Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Final > GI > Flashcards

GI Flashcards

1
Q

viral causes of gastroenteritis

A

NOROVIRUS, ROTAVIRUS, adenovirus etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

bacterial causes of gastroenteritis

A

salmonella, campylobacter jejuni, shigella, e. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

protozoal causes of gastroenteritis

A

giardia, cryptosporidium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

recently on course of abx (clindamycin) and suddenly keeps shitting pants what do you suspect

A

c.diff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

acute diarrhea mainly caused by

A

infectious source or med side effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

causes of persistent/chronic diarrhea

A

celiac, hyperthyroidism, microscopic colitis, lactose intolerance, irritable bowel disease, IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when are diagnostics for diarrhea needed

A

sever symptoms : severe dehydration, bloody stool/rectal bleeding, weight loss, severe abd pain, prolonged symptoms (>1 wk), recent hospit/antibiotics, >65yo, comorbidities such as HIV or DM, pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

selectively antagonizes serotonin 5HT3 receptors

A

zofran (ondansetron)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

zofran (ondansetron) administered forms

A

IV, IM, PO, ODT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

zofran (ondansetron) indications

A

N/V prevention; maybe for chemo or post op, off label use for hyperemesis gravidarum; effective, expensive,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

does zofran (ondansetron) or Phenergan(promethazine) or lomotil need dosing adjustment for renal or liver dysfunction

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

zofran (ondansetron) side effects

A

few; most common are HA, and constipation; QT prolongation, serotonin syndrome(in combo with other serotonergic agents)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pregnancy category B BUT readily crosses placenta

A

zofran (ondansetron); possible adverse fetal event associated with zofran (ondansetron) use in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

caution if administered to nursing women

A

zofran (ondansetron); not known if it is excreted into breast milk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

can cause dose-dependent QT interval prolangation

A

zofran (ondansetron); avoid with other meds that prolong QT interval (class 1 and 3 antiarrhythmics; 32 mg dose taken off market bc of torsades; NO current recommendation to obtain EKG prior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Phenergan forms

A

IM, PO, rectal, IV?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Phenergan moa

A

phenothiazine derivative with antidopaminergic effect; blocker of mesolimbic DA receptors and ALPHA ADRENERGIC Receptors in brainl anithistamine effect H1-receptor blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Phenergan indications

A

symptom tx of allergic conditions, antiemetic, motion sickness, sedative, adjunct to post op analgesic and anesthesia; off label for N/V in pregnancy; relatively inexpensive,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why do you not want to administer Phenergan by IV

A

severe chemical irritation and damage to tissues; adverse rxns can include burning, pain, thrombophelebitis, tissue necrosis, gangrene, aputation; IM preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Phenergan contraindications

A

children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Phenergan pregnancy category

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Phenergan side effects

A

sedation, resp depression; CAUTION with other CNS depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Reglan (metocloperamide) forms

A

IV, IM, PO, ODT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Reglan (metocloperamide) MOA

A

BLOCKS DA RECEPTORS; blocks serotonin receptors in CNS with high doses; enhances RESPONSE TO ACH in tissue of upper GI tract causes ENHANCE MOTILITY AND ACCELERATED GASTRIC EMPTYING and INCREASES LES tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Reglan (metocloperamide) indications

A

antiemetic, promotility agent, GASTROPARESIS (DM) and GERD; inexpensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Reglan (metocloperamide) side effects

A

boxed warning TARDIVE DYSKINESIA (mvmt disorder that is often irreversible-increased risk with long duration of tx and total cumulative dose); EPS (generally acute DYSTONIC RXNS), can cause DEPRESSION in pts w and w/o underlying depressive disorders,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

AVOID IN GI obstruction

A

Reglan (metocloperamide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Compazine (prochlorperazine) forms

A

IV, IM, PO, rectal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Compazine (prochlorperazine) MOA

A

piperazine phenothiazine ANTIPSYCHOTIC which BLOCKS POSTSYNAPTIC mesolimbic DA receptors in the brain; exhibits strong ALPHA ADRENERGIC and ANTICHOLINERGIC BLOCKING EFFECT; believed to depress RAS thus effecting basal metabolism body temp wakefulness vasomotor tone and EMESIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Compazine (prochlorperazine) indications

A

severe N/V; off label for migraine; historically used for psychotic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Compazine (prochlorperazine) boxed warning side effect

