Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
74 Cards in this Set
- Front
- Back
|
What maintains the acidity of the stomach?
|
The H+/K+ protein pump
|
|
|
What drugs are used to treat Gastroesophageal Reflux disease?
|
1. Histamine Receptor Antagonists
2. Proton Pump Inhibitors 3. Antacids 4. GIi Protectant 5. Prostaglandin |
|
|
What is the common suffix for Histamine Receptor Antagonists?
|
"Tidine"
|
|
|
Describe the MOA of Histamine Antagonists.
|
REVERSIBLY inhibit gastric acid secretion by competetively antagonizing H2 receptors on parietal cells
|
|
|
Why are histamine antagonists only good for moderat control?
|
They only block 1 of 3 receptors
|
|
|
What is the one Histamine Antagonist that is excreted by the kidneys?
|
Nizatidine
|
|
|
Which drug causes delirium, sedation and male breasts to grow?
|
Histamine Antagonists
|
|
|
Which of the Histamine antagonist inhibit CYP 450 enzymes?
|
Cimetidine
|
|
|
Azole antifungals (require acid) have a drug interaction with which reflux drug?
|
Histamine Antagonists, PPIs, Antacids
|
|
|
Which drug class IRREVERSIBLY bind to proton pumps and inhibit ACTIVE pumps?
|
Proton Pump Inhibitors
|
|
|
Are PPIs active upon ingestion?
|
NO, activate in the presence of food
|
|
|
What is the advantage of perscribing PPIs?
|
They have a short half life but are long lasting (24 hours) Better for compliance
|
|
|
Which reflux drugs are Enteric Coded? What does that mean for pt teaching?
|
PPI's
-Tell pts not to crush them! Take them whole! |
|
|
Which reflux drugs are safe for children?
|
PPIs
|
|
|
What liver enzymes metabolize PPIs?
|
CYP2C19
|
|
|
Which drugs are considered "Safe and well tolerated?"
|
PPIs
|
|
|
Give some adverse effects of PPIs?
|
GI and CNS (dizziness, headache)
|
|
|
Which reflux drugs are used for symptom relief only?
|
Antacids
|
|
|
Na, Ca, Mg and Al are examples of what GERD drugs?
|
Antacids
|
|
|
What are the most frequently used antacids?
|
Mg and Al compounds
|
|
|
Which antacids produce bloating and belching?
|
Na and Ca compounds
|
|
|
Which antacids causes constipation? How is it counteracted?
|
Ca and Aluminum, given along with Magnesium (causes diarrhea)
|
|
|
What are some drug interactions for Antacids?
|
Complexation (Chelation) with Fluoroquinolone and tetracylines
|
|
|
How should antacids be administered?
|
PO and 1-2 hours before tetracyclines and fluoroquinolines
|
|
|
What is the one GI protectant?
|
Sucralfate
|
|
|
How is Sucralfate administered?
|
Orally: viscous paste in water or acid
|
|
|
What is the MOA of Sucralfate?
|
bind to damaged, ulcerated tissue forming a protective barrier
|
|
|
Which GERD drug is NOT absorbed and excreted in the feces!?
|
Sucralfate
|
|
|
What are some adverse effects of Sucralfate?
|
Constipation, dry mouth, nausea, rash
-Sedation or "feeling off" -Diarrhea |
|
|
What prostaglandin drug is used to treat GERD?
|
Misoprostol
|
|
|
which drug is only FDA approved to treat GERD in patients on long term NSAIDs?
|
Misoprostol
|
|
|
What is the WORST adverse effect of Misoprostol?
|
Causes uterine contractions! ABORTION!
|
|
|
Which GERD drug is a pregnancy category X?
|
Misoprostol
|
|
|
What are adverse effects of Prostaglandin drugs?
|
Spontaneous abortion
-Stomach Pain -Diarrhea |
|
|
How do indirect acting stimuli work to bring about emesis?
|
They first activate chemoreceptor trigger zone
|
|
|
What receptors are involved in emesis?
|
Seretonin, Dopamine, Ach, Histamine
|
|
|
What are the drugs for Nausea and Vomiting?
