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63 Cards in this Set
- Front
- Back
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Define Peptic ulcer disease (PUD)
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Degrees of erosion of the gut wall
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What causes Peptic ulcer disease? Generally
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Imbalance between mucosal and aggressive factors
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What are the Defense factors in the stomach?
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Mucus, Bicarbonate, blood flow, Trpstaglandins
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What are some aggressive factors that can lead to PUD
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H. Pylori
NSAIDs Gastric acid Pepsin Smoking-- reduces blood flow |
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What are the Classes of Antiulcer drugs (5)
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Antibiotics
Antisecretory agents Mucosal protectants Antisecretory agents that enhance mucosal defense Antacids |
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How can you test for H. Pylori?
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Breath test, or serum test
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What is H. Pylori treated with?
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Antibiotics
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Name 4 drug therapies for GERD
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Antacids
Histamine-2 receptor Antagonists Proton Pump Inhibitors (PPI) Home Remdies (tums, MOM, OTC struff, etc) |
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Why must you have "maintenance therapy" while you are on GERD Drug Therapy?
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Drug Therapy eleviates the GERD Symptoms, but You must have maintenance therapy in the mean time to try to emilinate the cause of the GERD
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What are the 3 types of Maintenance therapies when dealing with GERD?
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On-Demands
Intermittent Continuous Therapy |
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Which maintenance Therapy for GERD do you start when symptoms arise, and Stop quickly! Usually OTC meds
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On-demand maintenance therapy
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Which maintenance Therapy for GERD do you start when symptoms arise, and Stop after 2-4 weeks when patient is asymptomatic
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Intermittent Maintenance Therapy
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Which Maintenance therapy for GERD do you take drugs 2-3 months in a row?
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Continuous Therapy
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Which Maintenance therapy for GERD is better, and more typical way to treat underlying cause of GERD.
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Intermittent maintenance therapy
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Which Maintenance therapy for GERD is more costly, and causes people to have problem with adherance
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Continuous therapy
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What is a big problem with overuse of Antacids?
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Metabolic Alkalosis
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How do Antacids work?
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Antacids bind with acid to make pH go up and become less acidic
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Does Antacids Tighted or Loosen the Lower Esophageal Sphincter? (LES)
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tightens the LES to hopefully prevent reflex
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Pain when stomach is (empty or full) is a RED FLAG for stomach ulcers
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EMPTY
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Because when you have stomach ulcers, you feel pain on an empty stomach, when should you take an antacid? and is it frequent or not?
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between meals, and needs frequent administration
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True or False, Antacids are Less Palatable (taste bad)
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TRUE
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What are many drug drug interactions with being treated with antacids for GERD caused by?
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elevated pH
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Amphojel is an antiacid prototype made with ____ ____
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Aluminum Salts
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True or false, If you have Osteomalcia (soft bones) you cannot take amphojes (aluminum salts)
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TRUE
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True of False, Amphojel is used in Renal Faliure patients to increase calcium in thier blood
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TRUE
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What are 3 adverse effects Amphojel can cause?
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Constipation
Hypercalcemia Hypophosphatemia |
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If you are on a drug like Cipro, when should you take your antiacids in comparison to your Cipro?
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take antacid 2 hours before of 2 hours after you take cipro.
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ALL ANTACIDS bind to _______, and (increase or decrease) aborption of Warfarin, Digoxin, and Cipro?
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Tetracycline
Decrease |
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Tums are a Prototype of Antacids that are made of ____ _____.
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Calcium Carbonate
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True of False, any antacid is good for bones
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FALSE, any antacid is no good for bones!
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What are the 3 side effects of Tums?
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Constipation
Hypercalacimia Metabolic alkalosis |
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True of False, Any antacid can cause Metabolic Alkalosis
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TRUE
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What is the TYPICAL side effect you will see with antacids??
