emptying rate
Cisapride (Propulsid)
b)clinical indication
Cisapride (Propulsid)
b)clinical indication: symptomatic treatment of GERD; treatment of other GI motility disorders (e.g. gastroparesis)
Cisapride (Propulsid)
e)drug interactions
Cisapride (Propulsid)
e)drug interactions:
1. antifungals (ketoconazole, itraconazole, miconazole IV) and antibiotic (troleandomycin): concurrent administration is CONTRAINDICATED due to decreased metabolism of cisapride and potentially fatal cardiac arrhythmias
2. cimetidine: decreases metabolism of cisapride
3. anticholinergics: decreases effectiveness of cisapride
4. anticoagulants: possible decreased coagulation times
Cisapride (Propulsid)
f)cautions
Cisapride (Propulsid)
f)cautions: contraindicated when increased GI motility is harmful (e.g. obstruction, perforation, hemorrhage)
Sucralfate
a)mechanism of action
Sucralfate
a)mechanism of action: local mucosal protection- binds to inflamed tissue; forms barrier to prevent diffusion of acid and pepsin into the epithelial lining; inhibits activity of pepsin; binds bile salts.
H2As
a)mechanism of action
H2As
a)mechanism of action: decreases gastric acid secretion thereby decreasing the irritant properties of refluxed stomach contents
H2As
b)dosage
H2As
b)dosage: duration = 6 to 12 weeks; OTC H2As for relief of mild heartbur, acid indigestion, sour stomach = 1 tablet (less than or equal to 2 weeks)
Omeprazole (Prilosec)
a)mechanism of action
Omeprazole (Prilosec)
a)mechanism of action: inhibits the H+/K+ ATPase pump thereby inhibiting gastric acid secretion
Omeprazole (Prilosec)
b)clinical indications
Omeprazole (Prilosec)
b)clinical indications: short-term treatment of severe erosive esophagitis associated with GERD and for symptomatic GERD poorly responsive to usual medical treatment, including H2A therapy
Lansoprazole (Prevacid)
a)mechanism of action
Lansoprazole (Prevacid)
a)mechanism of action: inhibits the H+/K+ ATPase pump thereby inhibiting gastric acid secretion
Lansoprazole (Prevacid)
b)clinical indication
Lansoprazole (Prevacid)
b)clinical indication: short-term treatment of erosive esophagitis