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98 Cards in this Set
- Front
- Back
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agents that protect the esophageal mucosa
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alginic acid
sucralfate |
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prokinetic agents (inc esophageal and gastric clearance)
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bethanechol
metoclopramide cisapride macrolides |
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T/F: Tagamet has more side effects and Zantac
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true
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T/F: Pepcid has more side effects than Axid
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false
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T/F: Zantac has more drug interactions than Tagamet
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false
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T/F: Axid has more drug interactions than Pepcid
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true
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H2 blocking agents
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Tagamet
Zantac Axid Pepcid |
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T/F: You might have to double the doses of H2 blockers for them to be effective for GERD
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true
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T/F: To control sxs and healing, you may need to divide the doses of H2 blockers
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true
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PPI agents
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Omeprazole (Prilosec)
Lansoprozole Rabeprazole Pantoprazole Esomeprazole (Nexium) |
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PPIs will heal gastric ulcers up to 96% in ___ wks
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4
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PPIs will heal duodenal ulcers up to 97% in ___ wks
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8
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If you stumble upon Abx associated colitis...
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-stop Abx, avoid antimotility agents
-Metronidazole or Vanco |
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Sns and Sxs of IBS
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-diarrhea/ constipation
-abd pain -mucous in stool -inc'd flatus |
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T/F: Diagnosis of IBS is based upon laboratory tests
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False- based clincially
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Mgmt of constipation IBS
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-inc fiber
-stool softeners -psyllium -avoid anticholinergics |
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Mgmt of diarrhea IBS
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-eliminate sorbitol, lactose
-cholestyramine -loperamide |
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Which agent is used for diarrhea IBS?
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Alosetron
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Which agent is used for constipation IBS
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Tegaserod
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Describe the pathway of Ascites
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1. cirrhosis
2. portal htn 3. splanchnic vasodilation 4. inc splanchnic cap pressure 5. lump formation |
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What diuretics might you use to tx ascites?
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-spironolactone
-furosemide -amiloride |
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T/F: a combo of neomycin and kristalose will not be effective in a pt who failed to respond to either agent alone
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false- it may be effective
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What are the specific agents for sclerotherapy? (varices)
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sodium tetradecyl sulfate
ethanolamine oleate |
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In which pt should you be careful if prescribing vasopressin?
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those with vascular disease or CAD
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T/F: Azulfidine is considered inferior to corticosteriods in the mgmt of Crohns bc it has a slower onset
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true
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What is the most useful purpose of Azulfidine?
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maintaining remission of IBD
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T/F: Rowasa is better tolerated than Azulfidine
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true
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Olsalzine for IBS is released when?
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when colonic bacteria acts on it (like Azulfidine)
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What are the corticosteriod therapies available for IBD?
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cortenema
cortifoam prednisone entocort ec |
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When are IV corticosteriods indicated for IBD?
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for severe exacerbations
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What are the immunomodulatory agents for IBD?
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imuran
6 mercaptopurine methotrexate neoral infiximab thalidomide |
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What are the risk factors for PUD?
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age
institutionalization crowded living conditions family members with disease |
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What types of diseases is H pylori most associated with?
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duodenal ulcer
gastric ulcer type B antral gastritis gastric ca |
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H2 blockers heal duodenal uclers up to 84% in __ wks
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4
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H2 blockers heal gastric ulcers up to 82% in __ wks
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8
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T/F: you are not required to tx a H pylori infx with abx. You can just tx with antisecretory drugs
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false- need abx
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Combo meds for H pylori
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Helidac (tetracycline, metronidazole, bismuth)
Prevpac (amox, clarith, lansoprazole) |
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What causes spasticity?
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1. UMN lesions dec inhibitory tone to LMN (they are left hyperexcitable)
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What is the aim of muscle relaxant therapy?
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-to inc inhibitory tone to the LMN and dec the excitability of the Ia fibers (to dec the firing)
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Valium happens to be the DOC for...
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status epilepticus
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T/F: Lioresal results in less sedation than Valium
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true
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If a pt has severe spasticity, where might you inject Lioresal?
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intrathecally
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T/F: Cardiac and smooth muscle are greatly effected by Dantrolene
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false
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other muscle relaxants for "acute spasm"
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flexeril
norflex parafon forte robaxin skelaxin soma |
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tumor development is affected by...
