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Pharmacy Practice V > GI Mucoskeletal Material Exam Two > Flashcards

GI Mucoskeletal Material Exam Two Flashcards

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1
Q

Colcrys

Colchicine

A

Prophylaxis: 0.6 mg BID, QD if intolerant, MAX 1.6 mg/day
0.3 mg QD if CrCl <30
Flare: Day One 1.2 mg then 0.6 mg in 1 hr, Day 2 & MD 0.6 mg QD or BID
Alternative Day 1 Dosing: 0.6 mg TID MAX 1.8 mg/day
CI: Amiodarone, Verapamil, 3A4 Inhibitors Itraconazole
AE: GI Upset
Warning: Blood dysscrasias, neuromuscular toxicity

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2
Q

Ulcerative Colitis Meds

A

MILD-MOD: 5-ASA
Mod-Severe: Budesonide or Prednisone
Severe-Fulminant: IV Methylprednisolone or Hydrocortisone

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3
Q

Crohn’s Disease Meds

A

MILD-MOD: Sulfasalazine, Metronidazole (perianal), Budesonide (small bowel)
Mod-Severe: Prednisone + infliximab, adalimumab, certolizumab, methotrexate, azathioprine, mercaptopurine, or vedolizumab
Severe-Fulminant: IV hydrocortisone

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4
Q

Proton Pump Inhibitors

A

MOA: irreversibly inhibit the K+/H+ ATPase which inhibits the final step in the secretion of hydrogen ions into the gastric lumen lowering stomach acid
Indication: Erosive and Maintenance GERD therapy, H. Pylori, Ulcers
Warnings: Pneumonia, risk of C.Diff, risk of hip fracture, hypomagnesemia/vitamin b12 deficiency
AEs: HA, abdominal pain
DDIs: PLAVIX via 2C19, WARFARIN, Posaconazole, Iron Salts
PC: USE DAILY NOT PRN
Initial treatment for erosive esophagitis typically 4-8 weeks, then begin long term maintenance therapy

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5
Q

Aciphex

Rabeprazole

A

Caps/Delayed Release Tabs
Cap: 30 mins before meals
Tabs: without regard to meals
Dose: 20 mg
4-8 wk initial treatment, 20 mg daily maintenance

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6
Q

Nexium

Esomeprazole

A

Caps/Granules/IV/Tabs
60 minutes before food
Dose: 20-40 mg
4-8 wk initial treatment, 20 mg daily maintenance

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7
Q

Prevacid

Lansoprazole

A

Caps/Tabs/Oral Disintegrating Tabs
30-60 mins before meals
Food DECREASES absorption
Dose: 30 mg
8 wk initial treatment, 30 mg daily maintenance

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8
Q

Prilosec

Omeprazole

A

Tabs/Caps/Oral Suspension
30-60 mins before meals
Dose: 20-40 mg
8 wk initial treatment, 20 mg daily maintenance

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9
Q

Protonix

Pantoprazole

A

Tabs/IV/Delayed Release Oral Suspension
TAB: without regard to meals
Dose: 40 mg
8 wk initial treatment, 40 mg daily maintenance

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10
Q

Dexilant

Dexlansoprazole

A

Caps: without regard to meals
Dose: 60 mg
8 wk initial treatment, 30 mg daily maintenance

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11
Q

H2 Receptor Antagonists H2RAs

A

MOA: Reversibly complete with histamine at the H2 receptor sites in the parietal cells of the stomach to inhibit acid secretion
Indication: heartburn OTC, ulcers, MILD GERD WITHOUT esophagitis
Warnings: Vitamin B12 deficiencies
AEs:
DDIs: Benzos, Carbamazepine, BB, Phenytoin, Warfarin, and Plavix
PC: Take with food, take antacids no sooner than 2 hrs following dose

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12
Q

Pepcid

Famotidine

A

PO,IV
CAN be given with Antacids
Dose: 10-20 mg BID

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13
Q

Tagamet

Cimetidine

A

TABS
DRUG Interactions
Take with food; take antacids no sooner than 2 hrs

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14
Q

Zantac

Ranitidine

A

Withdrawal from market due to NDMA levels

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15
Q

Carafate

Sucralfate

A

MOA: forms protective coating on peptic ulcer
AE: constipation, indigestion
DDI: digoxin, warfarin, phenytoin, theophylline, levothyroxine, tetracyclines, and antacids
AVOID antacids within 30 mins before/after
Dose: 1 gram QID (before meals and at HS)
4-8 wk initial course; 1 gram BID maintenance