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Constipation
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with antacids, Drug Drug interactions include; Absorption of Drugs which require Low pH-- (increased or decreased)
Absorption of drugs that require a higher pH-- (increased or decreased) |
Decreased
Increased |
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Mylanta Supreme is a prototype that is made from Calcium Carbonate AND Magnesium Hydroxide. Why would you combine these two drugs?
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Calcium carbonate causes constipation, magnesium hydroxide causes diarrhea (they balance eachother out)
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Milk of Magnesium (MOM) is Made from Magnesium Salts, What Side effect is commonly seen with MOM?
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DIARRHEA
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Maalox Plus and Gavison are both made with Aluminum AND magnesium salts, why would you combine these?
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Aluminum causes constipation, magnesium salts causes diarrhea (they balance eachother out)
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How does Histamine-2 receptor antagonist work for GERD of Ulcers?
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H2RA Decrease gastric acid production by blocking H-2 receptor on parietal cell
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For PUD, how long should you use Histamine 2 Receptor Antagonists?
For GERD, how long should you use Histamine 2 Receptor Antagonists? |
PUD: 4-8 weeks
GERD: 8-12 weeks |
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Why should you be careful giving Histamine-2 Receptor Antagonists to patients with over 50, with kidney and liver problems?
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cause they aren’t going to metabolize or excrete it properly
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Histamine-2 Receptor Antagonists (inhibit or promote) P450 Drug interactions?
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Inhibit P450
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What is the Proton Pump Inhibitor Prototype?
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Omeprazole (Prilosec)
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How does protom pump inhibitors work?
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they inhibit the enzyme that makes gastric acid
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true or False, Prilosec is usually given as triple therapy with, amoxicillin, and clarithomycin, OR dual therapy with amoxicillin
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TRUE
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What are two ways to administer Prilosec?
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Swallow WHOLE pill before eating, or open the pill and sprinkle the granules on food or down people NG tubes
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True of False, If you open Prilosec pills, and granules come out, can you crush the beads and put them on food or in NG tube?
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NO
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Prilosec is a good treatment for GERD because they (inhibit or promote) Gastric secretions?
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Inhibit
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Prilosec has a short half-life, so how often should you take prilosec to maintain therapeutic effects?
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Take everydayHeadace
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What are Adverse effects seen with Prilosec?
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Headache--usually goes away (Pretty Common)
Gastrointestinal --every drug can have |
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what are other drugs for GI Problems?
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Antiinfectives
Anticholinergics Prokinetic Drugs Antisecretory Drugs Cytoprotective Drugs that help coat stomach Antidiarrheal drugs Drug for constipation |
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what do anti-infectives like Flagyl help in gut?
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Helps with C. Diff and anaerobes that live in gut
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Anticholinergics do what to help with GI disterbances?
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Suppress gastric acid secretion by blocking muscarinic receptros on parietal cells
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What is the most common Side Effect seen with anticholinergic drugs?
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DRY MOUTH
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Prokinetic drugs help with GI disturbances by doing what?
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Increases rate of gastric emptying by imcreasing movement through the gut
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What is a contra to Prokinetic drugs??
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Epilepsy-- the precepitate seizures
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Antisecretory agents prevent ulcers by doing what?
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Prevention of NSAIDs induced ulcers
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What do Antisecretory agents like Cytotec do to prevent ulcers?
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***Increase Bicarbonate, increase gastric mucuous, and suppresses gastric acid secretions
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What is the Side effects for Antisecretory agents like Cytotec?
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Uterine Contraction, Diarrhea, abdominal pain, and flatulence!!
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What category teratogenic is Antisecretory agents like Cytotec
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Category C drugs for pregnant women
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Why should you avoid antacids while taking Antisecretory agents like Cytotec
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, if a person is on cytotec and has antacids because that means cytotec isn’t strong enough, you shouldn’t have to take anacids!!
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Cytoprotectant drugs like Carafate help protect from what type of ulcers, which are VERY common?
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Duodenal ulcers
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what is the side effect of Cytoprotectant drugs like Carafate
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CONSTIPATION
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how should you administer Cytoprotectant drugs like Carafate
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Dissolve tab in water; do not crush!
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