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92 Cards in this Set
- Front
- Back
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What are potential causes of PUD
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NSAIDS/H Pylori, Corticosteriods
Bisphophontes, Smokings, ETHOD |
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What is typical presentation of PUD
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PAIN 1-3 hours after meals, and relived by FOOD
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What is the mechanism for how NSAIDs cause msucosal damage
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DIRECT and systemic inhibtion of protaglandins
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Inhibtion of proglandins causes what
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decrease bicarb section, and mucus secretion and production
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H. Pylori infections, generally cause DUDONEAL ulcers
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YES
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What are goals of thearpy for H. Pylori eradication
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Relive pain
faciliatate healing reduce risk of cancer |
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What is general treatment of NSAID PUD
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PPI or h2RA for 4-6 weeks
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Antacids are used for GERD symptoms what is MAJOR DI
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BIND LEVOTHYOXINE, TETRACYCLINE and FLUROQUINOLINES, DIGOXIN
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What is MOA of Antacids
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BIND to H+ secreted in stomach and NEURALIZE
VERUS PPI INHIBIT H+ production |
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What does Mg+cause
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DIARRHEA
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What does aluminum cuase
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constipation
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Should Na+ Bicarb be avoided in pts with HF
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YES
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Gaviscon or Alginic acid, MOA
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severes a protective barrier for ESOPHAGUS against gastric concents
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What is ZANTAC, PEPCID, TAGAMET, and AXID
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ZANTAC-Ranidine
Famotidine-Pepcid Cimetidine-Tagament Nizatidine-Axid |
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What is MOA of H2Ra
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reversible ininbhit H2 receptor on parietal cells which result in decrease H+ production
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What PPI's come in IV
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Nexium
Prevaid (Lansoprazole) Protonix (Pantoprazole) |
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What is MOA and role sucralfate (Carafate)
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sulfated sucrose with AL OHattached and BIND TO PROTEIN in ULCER
ROLE: ONLY PUD |
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What are DRUG INTERACTIONS with SCRALFATE and why
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ALOH---same as antacids
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What is generic Cytotec
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Misoprostol
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What is MOA of Misoprostol (Cytotec)
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PGE analog, that increase mucus and bicarb section
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What is AE of Cytotec (Misprostol)
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DIARHEA, and cramping, use also for abortion/labor
CATEGORY X |
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What is TRIPLE THERAPT for H. PYLORI
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PPI BID
AMOX 1g BID and Clarithromycin 500 mb BID for 14 days |
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What is alteranative to AMOXICLLIN in TRIPLE therapy
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Flagyl 500 mg BID
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What is quadruple therapy
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BMT and PPI
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What are the type of Gastroesophageal reflux disease
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NON erosive
erosive leading complications---barrett's |
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What is overal goal of GERD
GastroESOPHAGEAL reflux disease |
neutralize reflux ph>4, so when does reflux it does NOT cause damage and prevents activation of pepsinogen
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What PRO-kinetics are availabe for GERD and gastroparesis
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Metoclopramide (reglan)
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What is MOA of Metoclopramide (Reglan)
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increase Ach, and DOPAMINE antagoinst
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What are AE of Metoclopramide
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diarrhea, EPS (bc of dopamine antagoinism)
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IBD--in general thinking DIARRHEA and ABDOMINAL PAIN
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YES
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What are the 2 types of IBD
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UC
Chron's Disease |
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What is UC (ulerative colitis
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COLON/rectum and continous lesions
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What is Chron's Disease
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any part of GI, skis lesions
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What disease is MORE common do have bloody diarrhea
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UC
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IBD is divided in disease based on stools, mild <4, moderate 4 or more stools day, SEVERE disease >6 stools a day, what FULMINANT disease
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>10 BM day, and continous bleeding
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What do you STOP with TOXIC MEGACOLON
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stop all opidates and anti-cholinergic agents
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What is preferred treatment for UC (colon and rectum)
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5-ASA (Aminosalsylates)
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If UC is only limited to rectum what is treatment of choice
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suppository
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What is UC treatment is limited to distal colitis
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ENEMA or oral 5ASA
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Can you give pts with IBD both ORAL and topical thearpies
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YES
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Sulfasalazine can be used for what TWO treatments
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RA (DMARD)
UC/Chron's |
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What is unqiue MOA sulfasalazine
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when taken, the bacteria in gut cleave and make Sulfapyridine and 5-ASA
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5-ASA and Mesalamide are preferred for what disase
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UC
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What are BRANDname Mesalamine products
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Aacol, Canasa, Pentasa, Rowasa
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CORTICOSTERIODS are preferred CHRON's disease which is
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CONTROLLED release Budesonide (ENTOCORT EC)
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Can you Mesalamine and 5-ASA for Chron's
