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Pharmacy 1 > Exam 3 - 50 51 52 54 > Flashcards

Exam 3 - 50 51 52 54 Flashcards

1
Q

Acid-related diseases are caused by?

A

imbalance of the three cells of gastric gland their secretions

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2
Q

What is the most common acid relate disease?

A

hyperacidity

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3
Q

What symptoms do clients report of acid-related diseases?

A

Clients report symptoms of overproduction of HCl by the parietal cells as indigestion, sour stomach, heartburn, acid stomach

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4
Q

What are some acid-related diseases?

A

PUD: peptic ulcer disease
GERD: gastroesophageal reflux disease
Helicobacter pylori (H. pylori)

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5
Q

Bacterium found in GI tract of 90% of patients with duodenal ulcers, and 70% of those with gastric ulcers is what bacteria?

A

H. Pylori

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6
Q

What therapy is used most often to eradicate H.pylori?

A

Combination therapy

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7
Q

What is the treatment for H.Pylori?

A
  • Eight regimens approved by the FDA
  • H. pylori is not associated with acute perforating ulcers
  • It is suggested that factors other than the presence of H. pylori lead to ulceration
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8
Q

What are the types of acids-controlling agents?

A
  • Antacids
  • H2 antagonists
  • Proton pump inhibitors
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9
Q

What is the mechanism of action for antacids?

A

Promote gastric mucosal defense mechanisms

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10
Q

Antacids have secretions of the mucus, bicarbonate, and prostaglandins. What are the mechanism of action for those?

A
  • Mucus: protective barrier against HCl
  • Bicarbonate: helps buffer acidic properties of HCl
  • Prostaglandins: prevent activation of proton pump which results in  HCl production
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11
Q

Antacids _____ prevent the over-production of acid?

A

DO NOT

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12
Q

Antacids _____ neutralize the acid once it’s in the stomach?

A

DO

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13
Q

What are some drug effects of antacids?

A
  • Reduction of pain associated with acid-related disorders
  • Raising gastric pH from 1.3 to 1.6 neutralizes 50% of the gastric acid
  • Raising gastric pH 1 point (1.3 to 2.3) neutralizes 90% of the gastric acid
  • Reducing acidity reduces pain
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14
Q

What 2 forms of antacids of aluminum salts are there?

A

Carbonate and Hydroxide

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15
Q

Aluminum salts can cause what kind of effects?

A

constipating effects

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16
Q

The counteract constipation with aluminum salts, what should you do?

A

It is often used with magnesium

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17
Q

What are some examples of aluminum salts?

A
  • Aluminum carbonate: Basaljel
  • Hydroxide salt: AlternaGEL
  • Combination products (aluminum and magnesium): Gaviscon, Maalox, Mylanta, Di-Gel
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18
Q

What forms of magnesium salts are there?

A

Forms: carbonate, hydroxide, oxide, trisilicate

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19
Q

Magnesium salt commonly causes what?

A

diarrhea; usually used with other agents to counteract this effect

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20
Q

what antacid is dangerous to use with a pt with renal failure?

A

magnesium salt; the failing kidney cannot excrete extra magnesium, resulting in hypermagnesemia

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21
Q

Hypermagnesemia is the result when the kidney what?

A

when the failing kidney cannot excrete extra magnesium

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22
Q

What is MOM abbreviation?

A

Milk of Magnesia (magnesium hydroxide)

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23
Q

What are some examples of magnesium salts?

A

Hydroxide salt: magnesium hydroxide (MOM)
Carbonate salt: Gaviscon (also a combination product)
Combination products such as Maalox, Mylanta (aluminum and magnesium)

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24
Q

which antacid tastes like chalk?

A

Hydroxide salt: magnesium hydroxide (MOM)

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25
Q

What are some adverse effects using MOM?

A
  • Abdominal cramping
  • Diarrhea
  • dehydration
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26
Q

If using MOM in the A.M., what happens in the P.M.?

A

a bowel movement

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27
Q

Milk of Mag stops the burning and keeps it under control where?

A

the stomach

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28
Q

What is the forms of calcium salts?