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16
Q

Cytotec

Misoprostol

A

MOA: PGE1 Analog
Indication: Prevent NSAID induced gastric ulcers
CI: Pregnancy
AE: Diarrhea, abdominal pain
PC: Take with meals and at bedtime
Dose: QID dosing

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17
Q

5-Aminosalicylic Acid Derivates

A

MOA: Anti-Inflammatory
Indication: IBD
CIs: ASA allergy, sulfa allergy
AEs: Abdominal pain, dyspepsia, HA, nausea

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18
Q

Asacol

Mesalamine

A

Delayed Release TABS
PC: may cause constipation, do not cursh, avoid concurrent antacids

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19
Q

Colazol

Balsalazide

A

CAPS
PC: can sprinkle contents on applesauce

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20
Q

Dipentum

Olsalazine

A

CAPS
PC: may cause diarrhea; take with food

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21
Q

Azulfidine

Sulfasalazine

A

Regular and Delayed Release TABS
PC: may cause rash/anorexia, folate deficiency, hepatic necrosis, infections
Take at even intervals after meals with ample fluids
Take >3-4 wks to see effect
Monitor LFTs

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22
Q

Bentyl

Dicyclomine

A

Anticholingeric; antispasmodic
Indication: IBS
CI: glaucoma, GI obstruction, severe UC, unstable CV
PC: drowsiness, avoid alcohol
TID-QID

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23
Q

Levsin/Levbid

Hyoscyamine

A

Anticholinergic; antispasmodic
Indication: IBS
CI: glaucoma, GI obstruction, severe UC, unstable CV
PC: empty stomach 30-60 mins prior, non concomitant antacids, do not crush or chew Levbid