A

boxed warning-DEMENTIA( elderly with demetia related psychosis tx with antipsychotic drugs at increased risk of death;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Compazine (prochlorperazine) side effects with IV admin

A

HYPOTENSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

causes akathisia (inner restlessness and a compelling need to be in constant motion)

A

Compazine (prochlorperazine) side effects; decreased if given with benadryl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

many drug interactions

A

Compazine (prochlorperazine), Phenergan, lomotil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Imodium OTC MOA

A

Acts DIRECTLYon circular and
longitudinal intestinal muscles, through the OPIOID
receptor
 INHIBIT PERISTALSIS and PROLONG TRANSIT TIME
 Reduces fecal volume, increases viscosity, and
diminishes fluid/electrolyte loss
 Increases tone on the anal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Imodium OTC INDICATIONS

A

CONTROL and symptom relief of CHRONIC DIARRHEA ASSOCIATED with IBD and of ACUTE NONSPECIFIC DIARRHEA; OTC and INEXPENSIVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Imodium OTC DOSING

A

oral: 4mg followed by 2 mg after each loose stool; up to 16 mg/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Imodium OTC pregnancy category

A

C; enters breast milk/not recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Imodium OTC side effects

A

well tolerated but can see dizziness, constipation, abd cramping, nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

when to d/c Imodium

A

constipation, abd pain, abd distension, blood in stool; may be dealing with bacterial diarrhea, may precipitate hemolytic uremic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

may precipitate hemolytic uremic syndrome

A

imodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

when not to used immodium

A

when peristalsis inhibition should be avoided due to POTENTIAL FOR ILEUS, and/or TOXIC MEGACOLON

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Lomotil (diphenoxylate/atropine) MOA

A

INHIBITS GI PERISTALSIS; sub therapeutic atropine makes OD unlikely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

when to d/c Lomotil (diphenoxylate/atropine)

A

if NO REPSONSE IN 48HRS of continuous therapy bc med is unlikely to be effective (bacterial source)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Lomotil (diphenoxylate/atropine) dosing

A

oral: 5mg 4 times a day to acheive control max 20 mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Lomotil (diphenoxylate/atropine) pregnancy category

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

lomotil should not be used in

A

children under 2yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

precautions for lomotil

A

BLOODY or SUSPECTED BACTERIAL DIARRHEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

CAUTION with lomotil

A

SEVERE DEHYDRATION OR ELECTROLYTE IMBALANCE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Lomotil side effects

A

resp depression (seen if with other sedatives), toxic megacolon, ileus, constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

contain bismuth subsalicyclate

A

pepto-bismol, kaopectate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

pepto-bismol, kaopectate MOA

A

ABSORBS EXCESS WATER, topical mucosal effects, REDUCES SECRETIONS, binds bacterial toxins, posesses ANTIMICROBIAL EFFECTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

pepto-bismol, kaopectate contraindications

A

ASA allergy (reyes syndrome), not recommended in pregnancy

54
Q

pepto-bismol, kaopectate side effects

A

black stool/tongue

55
Q

stool softener

A

colace(docusate sodium) (OTC); inexpensive

56
Q

colace(docusate sodium) MOA

A

reduces surface tension of the oil water interface of the stool resulting in ENHANCE INCORPORATION OF WATER AND FAT ALLOWING FOR STOOL SOFTENING

57
Q

colace(docusate sodium) precautions

A

acute abdomen, GI obstruction

58
Q

safe in pregnancy and breastfeeding

A

colace(docusate sodium)

59
Q

prolonged, frequent, or excessive, use may result in dependence

A

colace(docusate sodium)

60
Q

Lubricant

A

mineral oil (oral or rectal)

61
Q

mineral oil mechanism

A

eases passage of stool by DECREASING WATER ABSORPTION and LUBRICATING THE INTESTINE

62
Q

if inhaled can cause lipoid pneumonia

A

mineral oil; caution in elderly, debilitated, infants

63
Q

Osmotic laxatives

A

magnesium citrate, polyethylene glycol, lactulose, sodium phosphate

64
Q

Magnesium citrate MOA

A

promotes bowel evacuation by causing OSMOTIC RETENTION OF FLUID WHICH DISTENDS THE COLON AND INCREASES PERISTALTIC ACTIVITY; SECRET WEAPON (whatever the fuck that means)

