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Flashcards in antacid and ulcer drugs Deck (52):
1

Low systemic antacids

-Aluminum
-Calcium
-Magnesium

2

High systemic antacids

-sodium salts

3

the one supplemental antacid agent

simethicone

4

Do antacids reduce acid production and secretion?

NOOOO

5

What are the two antacids that have rapid onset and long duration of action and have good acid neutralizing capacity

-calcium
-Magnesium

6

MOA of simethicone antacid

-surfactant: decreases surface tension
-Aids in expulsion of gas (PRO FART)

7

Adverse effect of Aluminum antacid

constipation

8

adverse effect of magnesium antacid

Diarrhea (stool-softening/laxative-like activity)

9

adverse effect of calcium antacid

constipation

10

Adverse effect of sodium antacid

-Gas/Flatulence ("bicarb. burp)
-be cautious with HTN .. . hypernatremia

11

Drug interactions with antacids

TONS!!!!!!!!!!

12

Advice on when to take antacids

*****take all antacids 1-2 hours before other medications OR 2-4 hours after other meds

13

What are the 5 CATEGORIES of anti-ulcer agents

-H2 receptor antagonist
-Proton Pump inhibitor
-Surface Acting Agents
-PGE1 analog
-Bismuth compounds

14

H2 receptor antagonists have what ending

Tidine

15

Proton pump inhibitors have what ending

Prazole

16

If you give enough H2 antagonist, can you completely shut down acid production?

NO, multiple paths lead to acid production

17

Onset of action with H2 antagonist

.5-2 hours

18

How long until ulcer healing occurs after H2 antagonist given

4-8 weeks

19

Adverse effects of H2 antagonist

relatively mild and infrequent . . . GI related or CNS like drowsiness or headache

20

Adverse effect of Cimetidine with Long term, high dosage

-gynecomastia in men
-Galactorrhea in women

21

Drug interaction of cimetidine

PROTOTYPICAL inhibitor of CYP450 isoenzymes

22

which H2 antagonist would you use in pregnancy

Ranitidine

23

Proton pump inhibitor MOA

covalently bind to sulfhydryl groups of H+/K+ ATPase at parietal cell secretory sites, thereby inhibiting gastric acid secretion by IRREVERSIBLY inhbiting ase pumps

24

time takes for PPIs to start working

several days

25

when given a PPI, how long does it take ulcers to heal

4-8 weeks

26

Adverse effect of PPI

CDAD
-Clostridium Difficile Associated Diarrhea

27

Drug interactions for Omeprazole

PROTOTYPICAL CYP450 inhibitor

28

which PPI do you use for pregnancy

Iansoprazole

29

What is the anti ulcer drug that is a sulfated polysaccharide that creates a viscous, sticky polymer which adhere to epithelial cells around ulcers crater to prevent acid access in ulcer site

Sucralfate

30

Does sucralfate affect pH

no

31

adverse effect of sucralfate

constipation

32

dosing for sucralfate that makes it difficult

4 times a day and avoid with other meds

33

Misoprostol is an analog to what

prostaglandin E1

34

What type of protection does misoprostol provide

Cytoprotection by increasing mucosal defenses

35

Indication for misoprostal use

NSAID-induced gastric ulceration

36

Contraindication for misoprostal

Pregnancy

37

MOA of Bismuth compounds (pepto-Bismol)

anti- diarrheal and antimicrobial

38

Bismuth compounds are used with what in treatment of H. pylori

antibiotics

39

Adverse affects of Bismuth compounds

Black/Dark stools

40

Drug interactions with Bismuth compounds

Lots, take 2 hours after other meds

41

Absolute contraindication for Bismuth

-GI bleeding
-Salicylate hypersensitivity

42

Treatment for H. pylori . .generally

Combination . . AT LEAST 2 antibiotics and an acid reducer (PPI or H2 blocker

43

Time frame and number of drugs for H. pylori treatment

-10-14 days
-Triple drug therapy

44

normal triple drug therapy for H. pylori

-PPI
-Clarithromycin
-either amoxicillin OR metronidazole

45

Quadruple therapy for H. pylori

-PPI (or H2 blocker)
-Metronidazole OR Clarithromycin
-Amoxicillin OR Tetracycline
-Bismuth Subsalicylate

46

When is tetracycline useful in quadruple therapy for H. pylori

amoxicillin allergy and metronidazole resistance

47

Expain the time frame for continuation of PPI or H2 blocker after the 10-14 day combo therapy for H. pylori

consider for several weeks after for complete healing of ulcers

48

H. pylori therapy with PCN allergy

substitute metronidazole for amoxicillin

49

H. pylori therapy with metronidazole resistance

-substitute tetracycline
-consider quadruple therapy

50

H. pylori with clarithromycin resistance

-substitute either amoxicillin or tetracycline
-consider quadruple therapy

51

treatment of Pregnant patient with ulcer but without H. pylori

-short course of antacids or sucralfate
-if moderate consider ranitidine
-if severe consider Iansoprazole

52

If patient has an ulcer and on NSAIDs

-if it ISN'T required consider switching to Acetaminophen
-If NSAIDS are required then Misoprostol