GI Drugs Flashcards
(148 cards)
1
Q
Goals of Treatment for PUD
A
Alleviate SX, Promote Healing, Prevent Complications
2
Q
Antibiotics treat what GI infection?
A
H. pylori
3
Q
When curing H. pylori what drugs do you want to use?
A
2 ABX + a proton pump inhibitor
4
Q
Best ABX to use for H. pylori
A
Clarithromycin/amoxicillin plus omneprozl
5
Q
What drug is a Histamine2 Receptor Antagonist?
A
Cimetidine/ aka Tagment
6
Q
What is the suffix for H2 Blockers
A
tidine
7
Q
MOA of H2 receptor antagonist?
A
blocks H2 receptors on parietal cells to stop acid production
8
Q
Can Tagment cross the BBB?
A
Yes
9
Q
Serious complication of Tagment/Cimetidine?
A
Pneumonis due to lowering pH becomes alkiline
10
Q
What serious AE are unique to tagment?
A
CNS problmes and Antiandrogenic effects
11
Q
Should you take tagment with food?
A
Yes
12
Q
Pt education for Cimetidine?
A
looks for signs of worse bleeding, limit factors that contribute to PUD
13
Q
What are things that contribute to PUD?
A
smoking, drinking, alcohol, aspirin, NSAIDS
14
Q
What class of drug is OmeprazolePrilosec?
A
Proton Pump Inhibitor
15
Q
What drugs are used to treat Gastric and duodenal ulcers, and GERD?
A
PPI’s
16
Q
MOA of Proton Pump Inhibitors
A
Irreversibly inhibit the H and K+ ATPase that makes gastric acid
17
Q
Serious AE of Omeprazole/Prilosec?
A
Pneumonia, Fractures due to C+ lowering, Hypomagnesemia,
18
Q
What is possible if you stop taking Prilosec?
A
Rebound hypersecretion
19
Q
Hard no for Omeprazole/Prilosec?
A
Some HIV drugs
20
Q
Treating PUD with PPI how long do you want to take?
A
Orally low dose for shortest time required
21
Q
Careful of using PPI withpatients that have a hx of what?
A
Osteoporosis
22
Q
What PPI can you give IV?
A
Pantoprazole
23
Q
What electrolyte do you want to be careful of in using PPI?
A
Mag due to hypo magnesemia
24
Q
Wha tis Sucralfate used for?
A
Manage Duodenal ulcers
25
MOA of Carafate/Sucralfate?
Coats uclers to protect from acid
26
What drug is used for ulcers caused by NSAID use?
Misoprostol/Cytotec
27
MOA of Cytotec?
Analog of prostoglandin/ stimulates utrine contractions
28
Hard no for Cytotec?
Pregnancy due to stimulation of uterine contractions
29
What do Antacids do?
Neutralize acid and decrease destruction of gut wall
30
What antacids cause diarrhea?
Aluminum hydroxide and Calcium carbonate
31
What antacid can cause mag toxicity?
Magnesium hydroxide kidney is key
32
What is sodium Bicarb mainly used for?
treat acidosis and to alkalinize urine
33
What is the effect of Laxatives?
production of soft formed stool over 1 or more days and prevent constipation
34
What is the point of Catharisi?
prompt fluid evacuation of the bowel
35
How fast do group 1 laxatives work?
2-6 hours be sure to be safe
36
How fast do Group 2 lax's work and what ype of stool do they produce?
6-12 hours semifluid stool
37
What is the most frequently abused lax catergorey?
Group 3
38
How long do group 3 lax's take to work?
1-3 days
39
What type of stool do group 3 lax's make?
soft formed stool
40
contraindications to lax use?
appendicitis, diverticulitis, UC and abdominal pain
41
Should prego women us lax's?
Carefully could induce labor or go into breast milk
42
Bulk forming agents are what group of lax's?
Group 2
43
What type of lax is Metamucil/Psyllium?
Bulk forming agent
44
MOA of metamucil?
forms a gel that softens fecal mass
45
Do not give Bulk forming Metamucil if patient has what?
esophageal obstruction existing
46
What group of lax is Surfacants?
Group 3
47
What drug is a surfactans?
Colace...aka docusate sodium
48
What is Colace used for?
Prevent constipation
49
What is MOA of Colace?
Pulls water anf fat into stool
50
What Group of lax is a stimulant?
Group 2
51
What is Bisacodyl used for?
Opioid induced constipation and slow GI constipation
52
MOA of Bisacodyl?
Stimulate GI motility
53
Osmotic Lax are what class?
1 and 2
54
Miralax is what class of lax?
2
55
Use Osmotic Lax for what?
Chronic constipation bowel prep or aggressive parasite
56
Serious Adverse affect of Osmotic Laxatives?
Dehydration
57
Consequence of of overuse of Lax?
needing to use more laxatives because sensor to have BM does not work
58
Use of Antiemetics
suppress nausea and vomiting
59
Serotonin Antagonist Drug?
Zofran/Ondansetron
60
Most serious complication of Zofran?
prolonged QT
61
What receptor does Serotonin antagonist work on?
5-HT3
62
What drug is a dopamine antagonist?
Prochlorperazine
63
Where do dopamine bloc receptors at?
CTZ
64
What drug is an antiemetic that is a anticholinergic?
Scopolamine
65
What is Scopolamine used for?
Motion Sickness
66
What Se does Scopolamine cause?
