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Advanced Pharm Exam 4 > gi meds > Flashcards

gi meds Flashcards

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1
Q

promethazine, prochlorperazine MOA

A

phenothiazines

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2
Q

phenothiazines AEs

A

sedation, hTN, EPS, QT prolongation

promethazine - extravasation (admin slow!)

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3
Q

ondansetron, granisetron, palnosetron MOA

A

serotonin-3 receptor antagonist

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4
Q

serotonin-3 receptor antagonist AEs

A

QT prolongation

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5
Q

fosaprepitant MOA

A

substance P/neurokinin 1 antagonist

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6
Q

hydroxyzine, meclizine, dimenhydrinate MOA

A

h-1 receptor antagonist

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7
Q

histamine-1 receptor antagonist AEs

A

anticholinergic

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8
Q

scopolamine MOA

A

muscarinic receptor antagonist

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9
Q

scopolamine AEs

A

anticholinergic

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10
Q

scopolamine AEs

A

anticholinergic

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11
Q

loperamide, diphenoxylate/atropine, opium tincture MOA

A

antipropulsives

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12
Q

antipropulsives AEs

A

loperamide - consitpation, toxic megacolon

diphenosylate/atropine - anticholinergic AE, abuse potential

tincture - constipation, confusion, sedation, urinary retention, dependence, miosis

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13
Q

who is tegasterod approved for?

A

women <65 due to risk of serious CV events

for IBS-c

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14
Q

what are tegaserod and prucalopride used for?

A

IBS-C

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15
Q

lubprostone MOA

A

chloride channel activator

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16
Q

lubiprostone AE

A

diarrhea

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17
Q

linaclotide, plecanatide MOA

A

guanlyate cyclase receptor agonist

used for IBS-C

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18
Q

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A

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19
Q

alosetron MOA

A

serotonin-3 receptor antagonist

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20
Q

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A

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21
Q

dicyclomine, hyoscyamine, glycopyrrolate MOA

A

muscarinic receptor antagonist

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22
Q

metoclopramide MOA

A

dopamine-2 receptor antagonist

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23
Q

what is metoclopramide used for?

A

gastroparesis

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24
Q

alvimopan, naloxegol, methylnaltrexone, naldemedine MOA

A

mu receptor antagonist

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25
mu receptor antagonist AE
abd pain, diarrhea, opioid withdrawal alvimopan - MI - hospital admin only
26
polycarbophil, psyllium MOA
bulk-forming laxative
27
senna, bisacodyl MOA
stimulant laxative
28
laxatives AE
abd pain, bloating/cramping, GI obstruction, electrolyte disturbance, diarrhrea
29
lactulose, polyethylene glucol, mag hydroxide, mag citrate MOA
osmotic laxatives
30
antacid components AE
calcium - constipation, hyperCa mag - diarrhea, hypermag carbonate - eructation alumninum - constipation, hyperaluminemia, hypophosphatemia sodium - fluid retention
31
famotidine, cimetidine, nizatadine MOA
H2 receptor antagonist
32
H2 receptor antagonist AE
sedation, thrombocytopenia, confusion cimetidine - gynecomastia, decreased libido, impotence
33
esomeprazole, dexlansoprazole, pantoprazole,, omeprazole, lansoprazole, rebeprazole MOA
PPI
34
PPI AEs
c. diff, pneumonia, hypomag, B12 deficiency, iron deficiency, fractures take w food (except dexlansoprazole)
35
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GERD step up therapy
mild & intermittent H2 antagonist PRN H2 angagonist BID Low dose PPI QD PPI QD
40
GERD step down therapy
severe or frequent GERD PPI QD low dose PPI QD BID H2 antagonist PRN H2 antagonist
41
GERD tx considerations
not for long term tx except: Barrett's esophagus severe erosive esophagitis symptomatic GERD following PPI withdrawal
42
common causes of PUD
h. pylori infection NSAIDS (COX-1 inhibition) critical illness
43
PUD therapy principles
discontinue NSAID evaluate need for aspirin treat H. pylori give PPI!!! uncomplicated - QD complicated/H. pylori - BID
44
H. pylori treatment
PPI BID & abx amoxicillin & clarithromycin (resistance) x14d + PPI bismuth subsalicylate, tetracycline, metronidazole + PPI
45
post op N/V prevention
high risk - prophylaxis w 3 antiemetics from different classes moderate risk - 2 antiemetics from different classes low risk - depends on anesthesia (inhalation/total IV - dexamethasone + ondansetron)
46
CINV acute emesis occurs
within 1-2 h of chemo
47
CINV delayed emesis occurs
occurs >24h after chemo
48
3 categories with highest therapeutic index for mgmt of CINV
5-hydroxytryptamine receptor antagonist neurokinin-1 receptor antagonists glucocorticoids (dexamethasone)
49
tx of highly emetogenic regimens
4 days tx day 1 - NK1RA + 5HT2 + dexameth + olanzapine day 2-4: dexameth + olanzapine
50
tx of moderately emetogenic regimen
day 1 - NK1RA + 5-HT3RA + dexameth day 2-3: 5-HT3 RA + dexameth
51
low emetogenic regimen
day 1 - 5-HT3RA or dexameth
52
chronic constipation tx
dietary fiber/ bulk forming laxatives polyethylene glycol, senna, biscodyl
53
opioid induced consitpation tx
stimulant or osmotic laxative bulk-forming laxative lubiprostone or peripheral mu receptor antagonist
54
IBS-C tx
bulk forming laxative (psyllium)/soluble fiber polyethylene glycol libiprostone, linaclotide, plecanatide
55
IBS-D tx
loperamide bile acid sequesterants aldosetrol
56
IBS-D PRN meds
for abd pain/bloating dicyclomine, glycopyrollate, hyoscyamine
57
IBD med classes
``` 5-aminosalicylate derivative glucocorticoids immunosuppressants TNFA inhibitors a-4 integrin antagonist interleukin antagonists ```
58
most commonly used agent for IBD
mesalamine
59
sulfasalazine AE
rash, folic acid deficiency, bone marrow suprression, SJS
60
what is lubiprostone used for?
IBS-C and opioid induced constipation
61
what are linaclotide and plecanatide used for?
IBS-C
62
diphenoxylate MOA
structurally similar to meperidine, inhibits GI motility and slows GI propulsion
63
muscarinic receptor antagonist least likely to cross the BBB
glycoyrrolate
64
what med should not be give IV?
hydroxyzine, AEs through other routes
65
serotonin-3 receptor antagonist with the longest half life and highest receptor selectivity
palonosetron
66
misoprostol MOA
PGE1 analog - stimulates mucin and bicarb secretion used for GERD/PUD

Advanced Pharm Exam 4 (13 decks)

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