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98 Cards in this Set

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