65
Q

Magnesium citrate precautions

A

acute abd, bowel obstruction, RENAL IMPAIRMENT (hypermagnesemia),

66
Q

Magnesium citrate EXTREME CAUTION

A

patients with myasthenia gravis or other neuromuscular disease

67
Q

low risk in pregnancy

A

Magnesium citrate

68
Q

Magnesium citrate dose

A

drink 1/2 bottle if no results in 6hrs drink other half

69
Q

magnesium citrate indication

A

SECRET WEAPON (whatever the fuck that means)

70
Q

used in children with severe constipation

A

miralax

71
Q

large dose used for colon prep prior to GI surgery

A

golytely (polyethylene glycol)

72
Q

lower dose osmotic laxative for acute/chronic constipation

A

miralax

73
Q

polyethylene glycol, miralax, golytely MOA

A

increase WATER RETENTION in the stool INCREASES STOOL FREQUENCY

74
Q

polyethylene glycol, miralax, golytely precautions

A

bowel obstructionl electrolyte disturbance may be possible with golytely

75
Q

Lactulose forms

A

oral and rectal

76
Q

lactulose MOA

A

NONDIGESTABLE SUGAR that causes retention of water causing OSMOTIC EFFECT in the colon with resultant distention promoting peristalsis

77
Q

traps NH3 in colon and effectively reducing plasma NH3 concentrations and is used for hepatic encephalopathy

A

lactulose

78
Q

lactulose pregnancy category

A

B

79
Q

Lactulose side effects

A

well tolerated but diarrhea may be profuse especially in large doses for hepatic encephalopathy

80
Q

sodium phosphate forms

A

oral (solution or tablet osmoprep) rectal (fleets enema) and IV (parenteral nutrition and hypophosphatemia)

81
Q

sodium phosphate MOA

A

drawing water into the lumen of the gut PRODUCING DISTENTION AND PROMOTING PERISTALSIS and EVACUATION OF THE BOWEL

82
Q

sodium phosphate indication

A

BOWEL prep

83
Q

sodium phosphate black box warning

A

osmoprep can cause ACUTE PHOSPHATE NEPHROPATHY leading to permanent renal failuer and long term dialysis; caution in elderly, diabetics, renal failure, and CHF

84
Q

Stimulant laxatives

A

dulcolax, senna

85
Q

Stimulant laxatives forms

A

oral and rectal

86
Q

Stimulant laxatives MOA

A

STIMULATES PERISTALSIS by directly irritating the smooth muslce of the intestine; alters water and electrolyte secretion producing NET INTESTINAL FLUID ACCUMULATION and laxation

87
Q

Stimulant laxatives precautions

A

acute abdomen, bowel obstruction

88
Q

Stimulant laxatives side effects

A

sever rxns are rare; abd cramping, electrolyte disturbance possible, melanosis coli (senna-anthraquinone-containing laxative)

89
Q

Drug that causes melanosis coli

A

(senna-anthraquinone-containing laxative)

90
Q

misc med to tx constipation

A

amitiza (lubiprostone); relatively expensive

91
Q

amitiza (lubiprostone) MOA

A

ACTIVATES CHLORIDE CHANNELS increasing intestinal fluid secretion and motility

92
Q

amitiza (lubiprostone) indication

A

IDIOPATHIC chronic constipation, constipation predominant IBS, constipation associated with CHRONIC NARCOTIC HABITUATION

93
Q

amitiza (lubiprostone) precautions

A

GI OBSTRUCTION

94
Q

amitiza (lubiprostone) side effects

A

NAUSEA, diarrhea, abd pain, HA

95
Q

indicated for ulcer disease associated with H. pylori infection

A

abx

96
Q

mainstays of tx for ulcer healing

A

anti-secretory drugs (H2 receptor antagonists, and PPIs)

97
Q

induce ulcer healing but are NOT nearly as effective as H2 blockers and PPIs

A

antacids and sucralfate

98
Q

delivers growth factors to injured mucosa and thereby assist in healing

A

aluminum hydroxide

99
Q

promote angiogenesis in injured mucosa

A

antacids

100
Q

bind bile acids and also inhibit peptic ulcer activity

A

antacids

101
Q

suppress but generally DONT eradicate H. pylori

A

heavy metals

102
Q

Antacid indication

A

appropriate for relief of OCCASIONAL

dyspepsia and mild, intermittent GERD

103
Q

Antacid side effects general info

A

DEPEND ON THE QUANTITY CONSUMED and the DURATION OF THERAPY;