A

Many forms, but carbonate is most common

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29
Q

Calcium salts can cause diarrhea? T or F

A

False, Causes constipation

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30
Q

Using calcium salts too long may result in ___ ___?

A
  • kidney stones; Those with kidney stones should stay away from a calcium base
  • hyperacidity rebound
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31
Q

What is hyperacidity rebound?

A

increased gastric acid secretrion

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32
Q

how can hyperacidity rebound occur?

A

using antacid calcium salt too long; the acid action may cause increased gastric acid secretion

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33
Q

What is an example of a calcium salts?

A

-Tums (Calcium carbonate)

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34
Q

Calcium salt is often advertised as ?

A

An extra source of dietary calcium

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35
Q

Sodium bicarbonate offers as a buffer, it is a quick onset but short duration, the problem using this may cause what?

A

May cause metabolic alkalosis because of the Sodium content may cause problems in patients with HF, hypertension, or renal insufficiency (fluid retention)

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36
Q

True of false? Where ever salt goes, water will follow?

A

True

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37
Q

Along with antacids comes with antiflatulents. Antiflatulents are used for ?

A
  • to relieve the painful symptoms associated with gas

- Several agents are used to bind or alter intestinal gas and are often added to antacid combination products

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38
Q

What are some drugs of antiflatulents?

A
  • activated charcoal

- simethicone

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39
Q

What does simethicone do?

antiflatulent

A
  • Alters elasticity of mucus-coated bubbles causing them to break
  • it is used often, but there are limited data to support effectiveness
  • walking also relieve gas bubbles
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40
Q

Another name for Amphojel?

A

aluminum hydroxide

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41
Q

Amphojel does what?

A

lowers the phosphate and raise the pH

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42
Q

what must use watch for when using aluminum hydroxide?

A
  • fecal impaction
  • instestinal obstruction
  • hypophosphatemia
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43
Q

what type of salts are there for antacids?

A
  • Aluminum, Magnesium, and Calcium salts

- Sodium bicarbonate is also an antacid

44
Q

What are some side effects of antacids for the following:

  • Aluminum and Calcium
  • Magnesium
  • Calcium Carbonate
A
  • Aluminum and Calcium is constipation
  • Magnesium is diarrhea

-Calcium Carbonate
produces gas and belching; often combined with simethicone

45
Q

What does H2 Antagonists do?

A

Reduce acid secretion

All H2 antagonists are available OTC in lower dosage forms, any higher doses requires prescriptions

46
Q

What are some popular drugs of H2 Antagonists?

A
  • cimetidine (tagamet)
  • famotidine (Pepcid)
  • ranitidine (zantac)
47
Q

What is the mechanism of action for H2 antagonists?

A
  • Block histamine (H2) at the receptors of acid-producing parietal cells
  • Production of hydrogen ions is reduced, resulting in decreased production of HCl
48
Q

When would you use an H2 Antagonists?

A

The presence of:

  • GERD
  • PUD
  • Erosive esophagitis,
  • Adjunct therapy in control of upper GI bleeding
  • Pathologic gastric hypersecretory conditions (Zollinger-Ellison syndrome)
49
Q

What are some of the side effects of H2 Antagonists?

A
  • Not many side effects; overall less than 3% incidence of side effects.
  • Cimetidine may induce impotence and gynecomastia
  • May also see Headaches, lethargy, confusion, diarrhea, urticaria, sweating, flushing, other effects
50
Q

Another name for Cimetidine?

A

Tagamet

51
Q

Cimetidine (Tagemet) binds with ____ in the liver resulting in ____?

A

Binds with P-450 microsomal oxidase system in the liver, resulting in inhibited oxidation of many drugs and increased drug levels

52
Q

All H2 antagonists may inhibit the absorption of drugs that require an what?

A

Acidic GI environment for absorption

53
Q

Another drug interaction with H2 antagonists is smoking. Smoking does what to the H2 antagonist?

A

Smoking has been shown to decrease the effectiveness of the H2 blockers (increases gastric acid production)

54
Q

Proton Pump Inhibitors are?

