Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
What is the only "systemic" antacid? What does this mean (like you know what i'm asking)?
|
Sodium-salts
S-odium.....S-ystemic.. see? this = greater absorption |
|
|
What is the MOA of magnesium hydroxide? calcium carbonate?
|
Trick! same MOA
Carbonate molecules capture loose hydrogen atoms to make a different molecule (ie water, CO2, chloride salts) Can increase LES tone |
|
|
How do you measure potency of antacids?
|
ANC (acid neutralization... constant?)= amt of stomach acid neutralization that occurs per does over a period of time
|
|
|
What is the rule for taking antacids and other meds?
|
take all antacids 1-2 hours before other meds or 2-4 hours after other meds.... period.
|
|
|
Which antacids can cause constipation? Diarrhea?
|
Constipation: Aluminum, calcium
Diarrhea: magnesium (like a laxative) |
|
|
What antacids can be used to treat hyperphosphatemia?
|
calcium and aluminum ones
|
|
|
What are the 5 categories of anti-ulcer agents?
|
H2- receptor blockers
proton pump inhibitors surface-acting agents PGE-1 analogs Bismuth compounds |
|
|
What is the MOA of famotidine?
|
reversibly inhibit H2-receptors on basolateral membrane of parietal cells (anything ending in -tidine)
|
|
|
Which H2 blocker is a potent inhibitor of P-450?
|
cimetidine (randitidine... 10% of cimetidine's affects)
|
|
|
How long does it take for an ulcer to heal w/ PPI or H2-blocker treatments?
|
4-8 weeks
|
|
|
Which anti-ulcer category of drugs is most effective acid-inhibitor?
|
PPI's
|
|
|
Which anti-ulcer drugs would you choose for zollinger-ellison syndrome?
|
PPI's
|
|
|
What is the MOA of omeprazole?
|
Irreversibly inhibit H/K ATPase within stomach parietal cells (activated w/in the cells)
|
|
|
What is the MOA of sucralfate? Indications?
|
MOA: inhibits pepsin-mediated hydrolysis of mucosal proteins, protects ulcer base from acid
Indication: DU (other off-label uses) |
|
|
What is the MOA of misoprostol?
|
A PGE1 analog: inc. production of gastric mucous barrier (stim mucous/bicarb prod, inc mucosal blood flow, dec pepsin)
|
|
|
What is the most appropriate use for misoprostol?
|
prevention of NSAID-induced gastric ulceration
|
|
|
What is the MOA of bismuth?
|
inc production of bicarb and mucous, may bind to ulcer site; antibacterial actions
|
|
|
What are the characteristic AE's of metronidazole?
|
metallic taste....
Disulfram-like reaction (like alcohol w/drawal symptoms) |
|
|
What is a standard treatment for H. pylori?
|
Triple therapy (b.i.d. 10-14 days): PPI, clarithromycin, amoxicillin or metronidazole
-or- Quadruple therapy: PPI/H2block, Metro/Clarithro, Amox/Tetracycline, & Bismuth (subsalicylate) Also.... continue PPI/H2 2-6 wks post-regimen for healing |
|
|
Pt. has H. Pylori infection that is determined to be metronidazole-resistant. Pt mentions they are allergic to amoxicillin. What is your best treatment regimen?
|
Quad therapy:
PPI/H2blocker Clarithromycin Tetracycline Bismuth |
|
|
What is the sequential therapy for H. pylori?
|
1. PPI + amoxicillin for 5 days
2. PPI + clarithromycin + tinidazole for 5 days |
|
|
Rank onset of action of H2-blockers, PPIs, and antacids?
|
Quickest to slowest
Antacids>H2>PPI |
|
|
What do you use first for treating pregnant patients who have H. pylori?
|
antacids or sucralfate
Ranitidine & lansoprazole Mod disease: H2 Severe: PPI |
|
|
What is in prevpac?
|
amoxicillin, clarithromycin, lansoprazole (ACL)
|
|
|
What is in Helidac?
|
Bismuth
Metronidazole Tetracycline (BMT) |
|
|
H. pylori infection. First go-to if metronidazole-resistant?
|
tetracycline... consider Quad therapy
|
|
|
H. pylori infection. First go-to if clarithromycin-resistant?
|
Either amoxicillin or tetracycline (consider Quad therapy)
|
