Gi Meds

Front 1

What med is used for improvement of mucosal defense?

Back 1

sucralfate 1 gm QID

Front 2

What drug is used to increase prostaglandin defense for prophylaxis of PUD?

Back 2

Misoprostol 200 mcg QID

Front 3

What is the pharmacologic approach to HP-induced ulcers?

Back 3

multi-drug regimen

Front 4

Dual drug therapy approach to HP-induced ulcer - which drugs and how is the eradication rate?

Back 4

clarithromycin + PPI
Amoxicillin + PPI
Poor eradication

Front 5

Triple drug therapy aproach to HP-induced ulcer - which drugs?

Back 5

PPI + 2 abx (amoxil, metronidazole, clarithro)
or 2 abx + ranitidine

Front 6

Quad. drug therapy approach to HP-induced ulcer -

Back 6

Bismuth subsalicylate based (BSS)
2 abx + BSS +(H2 or PPI)
Poor compliance

Front 7

What do anticholinergics, ca channel blockers, benzos, estrogens/progesterones, narcotics, NSAIDS, nicotine, nitrates, xanthines predispose you for?

Back 7

GERD

Front 8

3 complications of untreated GERD?

Back 8

Erosive espohagitis and strictures
Barrett's esophagus
GI bleeding

Front 9

Typical symptoms of GERD

Back 9

heartburn
regurg
belching
hypersalivation

Front 10

Atypical symptoms of GERD

Back 10

chronic hoarseness
cough
dysphagia
wt loss
wheezing
non-cardiac CP
Bleeding

Front 11

Name 2 GERD meds that increases gut motility and increase LES resting tone.

Back 11

metoclopramide (DA antagonist)
erythromycin (stim motilin receptors)

Front 12

What are adverse effects of prokinetic agents used for GERD?


(metoclopramide and erythromycin)

Back 12

diarrhea, CNS effects, cardiac arrythmias

Front 13

What are CI to prokinetic agents for GERD?

(metoclopramide and erythromycin)

Back 13

bowel obstruction/perf
phemochromocytoma
seizure history

Front 14

Which drug class neutralizes pH of stomach acid within the lumen?

Back 14

Antacids

Front 15

Which drug class decreases acid secretion by competitive inhibition of histamine receptors in gastric parietal cells?

Back 15

H2 receptor antagonists

Front 16

Name 4 H2 RA's

Back 16

famotidine
ranitidine
cimetidine
nizatidine

Front 17

SE of H2 RA's

(7)

Back 17

H/A
diarrhea
constipation
CNS excitation (cimetidine)
thrombocytopenia -rare
cardiac arrhyth. - rare

Front 18

Do H2 RA's have Drug interations?

Back 18

yes

(warfarin, theophylline, diazepam, phenytoin, metronidazole, propranolol)

Front 19

Which drug class decreases gastric acid secretion by irreversible inhibition of the parietal cell H+/K+ ATP pump?

Back 19

PPI

(lansoprazole, omprazole, rabeprazole, pantoprazole, esomeprazole)

Front 20

Do PPI's have drug interactions?

Back 20

yes
keto/itroconizole
digoxin
diazepam
theophylline
carbamezepine

Front 21

What is the treatment for stage I GERD?
(intermittent, mild heartburn)

Back 21

lifestyle changes
antacids and/or H2RA's 2-4 wk
oromeprazole x 2 wks.

Front 22

What is the treatment for stage II GERD?
(symptomatic relief of GERD)

Back 22

lifestyle changes
H2RA's 4-12 weeks
or PPI's4-12 weeks QD

Front 23

what is the treatment for stage III GERD?
(tx of complications)

Back 23

lifestyle changes
H2RA's high dose 8 - 12weeks
PPI's 12 weeks BID

Front 24

What are drug interactions from when using sucrulfate?

Back 24

it binds to other drugs.

Front 25

What is a SE of Misoprostol?

Back 25

uterine contractions

Front 26

What is the MOA of Loperamide?

Back 26

Inhibit cholinergic nerves
increased colonic transit time and fecal water absorption
class - opiod agonist

Front 27

What drug is a naturally occuring peptide in GI tract?

Back 27

Somatostatin (octreotide)

Front 28

Which drug inhibits secretion of hormones, reduces intest and panc secretion, slows GI motility, inhibits gallbladder contract, and inhibits GH?

Back 28

Somatostatin (octreotide)

Front 29

What are SE of octreotide?
(9)

Back 29

Fat-soluable vitamin defic.
nausea
abd pain
flatulence
diarrhea
gallstones
glucose
hypothyroid
bradycardia

Front 30

What is the MOA of aminosalicylates?

(sulfasalazine, mesalamine, olsalazine, blasalazide)

Back 30

anti-inflammatory
for crohn and UC

Front 31

What are SE of aminosalicylates?

Back 31

N/V
anorexia
HA
rash
anemia
hepatitis
pancreatitis

Front 32

What drug is an immunosuppressant used for UC and crohn dz which decreased mets of purines?

Back 32

Azathioprine (imuran)
(response may take months)

Front 33

What are SE of azathioprine?

(Imuran)

Back 33

rash
nausea
diarrhea
neutropenia

Front 34

What is 6-MP?

Back 34

6-Mercaptopurine
cell cycle specific antineoplastic
may take months
for crohn and UC

Front 35

What drug is a selective serotonin agonist for women only?

Back 35

Tegaserod (zelnorm)
IBS

Front 36

What is Tegaserod (zelnorm) CI in?
(4)

Back 36

severe renal or hepatic dz
gallbladder d/o
bowel obstr.

Front 37

What are SE of Tegaserod?

(zelnorm)

Back 37

diarrhea, HA, abd pain, inc risk of cholecystect.

Front 38

What drug is a selective serotonin antagonist which improves diarrhea, and abd pain in females and is avail only with restricted use?

Back 38

Alosetron (Lotronex)

reports of severe constipation w/ bowel obstr.

Front 39

What drug class is effective for vagal stimulation and antiemetic during chemo?

Back 39

serotonin antagonist
(ondansetron, granisetron, dolasetron, palonosetron)
can be assoc with QT prolongation

Front 40

Are corticosteroids used in conjunction with other antiemetics?

Back 40

yes

dexaethasone
methylpredisolone

Front 41

Name a neurokinin receptor antagonist used for an antiemetic?

Back 41

Aprepitant
- crosses the BBB
- inhib CYP450
- $$$

Front 42

Which antipsychotics are used for antiemetics

Back 42

phenothiazines and butyrophenones

SE EPS
droperidol - prolongs QT

Front 43

What drug is excreted in bile, decreased hepatic chol secretion and used for symptomatc gallstones when surgery isn't possible?

Back 43

Ursodiol

Front 44

What drugs are given for GI bleed (varices)?

Back 44

Somatostatin (octreotide)
vasopressin