104
Q

cause diarrhea and hypermagnesemia

A

magnesium containing antacids (important in renal insufficiency)

105
Q

cause constipation

A

calcium antacids

106
Q

can cause colume overload in susceptible pts

A

antacids that may contain considerable sodium

107
Q

may interfere with absorption or elimination of multiple meds

A

antacids

108
Q

antacid drugs

A 
Tums (calcium carbonate)
 Rolaids (calcium carbonate and magnesium
hydroxide)
 Mylanta (magnesium hydroxide, aluminum
hydroxide, simethicone)
 Maalox (aluminum hydroxide, magnesium
hydroxide)
109
Q

Sulfated polysaccharide, sucrose complexed with

aluminum hydroxide

A

Sucralfate (Carafate)

110
Q

Prevents acute chemically-induced mucosal

damage and heals chronic ulcers

A

Sucralfate (Carafate)

111
Q

Does not altering gastric acid or pepsin secretion

or significantly buffering acid

A

Sucralfate (Carafate)

112
Q

Sucralfate (Carafate) adverse effects

A

minimal; possible aluminum toxicity; can BIND OTHER DRUGS if taken at the same time

113
Q

H2 receptor antagonists

A

cimetidine,

ranitidine, famotidine, and nizatidine; relatively low cost safe in pregnancy, can use PRN

114
Q

H2 receptor antagonists MOA

A

Inhibit acid secretion by blocking

histamine H2 receptors on the parietal cell

115
Q

H2 receptor antagonists indication

A

TXand MAINTENANCEtherapy of
PUD, treatment of GERD and
management of DYSPEPSIA

116
Q

Achieve less acid suppression than proton pump

inhibitors

A

H2 blockers

117
Q

H2 blocker side effects

A

SIDE EFFECTS ARE RARE
-Absorption of vitamin B12 depends upon
gastric acid
-not unexpected that LONG TERM H2
blocker (and proton pump inhibitor) use has
been associated with SERUM B12 DEFICIENCY
-renal toxicity, gynecomastia, AMS and dose adjustments should be
made in renal failure
-more common with Cimetidine

118
Q

PPI drug names

A

 Prilosec (Omeprazole) Rx & OTC
 Nexium (Esomerazole) Rx
 Prevacid (Lansoprazole) Rx & OTC (PO and IV)
 Aciphex (Rabeprazole) Rx
 Zegerid (Omeprazole & Bicarb) Rx & OTC

119
Q

PPI MOA

A

Block acid secretion by
IRREVERSIBLY binding to and inhibiting the
hydrogen-potassium ATPase pump that resides
on the luminal surface of the PARIETAL CELL(must be active to work cannot be fasting)
membrane

120
Q

wont work in fasting pts

A

PPIs

121
Q

most effective and longest lasting acid inhibitors

A

PPIs; many are OTC and are relatively affordable

122
Q

PPI indications

A 
tx of all acid-related
disorders including PUD, GERD and ZollingerEllison
syndrome
-effective in txand preventing NSAID
associated gastroduodenal mucosal injury and,
-in combo with abx
for H.
pylori infection
123
Q

PPI side effects

A

Hypochlorhydria /hypergastrinemia,
(GASTRIC ATROPHY)

-↓ Magnesium absorption
-↓ Efficacy of Plavix
( inhibit CYP-450s)
-↑ Risk of infection with C. Diff

124
Q

practical tips for PPIs

A

Use LOWEST EFFECTIVE DOSE and SHORTEST DURATION
needed
-best given in the MORNING 30-60 min before
eating

125
Q

for GERD dx hx is sufficient if

tx length

A

uncomplicated disease (esp

126
Q

When to do an EGD for GERD

A

SEVERE DISEASE or associated WORRISOME symptoms (dysphagia, anemie, GI bleeding signs, early satiety, weight loss

127
Q

EGD will confirm extent of esophageal inflammation which is normal in what % of people

A

up to 50% is normal

128
Q

definitve dx for GERD

A

pH probe with bipsy

129
Q

tx for mild intermittent symptoms of gerd

A

antacid and/or H2 blocker; ok to use PRN

130
Q

tx for moderate GERD symptoms

A

regular H2 blocker and/or PPI

131
Q

tx for erosive esophagitis or severe GERD symptoms

A

definitely PPI, EGD, tx H. pylori if needed

132
Q

Lifestyle changed for GERD

A

avoidance of alcohol, tobacco, NSAIDs, decrease stress

Pharm Final (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions