Mod 2: Management Of Gi Diseases

Front 1

Sodium Bicarbonate produces...

Back 1

CO2 (belching!) and NaCl

Front 2

Calcium Carbonate produces

Back 2

CO2 (belching!) and CaCl2

Front 3

Magnesium or Aluminum Hydroxide produces...

Back 3

No gas.

Al-Cholride or Mg-Chloride.

AE: Al: constipation, Mg: Diarrhea

Front 4

TEST QUESTION: What do antacids treat? Do they treat GERD/Reflux?

Back 4

Antacids only treat the feeling of heartburn. They are symptomatic drugs (adjunctive therapy) and they CANNOT TREAT GERD/Reflux.

Front 5

Maalox, Mylanta, and Riopan all have...

Back 5

Al + Mg

Think: MR. M

Front 6

Gaviscon active ingredients

Back 6

Mg+Carbonate

Antacid.

Front 7

Tums active ingredients

Back 7

Ca+Carbonate. (burb)

Antacid.

Front 8

Rolaids active ingredient

Back 8

Aluminum (constipation)

Front 9

Histamine 2 Antagonists

Back 9

Block H2 receptors.

Fairly Safe!

Include: Tagament, Pepcid, Axid, Zantac.

Think: ZAPT!

Front 10

H2 Antagonist MOA

Back 10

They inhibit H2 receptors on Parietal cells (HCl) on gastric mucosa.

Effective in Nocturnal Acid production.

OTC drugs have short half life and smaller dose.

AE: Endocrine effects: interferes with CYP450 pathway.

Use: Ulcers & Reflux, Stress Ulcer prophylaxis.

Front 11

TEST QUESTION: What class of drugs are effective in treating nocturnal acid production?

Back 11

H2 Antagonists

Front 12

Tagament

Back 12

H2 Antagonist.

Think: zapT!

Front 13

Pepcid

Back 13

H2 Antagonist.

Think: zaPt!

Front 14

Axid

Back 14

H2 Antagonist.

Think: zApt!

Front 15

Zantac

Back 15

H2 Antagonist.

Think: Zapt!

Front 16

Proton Pump Inhibitors Drugs and general MOA?

Back 16

Most Potent.

Prevacid, Prilosec, Nexium, Aciphex, Protonix, Kapidex

MOA: Administered as inactive prodrugs. Irreversibly inhibit H/K ATPase pumps.

Given on Empty Stomach. Short half life but suppress acid for 24 hours.

Front 17

Proton Pump Inhibitors are effective on _____ and ______ acid secretions.

Back 17

Fasting and Meal-Stimulated acid secretions.

Front 18

Adverse Effects of Proton Pump Inhibitors

Back 18

Decrease B12 levels with prolonged therapy. Increased GI infection risk.

Front 19

A serious and major Adverse Effect of Proton pump inhibitors (Omeprazole/Prilosec)?

Back 19

They may decrease the efficacy of Clopidrogrel (Plavix). This can cause CV events (MI or stroke).

Front 20

Prokinetic Agents selectivly stimulate...

Back 20

Gut motor function.

MOA: Cholinergic Stimulation.

Front 21

Metoclopramide

Back 21

Protkinetic Agent.

Dopamine antagonists in the GI tract. It increases esophageal peristaltic amplification.

AE: Extra Pyramidal Side Effects

Front 22

Lansoprazole (Prevacid)

Back 22

Proton Pump Inhibitor

Front 23

Omeprazole (Prilosec)

Back 23

Proton Pump Inhibitor: 1st.

Inhibits Clopidogrel (Plavix)

Front 24

Esomeprazole

Back 24

Proton Pump Inhibitor.

Rx form of Omeprazole (Prilosec)

Front 25

Rabeprazole (Aciphex)

Back 25

Proton Pump Inhibitor

Front 26

Pantoprazole (Protonix)

Back 26

Proton Pump Inhibitor

Front 27

Dexlansoprazole (Kapidex)

Back 27

Proton Pump Inhibitor

Front 28

Proton Pump Inhibitor Mnemonic

Back 28

PEDRO (the) L(ion) -prazole
Pantoprazole (Protonix)
Esomeprazole (Nexium)
Dexlansoprazole (Kapidex)
Rabeprazole (Aciphex)
Omeprazole (Prilosec)
Lansoprazole (Prevacid)

Front 29

H. Pylori Eradicator

Back 29

Fights Ulcers.

