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260 Cards in this Set
- Front
- Back
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omperazole therapeutic |
anti-ulcer drug |
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omeprazole pharmacologic |
proton pump inhibitor |
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omeprazole length of use |
short term 4-8 weeks |
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omeprazole mechanism of action |
reduces acid secretion in stomach by binding irreversibly to enzyme H+, K+-ATPase. inhibits the final pathway involved in acid secretion and effectively inhibits the active proton pumps |
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omeprazole |
significant first pass effect |
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omeprazole side effects |
HA, N, D, rash, abdominal pain |
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ranitidine therapeutic |
anti-ulcer drug |
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ranitidine pharmacologic |
H2-receptor antagonist |
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ranitidine trade name |
Zantac |
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omeprazole trade name |
prilosec |
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ranitidine mechanism of action |
blocks H2 receptors on parietal cells in stomach to decrease acid production |
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ranitidine |
smoking decreases the effectiveness |
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antacids |
inorganic compounds containing aluminum, magnesium, sodium or calcium that neutralize gastric acid and inactivate pepsin |
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diphenoxylate w/atropine therapeutic |
antidiarrheal |
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diphenoxylate with atropine pharmacologic |
opiod |
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diphenoxylate w/atropine trade name |
Lomotil |
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lomotil mechanism of action |
acts on smooth muscle of intestine to slow peristalsis |
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moving slowly through digestive tract |
absorbed really well |
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moving quickly through digestive tract |
not able to be absorbed |
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chief cells |
put out pepsinogen |
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parietal cells |
put out HCL acid |
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enteroendocrine cells |
stimulated by gastrin, produce histamine |
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normal pH of stomach |
1.5-3.5 |
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small intestine is made up of |
duodenum jeujunum illium |
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small intestine |
main site of absorption for food, nutrients, medications |
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large intestine |
main site of absorption for water |
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liver |
all drugs that reach circulation go through the liver regardless of whether they are taken PO, IM, SubQ, etc. |
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PUD |
imbalance of protective (mucous & bicarbonate) vs. aggravating factors (pepsin and gastric acid) |
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PUD |
may cause bleeding, perforation, penetration, GI obstructions |
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duodenum |
most common site for peptic ulcers |
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PUD |
ulcers in lower esophagus, stomach and small intestine |
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GERD |
stomach acids enter esophagus usually from relaxed lower esophageal sphincter |
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lifestyle factors to resolve GERD |
lose weight stop tobacco, alcohol eat smaller meals |
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lifestyle factors to resolve GERD
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avoid certain foods - caffeine, carbonation
decrease stress change medications if possible |
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medications to treat PUD and GERD |
PPIs H2 blockers Antacids |
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goal of pharmacotherpy for PUD and GERD Medications |
provide relief promote healing prevent complications prevent future recurrence |
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Proton Pump Inhibitors |
drug of choice for treating PUD, GERD |
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prazoles |
proton pump inhibitors |
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tidines |
H2 blockers |
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PPIs |
decrease acid more than H2 blockers do |
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PPIs |
best for long term prevention rather than acute episode |
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omeprazole |
used in treating H.Pylori |
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omeprazole |
irreversibly binds to H+, K+ proton pumps; inhibits proton pumps from releasing acid |
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Proton Pump Inhibitor Prototype |
Omeprazole |
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H2 receptor angatonists |
blocks acid production by blocking H2 receptors on parietal cells |
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H2 receptor antagonists |
blocks daytime, nighttime, fasting and food-stimulated secretion |
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H2 receptor antagonist prototype |
ranitidine |
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H2 receptor antagonists |
best used for short term use |
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H2 receptor antagonists |
help stop acid secretion at any time of day or night |
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PPIs |
effect cells best when acid is being produced because of food intake |
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ranitidine |
best for short term use |
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ranitidine |
may cause confusion in the elderly |
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ranitidine |
inhibits secretion of acid during eating, at night and during fasting |
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ranitidine |
decreased absorption with antacids |
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antacids |
don't protect stomach, don't promote ulcer healing |
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antacids |
neutralize pH of hydrochloric acid in stomach, reduces digestive action of pepsin |
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antacids |
treatment of pain associated with hyperacidity in PUD, GERD, heartburn, and indigestion |
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prototype antacid |
aluminum hydroxide |
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aluminum hydroxide antacid |
causes constipation |
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magnesium hydroxide antacid |
causes diarrhea |
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combination of magnesium hydroxide and aluminum hydroxide |
lessens constipating and diarrhea effects |
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calcium carbonate antacid |
causes constipation and can cause kidney stones |
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sodium bicarbonate antacid |
systematically absorbed - hypernatremia, water retention, metabolic alkalosis, acid rebound, causes bloating and belching |
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sodium bicarbonate antacid |
cannot be taken by people with HF, HTN, renal problems |
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antacids |
can cause rebound acidity when discontinued |
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h.pylori |
the only microbe that can survive in the stomach |
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patients that don't have H.Pylori |
should not receive antibiotics |
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H.Pylori |
patient needs to be compliant with medication - 1-2 weeks |
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H.Pylori treated with |
Anti-infectives (antibiotics) Proton Pump Inhibitors Antacids (bismuth preparations) |
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pepsin inhibitor (mucosal protective drug) prototype |
sucralfate |
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sucralfate |
is not absorbed patches ulcer, is sloughed off, and is excreted |
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sucralfate |
used for about 8 weeks to heal ulcers |
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sucralfate |
enhances mucus defenses |
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sucralfate side effect |
constipation |
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sucralfate |
take on empty stomach do not crush, chew or break tablets |
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sucralfate |
increase fluid intake, dietary roughage, and exercise to manage potential constipation |
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sucralfate |
give other meds 2 hours before or after |
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constipation |
waste material staying in the large intestine too long too much water reabsorbed decrease in BM's |
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treatment of constipation |
must rule out obstruction |
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two therapeutic reasons we use laxitives |
prophylaxis, treatment |
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treatment of constipation |
psyllium, bisacodyl, docusate, senna, magnesium hydroxide |
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diarrhea can be caused by |
infection - can be viral or bacterial drugs inflammation foods malabsorption |
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best treatment of diarreha |
opioids |
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prototype opioid to treat diarrhea |
diphenoxylate w/atropine (lomotil) |
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don't use anti-diarrheals |
with C-Diff or poisoning |
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nausea and vomiting |
controlled in the brain by the vomiting center |
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chemo trigger receptor zone |
area in the brain not protected by BBB |
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anticholinergic/antihistamine med for nausea |
meclizine |
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meclizine |
used for treatment of vertigo and motion sickness |
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phenothiazine used for nausea/vomiting |
promethazine |
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promethazine |
decreases N & V by blocking the dopamine receptors in the chemoreceptor trigger zone |
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phenothiazines |
used for cancer patients |
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promethazine |
can cause extra pyramidal symptoms (because of blocking of dopamine) |
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cannibinoid prototype for nausea/vomiting |
dronabinol |
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dronabinol |
cannabinoid used in treatment of N & V associated with cancer treatment as an appetite stimulant for individuals with HIV/AIDS |
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dronabinol |
increases appetite |
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giving dronabinol with phenothiazines |
improves N & V better than either drug alone |
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serotonin receptor antagonists prototype - for N& V |
ondansteron |
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ondansteron |
drug of choice for chemo and morning sickness |
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serotonin receptor antagonists |
block serotonin at 5-HT receptor sites in vagal nerve and at the chemoreceptor trigger zone |
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ondansterone |
relieves N & V from chemo, radiation, and post-op |
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dexamethasone |
helps with delayed nausea from chemotherapy |
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treatment of obesity |
diet exercise behavior modification |
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treatment of obesity |
lifestyle changes appetite suppressants lipase inhibitors |
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lipase inhibitor prototype |
orlistat |
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orlistat |
prevents lipid absorption from GI tract |
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orlistat side effects |
flatus, oily stool, fecal urgency, abdominal pain, HA |
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orlistat |
give drug within an hour of fatty meal |
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orlistat |
take fat-soluble multi-vitamin 2 hours before or after orlistat |
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orlistat |
avoid high fat meals |
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main female hormones |
estrogen, progesterone |
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importance of hormones |
growth/development/metabolism reproduction |
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importance of hormones |
contraception sexual function/satisfaction cancer treatment |
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estrogen |
mostly secreted by ovaries |
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female hormones |
secretion varies on a 28 day cycle |
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progesterone |
secreted by corpus luteum |
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at the end of the 28 day cycle |
negative feedback loop shuts off secretion |
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menstrual cycle |
whats happening in the ovaries and in the uterus |
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Estrogen |
encourages maturation of female reproductive organs and puberty |
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estrogen |
effects many other body tissues and organs decreases LDL increases HDL |
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estrogen |
prevents cardiac disease increases strength and length of bones prevents osteoporosis |
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estrogen |
usually combined with progestins to counteract adverse effects used to treat prostate cancer |
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estrogen |
taken to treat menopause |
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estrogen side effect |
HA, nausea, libido changes |
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estrogen increases clots |
don't give to people who have problems with blood clots |
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estrogen |
pregnancy category X |
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progesterone |
promotes breast development decreased levels of progesterone cause menses |
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progesterone |
maintains endometrium in early pregnancy limits and stabilizes endometrial growth |
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progesterone |
treats dysfunctional uterine bleeding treatment for endometrial cancer |
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progesterone |
inhibits midcycle LH surge - prevents ovulation encourages thick cervical mucus |
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medroxyprogesterone side effects |
breast tenderness breakthrough bleeding |
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medroxyprogesterone black box warning |
if combined with estrogen increases risk for stroke, DVT, MI, PE, breast cancer |
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medroxyprogesterone injectable form |
decreases bone mineral density - higher risk of osteoporosis |
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birth control |
mixture of estrogen and progesterone |
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estradiol and norethindrone |
combined estrogen and progesterone birth control |
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side effects of estradiol/norethindrone |
N, Weight Gain, breast tenderness, breakthrough bleeding Increased BP |
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Black Box Warning of estradiol/norethindrone
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smoking greatly increases the risks of CV problems - especially over age 35 |
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why should a woman not take oral birth control pills? |
breast cancer pregnancy cirrhosis of the liver |
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why should a woman not take oral birth control pills?