A

They are the parietal release positive hydrogen ions (protons) during HCl production also known as the process of the proton pump

55
Q

The parietal cells release positive hydrogen ions (protons) during HCl production is called what process?

A

Proton pump

56
Q

Can H2 blockers and antihistamines stop the action of the proton pump?

A

H2 blockers and antihistamines do not stop the action of this pump

57
Q

What is the mechanism of action for the proton pump inhibitor?

A
  • Irreversibly bind to H+/K+ ATPase enzyme

- Result: achlorhydria —ALL gastric acid secretion is blocked

58
Q

What are some PPI Drugs?

A

Total inhibition of gastric acid secretion:

  • lansoprazole (Prevacid)
  • omeprazole (Prilosec)
  • rabeprazole (AcipHex)
  • pantoprazole (Protonix)—only IV form used in the hospital
  • esomeprazole (Nexium)

*The first in this new class of drugs

59
Q

What are some indications to use PPI?

A
  • GERD maintenance therapy
  • Erosive esophagitis
  • Short-term treatment of active duodenal and benign gastric ulcers
  • Zollinger-Ellison syndrome
  • Treatment of H. pylori–induced ulcers
60
Q

Side effects of PPI?

A

Not so many side effects

  • Safe for short-term therapy
  • Incidence low and uncommon
61
Q

What are some other drugs of PPI?

A
  • sucralfate (Carafate)

- misoprostol (Cytotec)

62
Q

What type of agent is sucralfate and what is it used for?

A
  • It is a cytoprotective agent.

- Used for stress ulcers, erosions, PUD.

63
Q

Another name for sucralfate?

A

carafate; good drug to use, also used for codeine purposes

64
Q

Sucralfate should not be taken with any other medication. It is attracted to and binds to the what?

A

-binds to the base of ulcers and erosions, forming a protective barrier over these areas

65
Q

What drug protects these areas from pepsin, which normally breaks down proteins (making ulcers worse)?

A

Sucralfate (carafate)

66
Q

Sucralfate has little absorption from the gut, but it may cause what?

A
  • May cause constipation, nausea, and dry mouth

* May impair absorption of other drugs, especially tetracycline

67
Q

This drug Binds with phosphate; may be used in chronic renal failure to reduce phosphate levels

A

Carafate (sucralfate)

68
Q

True or false. We can mix drugs with sacralfate (carafate)

A

False, DO NOT administer with other medications

69
Q

Cytotec is another name for?

A

misoprostol

70
Q

Cytotec (misoprostol) does what?

A
  • Protect gastric mucosa from injury by enhancing local production of mucus or bicarbonate
  • Promote local cell regeneration
  • Help to maintain mucosal blood flow
71
Q

Misoprostol is used to prevent?

A

Used for prevention of NSAID-induced gastric ulcers

72
Q

Adsorbents coat the walls of the GI tract. Binds to the causative bacteria or toxin, which is then eliminated through the stool.
What are some examples

A

Examples: bismuth subsalicylate (Pepto-Bismol), kaolin-pectin, activated charcoal, attapulgite (Kaopectate)

73
Q

Anticholinergices decrease the intestinal muscle tone and peristalsis of GI tract resulting in?

A

Result: slowing the movement of fecal matter through the GI tract

74
Q

Belladonna alkaloid (donnatal), and atropine are examples of?

A

anticholinergics

75
Q

Intestinal flora modifiers are bacterial cultures of _____ organisms work by supplying ___ ?

A

Lactobacillus; supplying missing bacteria to the GI tract, suppressing the growth of diarrhea-causing bacteria

76
Q

Example of an intestinal flora modifier?

A

L.acidophilus (Lactinex)

77
Q

Opiates?

A
  • Decrease bowel motility and relieve rectal spasms

- Decrease transit time through the bowel, allowing more time for water and electrolytes to be absorbed

78
Q

Examples of opiates?

A

Examples:

  • paregoric
  • opium tincture
  • codeine
  • loperamide (Imodium OTC)
  • diphenoxylate (Lomotil-Rx)
79
Q

Loperamide is another name for ?

