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Flashcards in GERDFC Deck (30):
1

what is the MOA of alteplase?

causes fibrinolysis by binding to fibrin in a thrombus and coverts entrapped plaminogen to plasmin.

2

what is the dose of alteplase?

0.9 mg/kg IV (max 90 mg) IV over 60 mins with 10% of dose given as a bolus over 1 minute.

3

what is the timeframe for alteplase administration?

within 3 hours of of symtom onset

4

what is the role of antihypertensive therapy in stroke?

to decrease BP and qualify patients for alteplase therapy - decrease BP gradually

5

what is the MOA of osmotic diuretics such as mannitol?

increases the osmotic pressure to reduce intracranial pressure associated with cerebral edema.l

6

what routes of administration are approved for nimodipine?

Oral only

7

what are agents used for secondary prevention in pts with previous stroke?

ASA, Plavis, Aggrenox

8

what is the dose of aggrenox?

dipyrimadole/asa 200/25

9

what is the CYP interaction with clopidogrel?

it is a prodrug metabolized by CYP2C19. avoid with 2C19 inhibitors (azole, omeprazole)

10

what are some drugs that can decrease LES pressure?

anticholingerics, barbituates, dihydropyridine CCBs, estrogen, nitrates, NSAIDS

11

what is a side effect of aluminum found in some antacids?

can cause constipation

12

what is side effect of magnesium in antacids?

can cause diarhea

13

when should PPIs be taken?

30 minutes before breakfast because they inhibit proton pumps that are actively secreting acid.

14

omeprazole - Brand

Prilosec=

15

esomeprazole - Brand

Nexium

16

esomeprazole + naproxyn

vivomo

17

rabeprazole brand

aciphex

18

what are side effects of long term PPI use?

increase risk of osteoporosis/fracture, can increase risk of pneumonia in hospitalized pts, can increase risk of c.diff infections

19

which PPIs can be opened and mixed with apple juice or put down tube?

lansoprazole, esomeprazole, omeprazole

20

what drugs require an acidic pH and might have decreased absorption with PPIs?

azoles, calcium carbonate, iron

21

what are two cytoprotective agents used for GERD?

misopostol(Cytotec) and sucralfate (Carafate)

22

What is prego category of misoprostol?

Cat X - used for medical termination of preganancy

23

what is a common side effect of sucralfate?

constipation

24

why is metoclopramide sometimes used for GERD?

dopamine antagonist that enhances motility and accelerates gastric emptying and increases LES tone.

25

what pt population should avoid using metoclopramide?

parkinsons pts

26

what are the 3 common peptic ulcers?

H. pylori, NSAID-inuced ulcers, stress ulcers

27

duodenal ulcers are ____________ by eating while gastric ulcers are _____________ by eating.

duodenal = relieved

28

what is triple therapy for H. pylori?

PPI+ 2 antibiotics

29

What is quadruple therapy for H.pylori?

PPI + bismuth+ metronidazole + tetracycline

30

what is a major side effect of clarithromycin?

abnormal metallic taste