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migraines HTN History of Stroke Smoking |
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Progestin only birth control |
less effective than the combination, can have breakthrough bleeding |
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Progestin only birth control |
causes thick cervical mucus, discourages sperm and inhibits implantation |
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Progestin only birth control |
no risk of clotting, can be used if breast feeding |
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nonoxynyl 9 |
spermicide |
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Plan B |
prevents ovulation |
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mifepristone |
aborts implanted embryos |
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testosterone |
matures male reproductive system causes secondary sex characteristics |
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testosterone |
builds skeletal mass and causes bone growth increases erythropoietin - increased RBCs |
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testosterone |
treatment for testosterone deficiency, primary and secondary hypogonadism |
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testosterone |
may be used to treat anemia, muscle wasting diseases, some cancers |
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testosterone |
schedule III drug - potential for abuse |
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testosterone |
use with caution in patients w/prostatic hyperplasia |
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testosterone black box warning |
virulization may occur in women and children who are exposed |
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anabolic steroid side effects for men |
oligospermia testicular atrophy impotence acne aggression dependence |
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anabolic steroid side effects for women |
menstrual irregularity hair growth decreased breast size |
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anabolic steroid side effects for both men and women |
liver damage increased LDL decreased HDL HTN |
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sildenafil |
viagra |
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atherosclerosis |
number one risk factor for ED |
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PDE-5 inhibitor |
sildenafil |
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sildenafil |
don't use w/nitrates |
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sildenafil side effects |
HA dizziness flushing nasal congestion - all side effects from vasodilation |
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BPH drugs |
Alpha 1 adrenergic blockers 5-alpha reductase inhibitors |
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Benign Prostatic Hypertrophy |
enlargement of prostate - causes difficulty w/urination |
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drugs that make BPH worse |
alpha agonists, anti-cholinergics - both cause urinary retention |
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5-alpha reductase inhibitors |
makes it so testosterone can't encourage prostate to grow |
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alpha 1 adrenergic blockers |
cause smooth muscle in urethra to not contract |
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5-alpha reductase inhibitors |
blocks the enzyme that converts testosterone into active metabolite and shrinks prostate epithelial tissue |
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alpha 1 adrenergic blockers |
blocks adrenergic receptors and relaxes smooth muscle tissue in the urethra, bladder neck and prostate |
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finasteride |
5-alpha reductase inhibitor for BPH |
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finasteride |
takes several months to work |
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finasteride side effects |
gynecomastia impotence decreased libido |
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finasteride |
pregnancy category X |
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finasteride |
can't donate blood |
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finasteride |
testosterone blocker/inhibitor |
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Combination of drugs used to treat H. Pylori |
antibiotics PPIs bismuth |
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risk factors for PUD |
H. Pylori family history NSAIDS |
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risk factors for PUD |
caffeine stress Type O blood smoking |
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goal of PUD and GERD medications |
prevent complications prevent recurrence |
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goal of PUD and GERD medications |
promote healing provide relief |
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omeprazole |
long duration short half life - irreversibly changes acid producing cells |
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omeprazole |
for long term use highly protein bound |
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omeprazole |
inhibits pumps from releasing acid irreversibly binds |
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omeprazole |
decreases bioavailability of meds that need acidic environment (minerals) |
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omeprazole |
decreases effectiveness of clopidogrel |
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omeprazole |
avoid smoking, alcohol, spicy foods |
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omeprazole |
B12 malapsorption - may affect RBC concentration leading to anemia |
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omeprazole |
take in the morning |
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H 2 blocker |
short term use |
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PPI |
long term use |
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H2 blocker |
stops acid secretion at any time of day or night |
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ranitidine |
short term use |
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ranitidine side effects |
HA, N, D, confusion - in the elderly |
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ranitidine |
treats PUD, GERD and stress ulcers |
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ranitidine |
inhibits function of parietal cells (gastric secretion) |
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ranitidine |
don't smoke don't take other antacids may decrease absorption of other drugs |
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ranitidine |
take at night report excessive diarrhea, s/s GI bleeding |
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antacids |
don't promote healing of ulcers |
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antacids |
do not protect by coating stomach wall |
