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Pharm > GI > Flashcards

GI Flashcards

1
Q

Antacids: Sodium bicarbonate reacts rapidly with hydrochloric acid (HCl) to produce

A

carbon dioxide and sodium chloride

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2
Q

Antacids: Sodium bicarbonate: Formation of carbon dioxide results in

A

gastric distention and belching

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3
Q

Antacids: Sodium bicarbonate: Unreacted alkali is readily absorbed, potentially causing

A

metabolic alkalosis when given in high doses or to patients with renal insufficiency

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4
Q

Antacids: Sodium bicarbonate: Sodium chloride absorption may exacerbate ____ ____ in patients with heart failure, hypertension, and renal insufficiency.

A

fluid retention

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5
Q

Antacids: Calcium carbonate may cause

A

belching or metabolic alkalosis

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6
Q

Antacids: Excessive doses of either sodium bicarbonate or calcium carbonate with calcium-containing dairy products can lead to

A

hypercalcemia, renal insufficiency, and metabolic alkalosis (milk-alkali syndrome)

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7
Q

Antacids: Magnesium hydroxide or aluminum hydroxide containing products: do not cause

A

gas, belching

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8
Q

Antacids: Magnesium hydroxide or aluminum hydroxide containing products: unabsorbed magnesium salts may cause ___, and aluminum salts may cause ____

A

diarrhea, constipation

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9
Q

Antacids: Magnesium hydroxide or aluminum hydroxide containing products: Both magnesium and aluminum are absorbed and excreted by the kidney: patients with renal insufficiency should

A

not take these agents long-term

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10
Q

Antacids should not be given within 2 hours of doses of

A

tetracyclines, fluoroquinolones, itraconazole, and iron

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11
Q

cimetidine, what group

A

H2 receptor antagonist

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12
Q

ranitidine, what group

A

H2 receptor antagonist

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13
Q

nizatidine, what group

A

H2 receptor antagonist

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14
Q

famotidine, what group

A

H2 receptor antagonist

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15
Q

H2RAs are highly selective and do not affect

A

H1 or H3 receptors

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16
Q

H2 antagonists reduce acid in two ways:

A

block histamine

block gastrin/ACH

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17
Q

Patients may take either antacids or intermittent H2 antagonists for infrequent heartburn or dyspepsia (fewer than ___)

A

three times per week

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18
Q

antacid time of onset verse H2 blockers

A

antacids are faster

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19
Q

antacid duration verse H2 blockers

A

H2 last longer

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20
Q

H2 antagonists may be taken prophylactically

A

before meals in an effort to reduce the likelihood of heartburn

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21
Q

H2RAs Adverse effects

A

diarrhea, headache, fatigue, myalgias, and constipation

22
Q

PPIs are administered as inactive

A

prodrugs

23
Q

PPIs: oral products are formulated for delayed release as acid-resistant, enteric-coated capsules or tablets to

A

protect the acid-labile prodrug from rapid destruction within the gastric lumen

24
Q

PPIs: For children or patients with dysphagia or enteral feeding tubes, capsule formulations (but not tablets)

A

may be opened and the microgranules mixed with apple or orange juice or mixed with soft foods (eg, applesauce)

25
Q

PPIs should be taken on an empty stomach because

A

it increases the bioavailability

26
Q

PPIs: have a short serum half-life of about 1.5 hours, but

A

acid inhibition lasts up to 24 hours

27
Q

PPIs: Because not all proton pumps are inactivated with the first dose of medication, up to ____ medication are required before the full acid-inhibiting potential is reached.

A

3–4 days of daily

28
Q

PPIs: after stopping the drug, it takes ___ for full acid secretion to return

A

3–4 days

29
Q

PPIs: Adverse effects

A

Diarrhea, headache, and abdominal pain

30
Q

PPIs: of note, Acid is important in releasing ___ from food.

A

vitamin B12

31
Q

PPIs: in addition to B12 deficiency, it can cause

A

calcium deficiency, so you can break bones easier

32
Q

PPIs: Cases of severe, ____ with secondary hypocalcemia due to PPIs have been reported, possibly due to decreased intestinal absorption.

A

life-threatening hypomagnesemia

33
Q

another concern about PPI is is that acid is a barrier to

A

microbes

34
Q

Do PPIs cause adrenocarcinoma

A

unproven

35
Q

PPIs: Decreased gastric acidity may alter absorption of drugs for which intragastric acidity affects drug bioavailability, eg for k__, i___, d___, a___

A

ketoconazole, itraconazole, digoxin, and atazanavir. (but since PPIs have short half life, a drug-drug interaction is rare)

36
Q

Omeprazole may inhibit the metabolism of c___, w___, d___, p___

A

clopidogrel, warfarin, diazepam, and phenytoin.

37
Q

Esomeprazole also may decrease metabolism of d____.

A

diazepam

38
Q

Lansoprazole may enhance clearance of t____

A

theophylline

39
Q

Rabeprazole and pantoprazole have no significant

A

drug interactions.

40
Q

Clopidogrel is a ____ that requires activation by the hepatic P450 CYP2C19 isoenzyme

A

prodrug

41
Q

PPIs could reduce _____ activation (and its antiplatelet action) in some patients

A

clopidogrel

42
Q

When PPIs are prescribed to patients taking clopidogrel, agents with minimal CYP2C19 inhibition (____ or ____) may be preferred

A

pantoprazole, rabeprazole

43
Q

Bismuth Subsalicylate: Over __ of the bismuth appears in the stool

A

99%

44
Q

Bismuth Subsalicylate: describe how it works

A

coats ulcers

45
Q

Bismuth Subsalicylate: can also treat

A

diarrhea and is antimicrobial (especially H pylori)

46
Q

Bismuth Subsalicylate: Although minimal, bismuth is absorbed; it is stored in many tissues and has

A

slow renal excretion

47
Q

Bismuth Subsalicylate: Adverse effects

A
  • harmless blackening of the stool/tongue, which may be confused with gastrointestinal bleeding.
  • High doses of bismuth subsalicylate may lead to salicylate toxicity
48
Q

Bismuth Subsalicylate: Bismuth agents should be used for

A

short periods only and should be avoided in patients with renal insufficiency.

49
Q

Bismuth Subsalicylate: Drug interaction: w___ and D___

A

warfarin and DOACs (direct oral anticoagulant)

50
Q

H pylori

A

gram negative

causes PUD and a type of lymphoma

Has problems with resistance

Pharm (23 decks)

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