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24
Q

Levsin Dosing

A

Levsin 0.125 mg TAB/SL: 3-4x a day prn
Empty stomach prior to meals or prn

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25
Levbid Dosing
Levbid 0.375 mg: BID Extended release tablet
26
Lomotil
Anticholinergic and Opioid Agnist Indication: management of diarrhea CI: pseudomembranous colitis ADD ATROPINE to deter abuse 2.5 mg TAB: 2 tabs or TSP QID than daily BID Short term use, DC if no response within 10 days
27
Lotronex | Alosetron
5HT3 Antagonist Indication: IBS w/Diarrhea FEMALES (REMS) CI: constipation, IBS, Flucoxamine (DDI increase risk of serotonin syndrome) PC: DC immediately if constipation occurs
28
Viberzi | Eluxadoline
Mu-Opioid Receptor Agonist Indication: IBS w/diarrhea CI: alcohol abuse, pancreatitis, GI obstruction, severe constipation DDI: OAT1B1 Inhibitors (gemfibrozil) Warning: Sphincter of Oddi Spasm and risk of pancreatitis; severe constipation PC: take with food
29
Imodium | Loperamide
Peripheral Mu-Opioid Receptor Agonist/Antisecretory Indication: Acute/Chronic Diarrhea CI: diarrhea secondary to infection Warning: CNS depression, nausea, constipation, cramping PC: if siarrhea persists beyond 2 (or 10 days for people with chronic diarrhea) days call provider Initial 4 mg then 2 mg after each loose stool MAX 16 mg/day
30
What are the common/classic AEs of anticholinergic agents? | Beer List Considerations
* Blurry Vision * Dry Mouth * Urinary Retention * Constipation * CNS Impairment * Heat Exhaustion * Potential Pyschosis
31
Miralax | Polyethylene Glycol
Osmotic Laxative Indication: relief of constipation AE: bloating, cramping, flatulence, nausea Powder/Packet 1 scoop 17g in 8 oz liquid once daily, use water, juice, dosa, tea, coffee May take 48-96 hrs to see effect
32
CoLyte | Polyethyene Glycol
Osmotic Laxative Indication: bowel cleansing prior to GI procedure 80z of reconsituted solution every 10 mins as directed; drink until bowel effluent clear or 4 L gone
33
What are the steps to counsel a patient on for CoLyte?
1. Add water and shake well to dissolve powder 2. Can chill after reconsitution to improve taste 3. Do NOT eat wtihin 3-4 hrs prior to starting prep 4. Follow physician directions for when to start prep 5. Meds within 1 hr prior to prep may not be absorbed 6. Drink glasses quickly 7. No food or drink after completion of bowel prep
34
Senokot | Senna
Stimulant Laxative Indication: constipation AE: abdominal cramp, diarrhea, N/V ONSET: within 6-24 HRS PC: Take once (or BID) daily doses at bedtime, adminster 2 hrs before or after other medications
35
Colace | Docusate
Stool Softener Indication: Relief/Prevention of constipation PO or Rectal DDI: do NOT combine with mineral oil PC: more effective for prevention than treatment ONSET: 12-72 HRS QD or BID, take with full glass of water
36
Chronulac | Lactulose
Osmotic Effect Indication: constipation, portal system encephalopathy PSE PSE: TITRATE TO 2-3 STOOLS/DAY PO/Packet/Solution/Rectal AE: gas, abdominal discomfort ONSET: MAY TAKE 24-48 HRS TO PRODUCE BOWEL MOVEMENT
37
Amitiza | Lubiprostone
Prosecretory Agent Indication: IBS w/constipation in FEMALES CI: GI obstruction DDI: METHADONE AE: Nausea PC: Administer with food and water to decrease nausea
38
Linzess | Linaclotide
Prosecretory Agent Indication: IBS w/constipation CI: GI ostruction or Use in <6 yrs AE: Diarrhea PC: Empty stomach 30 mins prior to 1st meal
39
PAMORAs | Peripheral Mu Opioid Receptor Antagonist
METHYLNALTREXONE/RELISTOR MOA: peripherally acitng mu-opioid receptor antagonists DOSE ADJUST RELISTOR in renal impairment Warning: Risk of GI Perforation NEVER USE IN CONFIRMED OR SUSPCTED GI OBSTRUCTION AVOID in impaired integrity of GI wall Monitoring: symptoms of opioid withdrawal
40
Prucalopride | Motegrity
Selective 5-HT Agonist Warning: avoid if risk of Gi perforation AE: HA, dizziness, fatigue, diarrhea, SUICIDAL IDEATION Monitoring: mood and frequency of bowel movements
41
What are the AEs of Dopamine Receptor Antagonists?
Movement Disorders
42
What are the AEs of Serotonin Antagonists?
* Serotonin Syndrome * HA * Constiaption * Fatigue * OTc Prolongation
43
Compazine | Prochlorperazine
MOA: Dopamine Antagonist central Indication: severe N/V CI: CNS Depressants and Children <2 yrs <20lbs AE: Drowsiness, dizziness, and blurred vision
44
Phenergan | Promethazine
Dopamine Antagonist Indication: ACUTE N/V Dosing: IV/IM/SQ avoided due to risk of tissue injury AE: drowsiness, anticholinergic
45
Zofran | Ondansetron