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yes but less effective
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What is MAIN role of Corticosteriods in IBD
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cause remission---NOT for maintenace
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For in more severe causes of UC/CD, immuosuppresents may be used
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YES
Azthiprine Cyclosporine MTX TNF alpha blockers |
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The TNF-alpha inhibitors are more valuble in CD
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YES
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What are the Adverse effects of TNA-alpha blockers
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Infection, worseing of CHF and HA
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What are MAJOR cautions with TNF alpha blockers
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Class III/IV HF
RISK OF TB |
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What are TNF alpha blockers UC/CD
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Adalimuamb (Humira)
Enbrel Remicaid (Infliximab) |
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What IBD may use antibtioics
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CD
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What the antibiotics for CD
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Flagyl and Cipofloacin
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What is IBS (irritable bowel syndrome)
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diagnosis of exclusion
chronic diarrhea or constipation |
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What is treatment options for IBS with diarrhea
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Dicyclomine (Bentyl)
Hyoscayamine |
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What is MOA Bentyl (Dicyclominde)
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anticholinergic---slows down GI systemi
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What is role of Lubiprostone (Amitiza_
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constipation dependent IBS
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SSRI can also be used for IBS and treat
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increase 5HT---increases gastric motility
in general CONSTIPATION ONLY SSRI for Diarrhea is Paroxetine |
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What is RA
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autoimmune disorder results in inflammation of joing that causes pain and disability
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What are typical description of RA
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pain/inflammation in joints and MORNING stifness take 1 or 2 to get out of bed
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Is there a cure for RA
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NO
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What is the STANDARD of care for treatment of RA
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DMARDS--reduce DISEASE PROGESSION
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What are DMARDS available
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MTX
Azthioprine Hydroxychlorquine Sulfasalazine Leflunomide |
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Are TNF-alpha inhibitiors also DMARDS
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YES
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What is MOST common DMARD
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MTX (Rheumatrex, Trexall)
also dose with folic acid |
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What is MOA of Methotrexate
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inhibitior of dihydroholate reduacse
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What is typical dosing of MTX
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7.5-30 ONCE WEEKLY
PO, SUBQ, IM, IV |
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What are AE of MTX
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GI upset, liver fibrosis--pregnancy X, pulmonary toxcity
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What is MAJOR drug interaction with Azthioprine
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Allopurinol (zyloprim and Febuxostat (Uloric)
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What is other use of Hydroxychlorquine
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Plaquenil
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What is MAJOR SE of Plaquenil
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ocular damage
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Should you avoid sulasalazine in sulfa allergic tps
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YES
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Leflunomide (Avra) is another DMARD, what major CON
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Pregnancy X, and needs a washout period with cholestryamine and/or carchol
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What is generic of Humira
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Adalimumab
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What is generic of Enbrel
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Etaercept
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What is generic of Remicade
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Infliximab (ONLY IV infusion)
MUST BE USED WITH MXT |
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What is the IL-1 receptor antagoinst that may be used after failure of TNF-a inhibitors
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Anakinra (Kineret)
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Does Rituximab also need to be given with MTX
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YES
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Can you ever use 2 biologoic together
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NO
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What therapy for RA, can you not give live vaccines
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TNA-alpha or biologoic thearpy DONT give
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What is the GENERAL MOA OF OA
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LOSS of cartilage
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What joints does OA affect mainly
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weight bearing joing
HIPS, KNEES, HAND, FEET, SPINE |
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What are signs/symptoms of OA
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weight bearing joing
STIFFNESS, pain, crepitus |
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What is the standard of care for treatment of OA
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TYLENOL (APAP)
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What are the 2 situations that can result in uric acid precipitation
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OVERPRODUCERS
UNDER-exretors |
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What THINGS decrease EXCRETION OF URIC ACID
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Diuretics, Nicotinic acid, SALYCYLATES, alcohol
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What are complications of GOUT
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Uric acid nepholitathias
or Tophaceous and permanent deformitites |
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What are the 3 main acute treatment of GOUT
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Colchicine, NSAIDS, and Corticosteriods
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What is treatment for CHRONIC gout
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Allopurinol
Colchicine |
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How do you treat Nephotlithasis from URIC ACID
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alkalinzation of URINE with Sodium bicard with makes IONIED, adn more water soluble
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What is MOA of Probenecid
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increases uric acid secretion b/c inhibits renal tubular reabsoption
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