GERD/PUD Flashcards Preview

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Flashcards in GERD/PUD Deck (42):
1

drugs that decrease LES pressure

ANTICHOLINERGICS
barbs, benzos, caffeine, ca channel blockers, dopamine, estrogen, ethanol, isoproterenol, narcotic, nicotine, nitrates, phentolamine, progesterone, theophylline

2

meds that are esophageal mucosa irritants

ALENDRONATE, aspirin, iron, NSAIDs, quinidine, potassium chloride

3

these three classes suppress gastric acid production

antacids
H2 receptor agonists
PPIs

4

these two drugs can be used as promotility therapy in the treatment of GERD

metoclopramide
bethanechol

5

this class rapidly neutralizes acid to raise intragastic pH (decrease pepsinogen, increase LES pressure)

antacids

6

this antacid includes alginigc acid, which adds a viscous layer acting as a barrier to reflux

Gaviscon

7

this class can cause diarrhea, constipation, or gas. Should not be given in anyone taking a calcium supplement or with renal dysfuntion

antacids

8

this class has many drug reactions. It alters gastric and urinary pH and provides a physical barrier to absorption. Be careful with quinolone, isoniazid, tetracycline, ferrous sulfate, quinidine, and sulfonylurea

antacids

9

Patients should not have to take these meds for over 14 days. If so, should be evaluated for Barret's or upper GI pathology

antacids

10

this class reversibly inhibits H2 receptors on parietal cells

H2 receptor antagonists

11

this class is used for on-demand therapy for mild to moderate GERD symptoms. can be used before exercise or meals

H2 receptor antagonists

12

these drugs are rapidly and well absorbed after oral admin. they are largely excreted unchanged in the urine (adjust w renal impairment)

H2 receptor antagonists

13

this H2 RA is 90% bioavailable after first pass metabolism (others are 50%)

nizatidine

14

this class can cause HA, somnolence, fatigue, dizziness, constipation, or diarrhea. Thrombocytopenia is a rare but reversible SE

H2 receptor antagonist

15

this class interacts with CIMETIDINE to inhibit metab of warfarin, phenytoin, nifedipine, and propranolol. Also messes with ketoconazole, itraconazole, and ferrous sulfate (bc they require acidic environment for absorption)

H2 receptor antagonist

16

combine an antacid with what for more effective therapy?

H2 RA

17

this class eliminates symptoms and heals esophagitis more rapidly than other drugs, and should always be given before meals

PPIs

18

this class inhibits the action of H, K, -ATPase

PPIs

19

all drugs in this class are considered prodrugs- need the acidic environment to work

PPIs

20

this class doesn't usually cause ADRs, but can cause N/D/C, HA, dizznessiness, somnolence, perhaps a higher incidence of CAP

PPIs

21

be cautious giving this class to patients with asthma, COPD, immunocompromise, young, old

PPIs

22

which PPIs are metabolized by P450

OLEP
reduce metabolism of diazepam, phenytoin, warfarin

23

this class works to reverse LES incompetence, decreased esophageal clearance, and delayed gastric emptying

promotility agents

24

CNS effects of this class include drowsiness, irritability, extrapyramidal effects

promotility agents

25

this drug is contraindicated in parkinsons, mechanical obs, use of dop ags, anticholinergics, and pheochromocytoma

metoclopramide

26

this drug may increase acid production and is not well tolerated due to cholinergic side effects

bethanechol

27

this promo agent can cause fatal cardiac dysrhythmia

cisapride

28

this class of drug is not recommended for use except in very mild cases of GERD

mucosal protectants

29

this drug polymerizes and cross links to form a sticky, yellow-white gel that adheres to atypical epithelial cells in the base of ulcer craters (when pH is below 4-administer before meals)

sucralfate

30

this drug is effective at promoting motility in PUD and is more efficacious in duodenal rather than gastric ulcers. Can be used to prevent stress ulcers

sucralfate

31

ADRS include constipation, dry mouth, and abdominal discomfort

sucralfate

32

this drug should not be administered with agents that decrease acid. Reacts with phenytoin, digoxin, tetracycline, ketoconazole, fluroquinolone

sucralfate

33

Is this effective for maintenance of GERD: full dose H2 receptor antagonist once daily?

NO. Use reduced dose PPIs (alternate day dosing or weekend therapy)

34

treatment for zollinger-ellison syndrome

PPIs, chemo

35

DOC for PUD

PPI

36

3 dose regimen for PUD: PAC

PPI
Amoxicillin
Clarithromycin

37

3 dose regimen for PUD: PMC

PPI
Metronidazole
Clarithromycin

38

4 dose regimen PUD: PBMT

PPI
Bismuth subsalicylate
metronidazole
tetracycline

39

this drug is beneficial for treating PUD: cytoprotection through enhanced secretion of mucous and HCO3, inhibit pepsin activity, antibacterial effects, promotes ulcer healing

bismuth subsalicylate

40

this is a prostaglandin analogue that helps maintain the integrity of the gastroduodenal mucosal barrier and promotes healing

misoprostol

41

this class is indicated for ulcer healing and prophylaxis w NSAID use

prostaglandin analogue

42

this class can cause diarrhea or constipation. It is contraindicated in people with hypotension, breastfeeding, or pregnancy

prostaglandin analogue