|
Phenothiazines
-Nonphenothiazines -Seretonin 5HT3 antagonists |
|
|
What class of antiemetics are antipsychotic?
|
Phenothiazines
|
|
|
Which drugs inhibit dopamine and muscarinic receptors (CTZ) and cause sedation by blocking histamine?
|
Phenothiazines
|
|
|
What are the 3 routes of admin for Phenothiazines?
|
PO, IV and PR!!
|
|
|
Does Rectal or oral admin have a longer duration in phenothaizines?
|
RECTAL
|
|
|
Which Antiemetics cause both extrapyramidal and anticholinergic effects?
|
Phenothizines
|
|
|
Metoclopramide (Reglan) is under what class?
|
Nonphenothiazine…Antiemetic
|
|
|
What is the MOA of Metoclopramide?
|
inhibits Dopamine and SERETONIN in the CTZ
|
|
|
Pts with Obstructions of the GI should not take?
|
Metoclopramides
|
|
|
What are the adverse effects of Metoclopramide?
|
CNS (sedation, confusion, extrapyramidal, seizures) crosses the BBB
-Diarrhea |
|
|
Which antiemetics are used to treat chemotherapy induced nausea?
|
Seretonin Antagonists
|
|
|
When are Seretonin Antagonists administered>?
|
30 -60 mins prior to chemotherapy
|
|
|
Which drugs block both the peripheral and central stimulation of vomiting?
|
Seretonin Antagonists
|
|
|
Which Seretonin Antagonist is dosed ONCE WEEKLY?
|
Palonosetron
|
|
|
What are the adverse effects of Seretonin Antagonists? How often do they occur?
|
Do not occur often
-headache -sedation -dizziness -constipation |
|
|
What is constipation determined by?
|
Stool consistency, not frequency
|
|
|
What are the laxative classes?
|
Chemical Stimulants
-Bulk Stimulants -Lubricants |
|
|
Which laxative increase the amount of fluid in the stool and increase peristalsis?
|
Chemical Stimulants
|
|
|
What drug causes pink, yellowish-brown urine?
|
Senna
|
|
|
What can long term use of chemical stimulants cause?
|
Laxative dependence
|
|
|
What are some of the common adverse effects of laxatives?
|
Nausea, vomitting, cramping flatulence
|
|
|
Which laxatives most resemble fiber and are safe to take normally?
|
Bulk Stimulants
|
|
|
What is the predominant use of Bulk stimulants?
|
Prevention of constipation
|
|
|
What is the MOA of bulk stimulants>
|
Mechanical Distention of the Bowel (expands the stool)
|
|
|
What type of bulk stimulant should DM pts take?
|
One that is sugar free
|
|
|
What is the prototype Lubricant?
|
Docusate (Colase)
|
|
|
What is the outcome of using Docusate?
|
Stool Softening
|
|
|
Which type of pts are often perscribed colase?
|
Cardiac pts, post operatively, or pts on opioids (prevent straining)
|
|
|
What are the antidiarrheal agents?
|
2. Diphenoxylate/atropine (Lomotil)
3. Bismuth-subsalicylate (Pepto-bismol) |
|
|
What antidiarrheal is Rx ONLY?
|
Diphenoxylate/atropine
|
|
|
Which antidiarreal acts directly on the MUSCLES of the GI tract to slow motility?
|
Loperamide (Imodium)
|
|
|
List some common side effects for antidiarrheals.
|
Nausea, vomiting, constipation, abdominal discomfort
|
|
|
State the antidiarrheal that acts on the opioid receptors to decresase motility
|
Diphenoxylate/atropine
|
|
|
Why is atropine added to Diphenoxylate?
|
To prevent pts from abusing the medication because of opioid effects
|
|
|
What affects are seen with high doses of Diphenoxylate/atropine?
|
Morphine-like effects, light headedness, hallucinations
|
|
|
Which antidiarrheal turns the stool and tongue black?
|
Bismuth Subsalicylate
|
|
|
Which antidiarrheal can cause tinnitus?
|
Pepto-Bismol
|
|
|
Which patients cannot take pepto-bismol?
|
Warfarin and those with asaprin allergy
|
