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NAPLEX > GERD PUD > Flashcards

GERD PUD Flashcards

1
Q

which cells secrete HCl in the stomach

A

parietal

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2
Q

diagnosis of GERD involves experience of symptoms how often

A

2 times per week

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3
Q

what drugs can worsen GERD symptoms

A

ASA, NSAIDs, bisphosphonates, dabigatran, estrogen products, fish oil products, iron supplements, NRT, steroids, tetracyclines

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4
Q

when should you refer GERD patient to a doctor

A

2 weeks OTC/lifestyle mods, alarm symptoms (odynophagia, dysphagia, N/V, hematemesis, bloody stoold, unintentional weight loss)

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5
Q

frequent or severe GERD should be treated with

A

8 weeks of PPI

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6
Q

infrequent heartburn should be treated with

A

antacids or H2RAs

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7
Q

couseling point for alka seltzer

A

aspirin component will inc risk of bleeding if used too frequently

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8
Q

calcium SE

A

constipation

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9
Q

aluminum SE

A

constipation

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10
Q

magnesium SE

A

loose stools

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11
Q

alka seltzer contains >500 mg Na which can

A

worsen edema in pt with heart failure or cirrhosis

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12
Q

H2RAs may cause confusion in

A

elderly, severely ill, renal impairment

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13
Q

high dose of cimetidine may cause

A

gynecomastia, impotence

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14
Q

PPIs reversibly/irreversibly bind to the proton pump

A

irreversibly

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15
Q

H2RAs reversibly/irreversibly bind to the H2 receptors

A

reversibly

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16
Q

oral PPIs that must be given before breakfst

A

nexium, prevacid, prilosec

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17
Q

oral PPIs that can be given without regard to meals

A

dexilant, protonix

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18
Q

PPI warnings

A

C diff diarrhea, hypOmagnesemia, vitamin B12 deficiency, osteoporosis bone fracture

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19
Q

PPIs that should NOT be used with clopidogrel

A

omeprazole, esomeprazole

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20
Q

which PPIs are available IV

A

pantoprazole, esomeprazole

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21
Q

which H2RA can be injected

A

famotidine

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22
Q

metoclopramide should not be used in patients with which disease

A

parkinsons

23
Q

which drugs should be avoided completely if taking H2RAs or PPIs

A

dastinib, pazopanib, risedronate DR and (erlotinib and rilpivirine for PPI only)

24
Q

drugs that require an acidic gut

A

iron, mesalamine, TKIs, cephalosporins, azole antifungals, rilpivirine, atazanavir

25
Q

drugs that bind antacids

A

bictegravir, dolutegravir, elvitegravir, raltegravir, bisphosphonates, isoniazid, levothyroxine, mycophenolate, quinolones, sotalol, steroids, tetracyclines

26
Q

H2RAs and CNS depressants may cause

A

delerium, dementia, and cognitive impairment

27
Q

which H2RA should not be used with highest risk QT prolonging drugs

A

famotidine

28
Q

which H2RA has many drug interactions

A

cimetidine

29
Q

PPIs inhibit which enzyme

A

CYP2C19

30
Q

which PPIs should not be used with clopidogrel

A

omeprazole and esomeprazole

31
Q

h pylori is gram

A

negative

32
Q

PUD occurs when there is

A

mucosal erosion in GIT

33
Q

eating will decrease the pain in which type of ulcer

A

duodenal

34
Q

eating will increase the pain in which type of ulcer

A

gastric

35
Q

diagnostic test for h pylori

A

urea breath test (CO2)

36
Q

ACG recommends triple therapy for first line treatment of H pylori if

A

clarithromycin resistance rates are low; otherwise quadruple therapy

37
Q

h pylori treatments last for

A

10-14 days

38
Q

quadruple therapy can consist of which drug combinations

A

bismuth+metronidazole+tetracycline+PPI OR amoxicillin+clarithromycin+metrnidazole+PPI

39
Q

how often is PPI given in h pylori treatment

A

BID

40
Q

how often are the drugs given in the bismuth treatment for h pylori

A

QID

41
Q

how often are the drugs given in the amoxicillin treatment for h pylori

A

BID

42
Q

risk factors for nsaid induced ulcers

A

> 60y, history of PUD, high dose NSAIDs, use more than 1 NSAID, also using anticoag/steroid/SSRI/SNRI

43
Q

NSAIDs should be used in caution in

A

renal and CV disease

44
Q

celecoxib has ________ GI risk and __________ CV risk

A

dec, inc

45
Q

Vimovo

A

naproxen/esomeprazole

46
Q

yosprala

A

aspirin/omeprazole

47
Q

how is sucralfate cytoprotective

A

forms physical barrier over ulcer

48
Q

how is misoprostol cytoprotective

A

prostaglandin analog

49
Q

Dosing considerations for pepcid

A

Dec dose if crcl <60

50
Q

Which PPIs are taken 60 min before meal, 30 min before meal, and without regard to meals?

A

60 min: nexium, prevacid, prilosec
30 min: protonix
Without regard: dexilant

51
Q

H2RAs and PPIs may cause deficiency of

A

Vit B12

52
Q

Metoclopramide moa

A

Dopamine ANTagonist

53
Q

Avoid use in PD

A

Metoclopramide

NAPLEX (10 decks)

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