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for antacids to be therapeutic |
pH at 3.5 or above |
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magnesium hydroxide antacid |
causes diarrhea |
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calcium carbonate antacid |
causes constipation and kidney stones |
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sodium bicarbonate antacid |
don't give to people w/heart problems, HTN, |
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magnesium hydroxide antacid is usually combined with |
aluminum hydroxide |
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don't give beta blockers |
to people with diabetes - will cause they to not feel s/s of hypo |
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H. pylori meds |
patient must be compliant |
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H. pylori meds |
antibiotic PPI Bismuth |
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sucralfate |
decreases absorption of digoxin and warfarin |
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psyllium |
bulk forming laxative for every day use |
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psyllium |
take with water does not cause dehydration |
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psyllium |
slow acting laxative adds mass |
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bisacodyl |
stimulant type laxative |
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bisacodyl |
irritates mucosa and alters electrolyte absorption |
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bisacodyl |
rapid acting laxative not for everyday use |
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bisacodyl |
used for bowel preps causes diarrhea |
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docusate |
surfactant type laxative |
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docusate |
adds water and fat to stool - lubricates |
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docusate |
used for preventative measures for constipation |
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magnesium hydroxide laxative |
not for regular use good for dehydration |
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magnesium hydroxide laxative |
neutralizes gastric acid draws in water - osmotic |
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miralax |
saline osmotic laxative |
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senna |
herbal agent laxative |
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senna |
stimulates bowel increases peristalsis |
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mineral oil laxative |
discouraged |
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opiods for diarrhea |
diphenoxylate w/atropine- lomotil |
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opiods for diarrhea |
slow peristalsis - for short term use |
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don't use anti-diarrheals |
with poisoning or C-diff |
|
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promethazine |
a phenothiazine |
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promethazine |
decreases N & V by blocking dopamine receptors in chemoreceptor trigger zone |
|
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promethazine
|
decreases N & V by blocking dopamine receptors in chemoreceptor trigger zone
|
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meclizine |
anticholinergic/antihistamine |
|
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drugs used to treat nausea and vomiting |
anticholinergics/antihistamines phenothiazines cannabinoids serotonin receptor antagonists |
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phenothiazine |
blocks dopamine receptors in chemoreceptor trigger zone |
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ondansetron |
blocks serotonin at receptor sites in the vagal nerve and chemoreceptor trigger zone |
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estrogen used for |
menopause symptoms, treat prostate and some breast cancers |
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don't use estrogen if |
history of: breast, cervical, endometrial and prostate cancer |
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don't use estrogen if |
lipid disorders, clot history |
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estrogen alone |
risk of endometrial cancer risk of clotting issues |
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estrogen |
encourages endometrial growth |
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progesterone |
limits and inhibits endometrial growth |
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progesterone |
encourages thick cervical mucus |
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progesterone |
inhibits midcycle LH surge - prevents ovulation |
|
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medroxyprogesterone |
prevents endometrial proliferation decreases dysfunctional bleeding |
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edroxyprogesterone |
prevents ovulation treatment for endometrial cancer |
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injectable form of medroxyprogesterone |
higher risk for osteoporosis - causes bone demineralization |
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menopause |
no menses |
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menarch |
first menstrual period |
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miss 3 days of birth control pills |
start over and use a condom |
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birth control pills |
prevent ovulation |
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don't take birth control pills if: |
breast cancer obesity lupus |
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don't take birth control pills if: |
depression pregnancy cirrhosis |
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don't take birth control pills if: |
prolonged immobilization migraines HTN history of stroke |
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use estrogen for |
prostate cancer |
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use testosterone for |
breast cancer |
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testosterone |
schedule III drug - potential for abuse |
|
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primary hypogonadism |
testes not creating enough testosterone |
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secondary hypogonadism |
pituitary or hypothalamus problems |
|
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testosterone |
treats anemia |
|
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testosterone |
treats muscle wasting in aids patients |
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sildenafil |
do not use with nitrates - can cause extreme hypertension |
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finasteride |
blocks testosterone from making the prostate bigger |
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finasteride |
blocks testosterone |
