GI FINAL-PUD

Question 1

Calcium Carbonate

Answer 1

Tums

Question 2

Magnesium

Aluminum Carbonate

Answer 2

Mylanta, Rolaids

Question 3

Magnesium
Aluminum
Simethicone

Answer 3

Maalox

Mylanta Classic

Question 4

Sodium Bicarb

Aspirin

Answer 4

Alka-seltzer

Question 5

Duration for Antacids

Onset for Antacids

Answer 5

30-60 minutes, doesnt require systemic absorption

O: 3-5 minutes

Question 6

What is the dosing problem with Antacids?

Answer 6

Frequent dosing throughout the day, 4-6x

Question 7

What does Magnesium cause?

Answer 7

Diarrhea

Question 8

What does Aluminum cause?

Answer 8

Constipation

Question 9

Side Effects of Antacids

Answer 9

Unpleasant taste
Constipation
Diarrhea
Bloating
Belching

Question 10

Why would Antacids be problematic in Renal impairment?

Answer 10

Al+ and Mg+ accumulate

Question 11

Famotidine

Answer 11

Pepcid

Question 12

Ranitidine

Answer 12

Zantac

Question 13

Cimetidine

Answer 13

Tagamet

Question 14

Nizatidine

Answer 14

Axid

Question 15

MOA of H2RA

Answer 15

Reversibly inhibits H2 receptors decreasing acid secretion

Question 16

When should you take H2RAs?

Answer 16

30-60 minutes before meals

Question 17

HR2A Dose adjustment based on CrCL

Answer 17

CrCL<30 Cimetidine
CrCl<50 Ranitidine
CrCl<60 Famitidine

Question 18

H2RA that has QT Prolongation

Answer 18

Famotidine

Question 19

H2RA that increases liver enzymes

Answer 19

Ranitidine

Question 20

Cimetidine problems…

Answer 20

2C19 Inhibitor

SE: Gynecomastia, impotence, increase SCr

Question 21

Important caution in H2RAs

Answer 21

CNS effects–>delirium, dementia, cognitive impairment

Increased confusion in severely ill or impaired

Question 22

Dexlansoprazole

Answer 22

Dexilant

Question 23

Esomeprazole

Answer 23

Nexium

Question 24

Lansoprazole

Answer 24

Prevacid

Question 25

Omeprazole

Answer 25

Prilosec

Question 26

Pantoprazole

Answer 26

Protonix

Question 27

Rabeprazole

Answer 27

Aciphex

Question 28

Omeprazole+ Sodium Bicarbonate

Answer 28

Zegerid

Question 29

MOA of PPI

Answer 29

Irreversible H+/K+ATPase Pump Inhibitor which blocks gastric acid secretion *Most effective agents*

Question 30

PPI that can cause SJS/TEN

Answer 30

IV Pantoprazole

Question 31

PPIs can cause what deficiencies

Answer 31

Hypomagnesemia | B12 Deficiency

Question 32

PPI that interacts with clopidogrel

Answer 32

Lansoprazole-Prevacid

Question 33

PPI that increases Liver enzymes

Answer 33

Nexium

Question 34

PPI that can help Nocturnal symptoms if taken at night...

Answer 34

Omeprazole + Sod Bicarb | ZEGERID

Question 35

Which PPIs should be taken 30-60 minutes before breakfast

Answer 35

Omeprazole Pantoprazole Rabeprazole

Question 36

PPI with minimal CYP450 Impact for intxns

Answer 36

Pantoprazole

Question 37

Colloidal Bismuth

Answer 37

Pepto-Bismol

Question 38

Carafate

Answer 38

Sucralfate

Question 39

MOA of Pepto-Bismol

Answer 39

Protective Layer & enhances mucous, bicard, and prostaglandin secretion

Question 40

MOA of Carafate

Answer 40

ACID: cross links to form sticky paste that sticks to everything. Inhibits pepsin-mediated breakdown of proteins in the ulcer. ALSO-Stimulates PG and EGF*

Question 41

Should you take other meds with Carafate?

Answer 41

2 hours before or 4 hours after for some meds (Warfarin, Phenytoin, Digoxin, Thyroid hormone...)

Question 42

Misoprostol

Answer 42

Cytotec

Question 43

PGE1 Analog name and what it does

Answer 43

Misoprostol-Cytotec Increases mucus secretion and bicarb

Question 44

Patient population you should be concerned giving Misoprostol

Answer 44

PREGGO - causes birth defects, premature birth - Dont give child bearing years without RELIABLE documented birth control

Question 45

4 types of Peptic Ulcers

Answer 45

H.Pylori NSAIDs Zolinger (ZES) Stress

Question 46

H Pylori Treatments

Answer 46

Triple 14 day: PPI + Clarithromycin + Amoxicillin Quad 10-14 day: PPI +bismuth subs+ tetracycline + metronidazole

Question 47

When to test for H Pylori eradication

Answer 47

4wk after ab completion and 1-2 week after PPI d/c

Question 48

How to tx HPylori thats resistant to Clarithromycin

Answer 48

PPI + Amoxicillin 1000mg BID 5days THEN PPI + Clarithromycin 500mg BID + Tinidazole 500mg BID 5days

Question 49

Drug option for failed HPylori tx

Answer 49

Rifabutin (MYCOBUTIN) -used only after 1-2 failed normal regimens

Question 50

Lab values indicating Stress Ulcer Prophylaxis

Answer 50

Plts<50,000 INR>1.5 PTT>2xcontrol value *OR MECHANICAL VENT >48HRS*