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balance of oncogene expression and tumor suppressor gene expression
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oncogenes aka...
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accelerators
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tumor suppressor genes aka...
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brakes
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Cancer's seven warning signs
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change in bowel/bladder
a sore that doesn't heal unusual bleeding or discharge thickening or lump in breast indigestion or dysphagia obvious change in mole nagging cough/hoarseness |
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radiation
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tx tumor locally
SE: skin and GI |
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Sensitive Chemo
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ALL
AML testicular lymphoma neuroblastoma Ewings |
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Intermediate chemo
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breast
colorectal sarcoma bladder chronic leukemia multiple myeloma prostate head/neck cervical gastric SCLC |
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Resistant chemo
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melanoma
NSCLC pancreatic thyroid hepatocellular renal |
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partial response
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> 50% reduction in all tumors
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stable disease
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<50% reduction or <25% inc in tumors
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progression
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>25% inc of tumors
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median overall survival
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time from enrollment until the death of 50% of pts
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time to progression
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time of enrollment to disease progression
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disease-free survival
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time of documented complete response until disease progression or death
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T/F: resistance in a cancer cell can only be inherited not acquired
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false- can be inherited and acquired
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NCI = 0
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no toxicity
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NCI= 4
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life-threatening toxicity
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T/F: NCI grade 0-1, chemo is considered tolerated
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true
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T/F: chemo is dosed based on cancer stage
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false- based on BSA
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nociceptive pain
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unpleasant sensory and emotional experience associated with tissue damage
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neuropathic pain
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-occurs after main injury has healed (all nociceptive pain is gone)
-nerve fibers generating APs without stimulus |
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examples of neuropathic pain
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phantom limb pain
PHN small fiber disease in DM post-mastectomy pain, etc |
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referred pain
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projected pain
NOT neuropathic |
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types of nociceptive pain
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somatic (bone, skin, tissue)
viceral (abd) |
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Step 3 of the ladder of analgesia
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mod-severe pain
use high potency opioid |
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Step 2 of the ladder of analgesia
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mod pain
use low potency opioid and a non-opioid |
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Step 1 of the ladder of analgesia
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mild pain
NSAIDs or APAP |
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Salicylates/NSAIDs
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ASA
Trilisate Dolobid Doan's Disalcid |
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Nonselective NSAIDs
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Naproxen
ibuprofen toradol |
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max daily dose of Ibuprofen
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3200mg
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max daily dose of naproxen
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1000mg
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max daily dose of toradol
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120mg IV
40mg PO |
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max daily dose of APAP
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4-8g
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T/F: APAP should be used with caution in ETOHics and those with liver dysfunction
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true
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Non-opioid analgesics
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ASA
Choline Salicylates Diflunisal APAP Etodolac Diclofenac Ibuprofen Fenoprofen Celebrex |
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mixed agonist/antagonist opioids
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butorphanol
pentazocine nalbuphine dezocine |
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T/F: mixed agonist/antagonist opioids can be used with cancer pain
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false
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T/F: mixed angonist/antagonist opioids can be used in combo with pure opioids
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false
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T/F: Codeine has more side effects than morphine
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true
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morphine agents
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mscontin
oramorph avinza kadian roxanol |
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max therapeutic level of transdermal fentanyl
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2-3 days
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T/F: Methadone can be used with renal and hepatic dysfunction
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true-it has no active metabolites
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to prevent constipation with opioids
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senna + docusate
bisacoydl |
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to manage opioid induced nausea
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prochlorperazine
promethazine droperidol dronabinol |
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to manage opioid induced pruritis
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2nd gen antihistamines
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to manage opioid induced sedation
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methylphenidate
dextroamphetamine modafinil caffeine |
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nerve pain
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burning, stinging, lacinating pain, numbness, follows nerve tracks
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TCAs
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amitryptiline
nortriptyline impramine desipramine clomipramine doxepin |
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What is duloxetine?
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SSNRI
-used for PDN |
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Anticonvulsants
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gabapentine
carbamazepine phenytoin lamotrigine oxcarbazepine topiramate |
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lidocaine patch
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worth a try
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capsaicin meta-analysis
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cheap and worth a try
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addiction
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drug-seeking behavior
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tolerance
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physical dependence
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