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Pharm II > Exam 2 Gastro > Flashcards

Exam 2 Gastro Flashcards

1
Q

Name the condition: acid regurgitation back into the esophagus and oral cavity

A

GERD

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2
Q

Name the condition: excessive acid production

A

hypersecretory condition

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3
Q

Name the condition: ulceration of the walls of the esophagus

A

erosive esophagitis

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4
Q

Name the condition: lining of esophagus altered to resemble that in intestines

A

Barrattes esophagus

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5
Q

4 symptoms of common GI disorders

A
  1. acidic taste
  2. pain/burning sensation
  3. difficulties with digestion
  4. ulceration and bleeding
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6
Q

6 oral symptoms of common GI disorders

A
  1. tooth erosion
  2. irritation of the buccal mucosa
  3. glossitis
    4,. burning mouth/tongue
  4. inflammation of oropharynx
  5. ulceration of pillars and pharyngeal walls
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7
Q

MOA for antacids

A

weak bases that interact with stomach acid to form water and salt, act local locally to treat excess acidity, raise gastric pH

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8
Q

Antacids do NOT inhibit ____ production by ____ cells

A

HCL
parietal
(need HCL for digestion, pepsin maximally active at pH = 2, when pH >4, pepsin activity decreases, best antactids are those that buffer to a pH of 3-4)

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9
Q

2 examples given in class of antacids

A

milk of magnesia

Maalox

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10
Q

MOA for aluminum products

A

aluminum is an astringent to stop bleeding, coats and protects ulcers from H+, and interferes with absorption of tetracyclines

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11
Q

example of an aluminum product discussed in class

A

Amphojel

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12
Q

another name for buffered aspirin

A

aluminum glycinate

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13
Q

What drug form complexes with albumin, fibrinogen, and globulin on ulcer surfaces, thus creating protective barrier to acid and pepsin?

A

Carafate - interferes with the absorption of many medications

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14
Q

4 examples of histamine H2 receptor antagonists discussed in class

A

Tagament
Pepcid
Axid
Zantac - preferred by GI docs

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15
Q

Histamine H2 receptors are most know for what?

A

Nocturnal acid control - address multiple symptoms

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16
Q

Proton pump inhibitors - Bind to ______ enzyme system in parietal cells, ____ gastric secretions, ______ gastric acid after release, and protect _____ _____ from damage. Used as a long term acid suppression with ___ onset and ___ nocturnal acid control.

A 
H+/K+ ATPase
reduces
neutralize
gastric mucosa
slow
poor
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17
Q

5 discussed PPIs

A
  1. Nexium
  2. Prevacid
  3. Prilosec
  4. Protonix
  5. Aciphex
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18
Q

Which PPI drug is second generation and better at healing erosive lesions than Prilosec? Used in the prevention and treatment of NSAID induced GI lesions

A

Nexium

19
Q

4 antibiotics used in the treatment of H. pylori

A
  1. amoxicillin
  2. metronidazole
  3. clarithromycin
  4. tetracycline
20
Q

Antibiotics plus what other 2 drugs are used in combination to treat H. pylori

A
  1. PPI

2. H2 receptor blocker

21
Q

When treating H. pylori, what is the standard first line therapy?

A

1 week triple therapy consisting of amocicillin, clarithromycin and a PPI

22
Q

If treating clarithromycin resistant strain of H pylori, what drug is added as part of the therapy?

A

levofloxacin (Levaquin)

23
Q

Important drug interactions with GI medications: binding of drugs in stomach = _____. Also interferes with the _____ and ____ of many drugs.

A

Metals
bioavailability
elimination

24
Q

Histamine antagonists decrease _____

A

antifungals

25
Q

histamine antagonists alter ____

A

warfarin

26
Q

Tagament increases serum concentration of what 3 things?

A
  1. . benzodiazepines
  2. lidocaine
  3. Cipro
27
Q

PPIs decrease absorption of ____ ____

A

systemic antifungals

28
Q

5 side effects of GI medications

A
  1. xerostomia
  2. taste alteration
  3. aphthous stomatitis
  4. candidiasis (esophageal)
  5. excessive salivation (mediated by vagus nerve in response to excessive gastric acid)
29
Q

Higher prevalence of stomach ulcers seen is association with these 6 things

A
  1. smokers
  2. heavy drinkers
  3. hyperparathyroidism
  4. renal dialysis patients
  5. uses of NSAIDS (chronic)
  6. elderly (death from disease more likely)
30
Q

H. pylori lives naturally where?

A

resides in the oral cavity but infects at the interface between surface of gastric epithelium and overlying mucous gel - usually acquired in childhood

31
Q

4 contributing factors to ulcer formation

A
  1. acid hypersecretion
  2. smoking
  3. stress - increase acid secretion
  4. Use of NSAID > 1 month
32
Q

H. pylori is associated with cancer of ____ ____ = lymphoma. Peptic ulcers rarely undergo transformation to _____. Ulcers in _____ _____ of stomach more likely to become malignant. ____ ____ caused by chronic use of PPis increases risk for stomach cancer

A

gastric mucosa
carcinoma
greater curvature
atrophic gastritis

33
Q

2 oral manifestations of peptic ulcer disease

A
  1. vascular malformation of lip

2. enamel erosion

34
Q

In patients with peptic ulcer disease, what medications should be avoided? and which one is ok?

A

Avoid aspirin and NSAIDS

acetaminophen ok

35
Q

Where is the site of ulcerative colitis?

A

large intestines and rectum

36
Q

Where does Crohn disease manifest?

A

entire wall of bowel - focal ulcerations along any point of alimentary canal - most common in the terminal ileum

37
Q

4 oral manifestations of Crohns

A
  1. apthous ulcerations
  2. mucosal ulcerations
  3. diffuse swelling of lips/cheeks
  4. cobblestone mucosal lesions
38
Q

In pts with IBS why is the use of corticosteroids questionable

A

risk for adrenal suppresssion

39
Q

3 categories of antidiarrheal agents and an example of each

A
  1. Absorbents - Pepto-Bismol (caution with salicylate allergy)
  2. Opioids-paregoric - Lomotil (codeine and diphenoxylate)
  3. Ioperamide - Imodium (muscle relaxant, decreases gut motility)
40
Q

4 classes of laxatives

A
  1. Bulk
  2. Osmotic
  3. Contact
  4. Lubricants
41
Q

Which class of laxative uses magnesium salts? - used as prep for colonoscopy

A

Osmotic

42
Q

Which class of laxative uses mineral oil/glycerin?

A

Lubricants, acts as emollients

43
Q

Which class of laxative uses bisacodyl (dulcolax) or caster oil?

A

Contact - also can be used as colonoscopy prep

44
Q

Which class of laxative uses carboxymethyl cellulose with psyllium? What does it do?

A

Bulk- absorbs water to form softened stools by increasing bulk of intestinal contents

Pharm II (18 decks)

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