GI

Question 1

Antacid indications

Answer 1

Hyperacidity, Peptic Ulcer Disease, GERD, Hyperphosphatemia, Calcium Deficiency

Question 2

Antacid precautions/contraindications

Answer 2

abdoominal pain of unknown case

Question 3

renalcalculi avoid

Answer 3

calcium containing antacids

Question 4

renal failure avoid

Answer 4

magnesium based antacids

Question 5

what is strongly cautioned against with renal failue

Answer 5

aluminum

Question 6

sodium content in antacids may affect patients with

Answer 6

HTN, CHV, or renal failure

Question 7

Adverse drug reactions - Antacids aluminum and calcium based

Answer 7

consipation

Question 8

Adverse drug reactions - Antacids magnesium based

Answer 8

diarrhea

Question 9

Antacid administration with other drugs need to be seperated by

Answer 9

at least two hours

Question 10

Antacid you should always do what first

Answer 10

find the underlying cause

Question 11

Combination products have the highest

Answer 11

acid neutralizing capcity

Question 12

docum content of antacid is

Answer 12

listed on the lable.

Question 13

monitoring for antacids

Answer 13

Magnesium level in older patients who use magnesium-containing products chronically

Question 14

provide ___ ___ for people taking antacids

Answer 14

Provide lifestyle chainage education - Stop smoking, elevate head while sleeping, and avoid spicy foods, alcohol, or foods that affect lower esophageal sphincter tone (fatty foods, chocolate, caffeine).

Question 15

Anti-diarrheal three classes

Answer 15

absorbent preparations
Opiates
Anti-cholinergics

Question 16

Kaolin

Answer 16

clay like powder that attraches and holds onto bacteria - anti-diarrheal

Question 17

pectin

Answer 17

thinkens stool

Question 18

bismuth sulfate

Answer 18

anti secretory and anti microbial effects

Question 19

Examples of opiates

Answer 19

loperamide (Imodium) (binds to opioid receptors and slows gastric motility), diphenoxin with atropine (Motofen), diphenoxylate (opioid) with atropine (Lomotil)

Question 20

anti-cholinergics are only useful in

Answer 20

IBS

Question 21

Kaolin and pectin are not

Answer 21

absorbed and are eliminated in feces.

Question 22

Bismuth subsalicylate dissociates into

Answer 22

into salicylate that is absorbed (similar to aspirin), metabolized in the liver, and excreted in urine with the bismuth that is not absorbed.

Question 23

The opioid agents are all absorbed and distributed …

Answer 23

systemically, metabolized in the liver, and eliminated in urine and/or feces.

Question 24

Opioids decrease __ and cause __

Answer 24

intestinal motility and may cause toxic megacolon.

Question 25

Bismuth subsalicylate is contraindicated

Answer 25

contraindicated in children with viral or flu-like illness. similar to given asprin. reyes syndrome

Question 26

Anti-dirrheals use caution in

Answer 26

older adults

Question 27

antidiarrheal are contraindicated in the

Answer 27

treatment of diarrhea in most children.

Question 28

Most common drug interaction with anti-diarrheals

Answer 28

constipation, dark stools with bismuth sulfate (warn patients of this)

Question 29

Diphenoxylate and difenoxin with atropine: have

Answer 29

have anticholinergic effects

Question 30

Drug interactions – Anti-diarrheals

Answer 30

Aspirin, insulin, CNS depressants

Question 31

Anti-diarrheals - culture stool

Answer 31

when appropriate (diarrhea lasting more than 7-10 days) and treat infection appropriately

Question 32

Most infectious diarrhea is

Answer 32

self limiting – from viruses or other bacteria. However, severe bacterial infections such as Salmonella, C Diff, Shigella etc. must be treated with antibiotics. Example traveler’s diarrhea.

Question 33

KEY to treatment of diarrhea is to

Answer 33

KEY to treatment of diarrhea is to

Question 34

Cytoprotective Agents example

Answer 34

sucralfate and misoprostol

Question 35

Sucralfate MOA

Answer 35

coats the lining/coats the ulcer to create a barrier to acid, pepsin and bile salts Technically topical in how it works, very safe, safe in pregnancy

Question 36

Misoprostol – inhibits

Answer 36

basal and nocturnal acid secretion also has protective qualities for mucosal lining

Question 37

MIsoprostol is contraindicated in and use with caution in

Answer 37

Contraindicated in pregnancy! May cause abortion or premature birth or birth defects. Caution in renal patients

Question 38

Cytoprotective Agents - ADR

Answer 38

Sucralfate: constipation Misoprostol: diarrhea, menstrual problems (CHECK pregnancy test in women of childbearing age)

Question 39

Cytoprotective Agents - Interanctions

Answer 39

Sucralfate: decreases absorption of other drugs Misoprostol: diarrhea with magnesium-containing antacids

Question 40

Cytoprotective Agents - Clincial indications

Answer 40

Ulcers associated with NSAID use (first step stop NSAIDs) Duodenal ulcers (sucralfate up to 8 weeks t heal ulcer, give up to 4 times a day, 1 hour before meals)

Question 41

Antihistamines (first generation) - MOA | Antiemetic

Answer 41

Have strong anti-cholinergic effects and histamine 1 blocking effects Phenothiazines

Question 42

Phenothiazines MOA | Antiemetic

Answer 42

Block dopamine receptors in the chemoreceptor trigger zone

Question 43

Cannabinoids MOA | Antiemetic

Answer 43

Work in the central nervous system (CNS) to prevent nausea and vomiting associated with cancer chemotherapy

Question 44

5HT3 Antagonists MOA | Antiemetic

Answer 44

Block serotonin on vagal nerve terminals and in the chemoreceptor trigger zone

Question 45

Sustance P/NK receptor antagonist MOA | Antiemetic

Answer 45

The emetogenic effects of substance P are mediated through the neurokinin-1 (NK1) receptor, a member of the G protein receptor superfamily

Question 46

Phenothiazines | Produce

Answer 46

extrapyramidal symptoms (EPS)

Question 47

Phenothiazines - contraindicated in

Answer 47

parkinson's disease

Question 48

dronabinol use with caution in patients with

Answer 48

seizure disorder

Question 49

5-Ht3 receptor antagonists

Answer 49

may mask progressive ileus