A

imodium

80
Q

Another name for lomotil?

A

diphenoxylate hydrochloride with atropine sulfate

81
Q

Adsorbents SE can cause what?

A
  • Increased bleeding time
  • Constipation, dark stools
  • Confusion, twitching
  • Hearing loss, tinnitus, metallic taste, blue gums
82
Q

Anticholinergics SE can cause what?

A
  • Urinary retention, hesitancy, impotence
  • Headache, dizziness, confusion, anxiety, drowsiness
  • Dry skin, rash, flushing
  • Blurred vision, photophobia, increased intraocular pressure
  • Hypotension, hypertension, bradycardia, tachycardia
83
Q

Opiates make you sleepy. What SE can it cause?

A
  • Drowsiness, sedation, dizziness, lethargy
  • Nausea, vomiting, anorexia, constipation
  • Respiratory depression
  • Bradycardia, palpitations, hypotension
  • Urinary retention
  • Flushing, rash, urticaria
84
Q

Adsorbents ____ the absorption of many agents, including digoxin, clindamycin, quinidine, and hypoglycemic agents.

A

decrease

85
Q

Adsorbents cause ___ bleeding time when given with anticoagulants.

A

increased

86
Q

Antiacids can _____ effects of anticholinergic antidiarrheal agents.

A

decrease

87
Q

Examples of bulk forming Laxatives?

A
  • psyllium (Metamucil)
  • methylcellulose (Citrucel)
  • Polycarbophil (FiberCon)
88
Q

Mechanism of action for Bulk Forming laxatives?

A
  • High fiber
  • Absorbs water to increase bulk
  • Distends bowel to initiate reflex bowel activity
89
Q

Surfactant Laxative mechanism of action?

A
  • Stool softeners (colace) and lubricants (mineral oil)
  • Promote more water and fat in the stools
  • Lubricate the fecal material and intestinal walls
90
Q

Examples for surfactant laxative?

A

Stool softeners: docusate salts (Colace)

Lubricants: mineral oil

91
Q

Osmotic laxative mechanism of action and result?

A

Increases fecal water content resulting in bowel distention, increased peristalsis and evacuation

92
Q

Examples of osmotic laxatives?

A
  • polyethylene glycol (GoLYTELY)
  • sorbitol (increases fluid movement into intestine)
  • glycerin
  • lactulose (Chronulac)
93
Q

Lactulose smells like?

A

rotten eggs

94
Q

What must you check before using lactulose?

A

Check ammonia labs

95
Q

What are some saline laxative examples?

A
  • magnesium sulfate (Epsom salts)
  • magnesium hydroxide (MOM)
  • magnesium citrate
  • sodium phosphate (Fleet Phospho-Soda, Fleet enema)
96
Q

Dulcolax goes up the?

A

booty hole!!! hahahahaha no but seriously. Bisacodyl is another name for it.

97
Q

All laxatives can cause what?

A

electrolyte imbalance

98
Q

Antiemetic and anti nausea does what?

A

stops nausea and vomiting.

99
Q

Reglan (prokinetic agent) is an antiemetic, and should not be used for more than __ days because it can cause major what?

A

3 days and cause major psychotic disorders

100
Q

Zofran (ondansetron) is a?

A

serotonin blocker

101
Q

Name a tetrahydrocannabinoid (THC) ?

A

dronabinal marinol

102
Q

What is tetrahydrocannabinoid used for?

A

-Used for N&V associated with chemotherapy, and anorexia associated with weight loss in AIDS patients

103
Q

Serotonin blockers used for?

A

Used for N&V for patients receiving chemotherapy and postoperative nausea and vomiting

104
Q

Prokinetic agents block dopamine in the CTZ but also cause?

A
  • Cause CTZ to be desensitized to impulses it receives from the GI tract
  • Also stimulate peristalsis in GI tract, enhancing emptying of stomach contents
105
Q

Reglan is also used for?

A

Also used for GERD, delayed gastric emptying

Pharmacy 1 (6 decks)

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