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Flashcards in GI drugs Deck (62)
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1

What is the tx of choice for acute ulcers?

antiacids

2

what type of therapy is needed to reduce the rate of recurrence for gastric ulcers?

antibiotic therapy

3

What do all the antibiotic therapies for the tx of ulcers have in common?

They all contain a PPI

4

what medications are included in the bismuth quadruple therapy?

bisuth, metro, tetra, and PPI

5

what is included in the concomitant quadruple therapy?

clarith, metro, amox and ppi

6

what is included in the triple therapy?

clarith, metro or amox and ppi

7

which tx for ulcers shows the greatest eradication rates?

the bismuth and concomitant quadruple therapy, triple therapy is old news baby

8

What two proton pump drugs do we need to know?

omeprazole and lansoprazole

9

You have an elderly pt with who just recently had a stent placed due to an MI so they put them on clopidogrel but now they have the GERD. What drug would you not recommend ?

omeprazole because its actions on cyp450 might inhibit the conversion of clopidogrel to its active form.

10

Can you have rebound gastric acidity after stopping a PPI?

yes yes you can

11

Is anyone PPI more efficacious than the other?

no they are all created equal

12

Clinical uses for PPI are?

Gerd- most effective agent

Peptic ulcer disease- more rapid symptom relief and faster healing than H2 anatagonists

NSAID induced ulcers

Prevention of stress gastritis

Zollinger-ellison syndrome- higher dose provides complete symptomatic relief

13

H2 receptor anatagonists?

Ranitidine
Cimetidine
famotidine
nizatidine

all of these are available OTC for acute gastritis

14

true or false: H2 blockers are better at suppressing nocturnal acid secretion than meal stimulated acid secretion?

True

15

True or false bothe PPis and H2 blockers are rapidly absorbed?

True

16

Clinical use of H2 blockers?

Gerd- if its infrequent

Peptic ulcer disease - but PPI is better

Stress-related gastritis- reduces bleeding when given IV

17

H2 blocker effects on CNS?

slurred speech, confusion more common with cimetidine

18

You have a pt taking ketaconazole (for something already forget possibly candida) and they have intermittent Gerd. should you use a PPI or H2 blocker?

neither they need to suck it up because all anitsecretory agents decrease ketaconazole absorption by causing an increase in gastric PH

19

out of all the H2 blockers which one has the most drug interactions?

Cimetidine

20

What are the drug to drug interactions brought on by cimetidine?

it inhibits cytochrom p450 oxidative metabolism.

This can increase the effects of many drugs. some of which are warfarin, phenytoin, carbamazepine, ketoconazole

21

which agent is a mucosal protective agent?

sucralfate

22

How does sucralfate work?

it binds to necrotic ulcer tissue to form a protective barrier. Single dose can last 6 hours

23

Should you administer sucralfate with an antacid or h2 blocker?

no becasue it is activated at a acid of less than 4.

24

true or false sucralfate has systemic absorption?

false

25

Whats the most common adverse effect of sucralfate?

constipation

26

So for antisecretory drugs we have?

H2 blockers
PPis
sucralfate
prostaglandins

27

true or false: Misoprostol is a prostaglandin?

true

28

what is the pharmacodynamic affect of prostaglandins?

inhibits cAMP formation which results in decreased H+ secretion (most important clinical effect)

29

does misoprostol stimulate acid neutralizing HCO3 formation?

yes- but most important effect is decrease secretion of H+

30

How rapid of an onset does misoprostol have?

this baby kicks in within 30 minutes but has a very short half life also 30 minutes