Dry Mouth works in inner ear
67
What are the two major groups of antidiarrheals
Specific and Non Specific
68
When is a specific time you would use an antidiarrheal
when someone. has a new poop route
69
What is a non specific antidiarrheal agent?
Tincture of Opium
70
When would you give tincture of Opium
when you want to have constipation
71
MOA of Opium Tincture?
Activate Mu receptors in GI tract
72
Lomotil has Atropine for what reason?
To prevent abuse
73
Atropine in Lototil is what?
A dose limiting agent
74
What Nonspecific antidiarrheal has little to no potential for abuse?
Loperamide
75
What are the three nonspecific antidiarrheals?
Opioid Tincture, Lomotil, Loperamide
76
What re specific antidiarrheals used for?`
treat diarrhea due to infection
77
How do you control diarrhea caused by infection?
ABX to kill and let diarrhea run its course
78
Should you use ABX for Salmonella?
Yes
79
ABX for Shigella?
Yes
80
ABX for Campylobacter?
Yes
81
ABX for Clostridium?
Yes
82
What is used to treat Travelers Diarrhea?
Ciprofloxacin or norfloxacin
83
What are two inflammatory bowel diseases?
Chrons and UC
84
What is the most common disorder of GI?
Irritable Bowel syndrome
85
IBS-C is what?
Constipation
86
IBS-D is what?
Diarrhea
87
IBS-M is what?
Constapation and Diarrhea
88
What is a specific drug for IBS?
Alosetron
89
MOA of specific drugs for IBS?
Blocks serotonin receptors on viscera neruons
90
Where is Alosetron metabolized?
Liver
91
Is IBD curable?
No just controlled
92
What does a pro-kinetic agent do?
makes bowel want to move
93
MOA of Pro-Kinetics?
Enchances the actions of acetylcholine for slowed gI movement
94
What drug is a ProKinetic?
Reglan
95
Serious Adverese Affect of Regln?
Irreversible tardive dyskinesia
96
What is the ideal vehicle for getting vitamins and minerals?
Food
97
What is a parenteral feeding?
Fed through an IV
98
What are fat soluable Vitamins?
ADEK
99
How long do fat soluble vitamin stay in system?
weeks or months
100
How are water soluble vitamins secreted?
Quickly and deficiencies are noted quickly
101
What eprcent of vitamins do you urinate out?
90%
102
What are the water soluble vitamins?
103
what is vit C required for?
Healing and a positive nitrogen balance.
104
What vitamin can reach levels of toxicity?
Vit A
105
what vit is a tetratogenic?
Vit A
106
Who needs Vit B1 the most?
alcoholics due to thiamine deficiency Banana bag
107
What is Vit B9 also called?
Folic Acid
108
What is folic acid used for?
pregnancy to reduce neural tube injury
109
Who needs B12?
Gastric Bypass patients and Pernicious anemia patients
110
What does Vit C faciliate?
Iron absorption
111
What is Vit K required for?
Bone health and clotting
112
What is the best source vitamins?
Well balanced diet
113
What exceptions for vit intakes should you supplement if have osteoporosis?
calcium
114
what VitC helps iron absorption?
Iron
115
What are the two types of minerals?
Macro and Micro
116
C+ Macro or micro mineral?
Macro
117
Magnesium, macro or micro mineral?
Macro
118
Phosphorous, macro or micro mineral?`
Macro
119
Potassium, macro or micro mineral?
Macro
120
Sodium, macro or micro mineral?
Macro
121
Iron, macro or micro mineral?
micro
122
Zinc, macro or micro mineral?
micro
123
Zinc is needed for what?
wound healing
124
What do you want to assess before giving K+
Cardiac rhythm status and serum levels
125
Should you ever push K+?
Never IV push
126
What mineral is a dose of no more than 10mq/hr
K+
127
Rate for K+ in a central line
20-40mq/hr
128
If patient has pain at IV site when giving K+ what should you do?
slow infusion rate
129
When do you reassess pt after starting K+ drip?
5-10 min after start
130
Wha route is MAG Sulfate?
IV
131
Wha route is MAG oxide?
PO
132
What is the MOA of Mag?
Blocks ACH neuromuscular junction
133
Hard no for Mag?
Serious cardiac disease
134
Do you ever IV push Mag sulfate?
No slow IV infusion
135
What is the reversal agent for Mag?
Calcium Gluconate
136
Sign of to much Mag?
Depressed DTR's
137
Hard no for Iron Supplement?
Anemia due to any other cause other than Iron Deficiency
138
Avoid taking iron with what?
stuff that effects absorption ie milk eggs, antacids and caffeine
139
Harmless SE of Iron supplements
Black Stools
140
Who gets Enteral nutrition?
GI works but cant take PO stuff
141
Important to make sure you have a order for this when someone is on enteral nutrition?
Free Water cause cant drink
142
Complication of Enteral Nutririon is what and could cause what??
Refeeding syndrome and causes electrolyte imbalances
143
Things to consider when giving drugs to Enteral nutrition people?
Check compability
Crush drug is ok
flush between drugs
144
How long should you stop tube feeding before and after med admin?
15 min
145
If you stop tube feed be sure to do what?
turn back on
146
Who gets PPN or TPN?
People who Gi tract does not work
147
What does TPN require to administer?
Central Line Access
148
How often is TPN modified?
Daily