Tx: 2 Antibiotics, 1 Acid Reducer.

Front 30

Bulk Forming Laxatives: Place, MOA, AE

Back 30

Place: Low-Fiber diets.
MOA: Acts like a fiber sponge to stimulate peristalisis. Patient must drink with 8oz water.
AE: Obstruction, Flatulence, Drug interactions.

Front 31

Bulk Forming Laxatives

Back 31

Metamucil, Citrucel, FiberCon, Malt Soup Extract

Think: Much Fiber Makes Crap.

Front 32

Metamucil

Back 32

Bulk Forming Laxative

Front 33

Citrucel

Back 33

Bulk Forming Laxative

Think: Much Fiber Makes Crap.

Front 34

FiberCon

Back 34

Bulk Forming Laxative

Think: Much Fiber Makes Crap.

Front 35

Malt Soup Extract

Back 35

Bulk Forming Laxative

Think: Much Fiber Makes Crap.

Front 36

Stimulant Laxatives: Place, Action, AE.

Back 36

Place: acute, non-febril constipation. Increases Peristalsis.

AE: Laxative Dependence.

Front 37

Senna

Back 37

Stimulant Laxative

Most common.

Front 38

Saline Laxative: Place and Action

Back 38

Used for acute evacuations of GI from poisonings or for surgery. Fluid is pulled into the gut to facilitate movement.

Front 39

Sodium Phosphate

Back 39

Saline Laxative

Front 40

Polyethylene Glycol Solutions

Back 40

Saline Laxatives.

Miralax OTC.

Also Nulytely, Trilyte, Halflyte.

Front 41

Osmotic Laxative Place and Drugs

Back 41

Place: acute evacuation of bowels (constipation or poisoning).

Drugs: Lactulose (most common) and Sorbitol (sugar free candies)

Front 42

Stool Softner

Back 42

Place: Relieve Chronic Constipation

Drug: Colace

Front 43

Antiperistaltics Properties

Back 43

Based on Opioid Agonists, but have no analgesic or euphoric effects.

Contraindication: Travelers Diarrhea.

Front 44

TEST QUESTION: What opioid adverse effect do Antiperistaltics use?

Back 44

Antiperistaltics inhibit GI peristalsis, but lack the analgesic and euphoic effects.

Front 45

Antiperistaltic Drugs (2)

Back 45

Loperamide (Imodium), Diphenoxylate + Atropine (Lomotil).

AE: Constipation, dry mouth, orhostatsis, dependence.

Front 46

Bismuth Subaliclyate (Pepto Bismol)

Back 46

Anti-diarrheal agent.

Coats the GI inhibiting secretions and absorption.

AE: Black tongue/stool.
AVOID IN KIDS: Rye Syndrome.

Front 47

Adsorbents

Back 47

Adsorption of water from the GI tract leading to formed stools. (Stops Diarrhea).

Front 48

Phenothiazines

Back 48

Antiemetic Agent.

Dopamine Antagonists.
SE: Cholinergic Side Effects, EPSE

Front 49

Prochlorperazine (Compazine)

Back 49

Phenothiazine class of Antiemetic Agent. DA antagonist.

Front 50

Serotonin Antagonists

Back 50

Antiemetic Agents.

Inhibits serotonin secretion in the vomiting center of the brain.

SE: Constipation.

Drugs: Ondansetron, Graniseton, Dolasetron. (Sounds like Reindeer).

Front 51

Ondansetron, Granisetron, Dolasetron

Back 51

Serotonin Antagonists for Antiemetic effects.

Sounds like Reindeer. Spells DOG

Front 52

Antihistamine/Anticholinergics

Back 52

Antiemeitic Agents.

MOA: Inhibit Cholinergic receptors preventing motion sickness. Must be taken before sickness starts.

SE: Anti-choinergic Effects.

Front 53

Dramamine

Back 53

Antihistamimne/Anticholinergic drug.

Prevent Motion sickness.

Front 54

Scope

Back 54

Antihistamimne/Anticholinergic drug.

Prevent Motion sickness.

Front 55

Simethicane

Back 55

Anti-Foaming Agent (Gas)

Decreases the surface tension of gas bubbles and combines them into large bubbles to pass more quickly.