Serotonin Antagonist Indication: prevention of chemotherapy/post-operative induced N/V AE: HA, fatigue, constipation QTc Prolongation w/high doses 8-16 mg/day and pre-medicate with 1st dose up to 30 mins before chemo
46
Reglan | Metoclopramide
Dopamine and Serotonin Antagonist Indication: GERD, diabetic gastroparesis, prevention of chemo N/V CI: GI obstruction BBI: risk of TARDIVE Dyskinesia, limit use to <12 weeks AE: drowsiness, fatigue, movement disorders, OTc PROLONGATION PC: QID take 30 minutes prior to food
47
NSAIDs
MOA: reversibly bind and inhibit COX enzymes, preventing synthesis of prostanoids and prostaglandins Analgesic/Antipyretic/Anti-Inflammatory Indication: OA, RA, GOUT BBI: increased risk of CV events/stroke/GI ulceration/bleeding/perforation PC: take with food/milk to minimize GI upset and avoid/limit alcohol intake
48
What risk factors increase the risk of a GI Bleed when on NSAIDs?
1. Long duration of use 2. Higher doses 3. Age above 60 4. History of PUD 5. Alcohol abuse 6. Concomitant glucocorticoids and/or anticoagulants
49
What are the Class DDIs of NSAIDs?
1. Warfarin 2C19 w/Celecoxib 2. All Anticoagulants 3. Probencid: decrease NSAID excretion 4. Lithium: increased lithium levels 5. Anti HTN Agents: NSAIDs decrease their effect 6. Loop Diuretics: NSAID reduce their efficacy 7. ACE Inhibitors: nephrotoxicity due to additive effects 8. High dose Methotrexate 9. Systemic Steroids 10. ASA: reduced cardioprotective effect, bleed risk
50
How can NSAIDs cause an AKI when used with ACE Inhibitors?
ACE: efferent dialate NSAID: afferent constrict = lower pressure and lower filtration = reduced eGFR
51
Naprosyn/Aleve | Naproxen
LONG ACTING Do not crush 500-1000 mg/day Daily dose usually split BID; may rarely increase to 1500 mg/day
52
Motrin/Advil | Ibuprofen
SHORT ACTING 1200-1300 mg/day Daily dose split 3-4x a day
53
Lodine | Etodolac
SHORT ACTING Do not crush
54
Voltaren | Diclofenac
SHORT ACTING Oral/Ophthalmic/Topical Gel Up to 200 mg/day
55
Clinoril | Sulindac
Prodrug LONG ACTING
56
Feldene | Piroxicam
LONG ACTING PO QD
57
Indocin | Indomethacin
SHORT ACTING Take w/food, milk, or antacids Up to 200 mg/day Daily dose usually split 2-3x a day ER: Up to 150mg/day
58
Toradol | Ketorolac
ORAL can only be given after first receiving a parenteral dose 5 DAY LIMIT ON DOSING DUE TO INCREASED ADEs CI: Pentoxifylline/Probenecid = severe renal impairment SHORT ACTING IM = 60 mg once, than 30 mg q 6h IV = 30 mg once, than 30 mg q 6h PO = 20 mg, then 10 mg q 4-6h Lower doses for those >65 yrs and/or <50 kg
59
Relafen | Nabumetone
Prodrug LONG ACTING
60
Celebrex | Celecoxib
SHORT ACTING DDI: Warfarin, 2C19 Fluconazole OA: 200 mg/day, either QD or BID RA: 200-400 mg/day, BID
61
Mobic | Meloxicam
LONG ACTING 7.5-15 mg PO QD
62
Disalcid | Salsalate
Inhibits prostaglandin synthesis Lacks effect on platelet function
63
Zyloprim | Allopurinol
100-800 mg daily Doses >300 mg may be given in divided doses CI: HLAB5801 positive DDI: Azathioprine
64
Methotrexate
Folate Antagonist IM/SQ/PO RA, once weekly dosing BBW: bone marrow suppression, hepatotoxicity, infection, etc. CI: pregnancy DDI: NSAIDs AE: N/V, diarrhea, photosensivity Monitor: CBC, LFTs, SCr/BUN
65
Plaquenil | Hydroxychloroquine
SLE, RA Warning: cardiomyopathy, bone marrow suppression, retinal toxicity AE: GI Upset Monitoring: CBC and opthalmologic PC: take with food or milk, watch for vision changes, do not crush 200-400 mg QD or BID MAX 400 or >5mg/kg/day whichever one is lower
66
JAK Inhibitors
Warning: serious infections (zoster), lymphoma, malignancies, thrombosis (DVT/PE), and tuberculosis XELJANZ/Tocacitinib
67
Humira | Adalimumab
TNFa Inhibitor CD, UC, RA, and Psoriasis
68
Muscle Relaxants
CI: Concomitant CNS Depressants Primarily for short term use
69
Flexeril | Cyclobenaprine
Indication: painful MS conditons CI: CHF, arrhythmias, acute MI AE: drowsiness, dizziness, dry mouth, fatigue
70
Robaxin | Methocarbamol
Indication: painful MS conditons AE: drowsiness 3-4 g/day QID Doses of 6g/day for the first 2-3 days up to 8g
71
Norflex | Orphenadrine
Indication: Painful MS conditions CI: conditions aggravated by anticholinergic effects (glaucoma or GI obstruction) AE: drowsy, dizzy, dry mouth Do not crush or chew
72
Skelaxin | Metaxalone
Painful MS Conditions CI: impaired hepatic/renal function AE: drowsy, dizzy, nausea Warning: serotonin syndrome
73
Soma | Carisoprodol
Painful MS Conditions AE: drowsy, nausea WARNING: SEIZURES or Central Depressant Activity (abuse)
74
Zanaflex | Tizanidine
RENAL DOSE ADJUST CI: Fluvoxamine or Cipro 1A2 inhibitors AE: hypotension and abnormal LFTs
75
Lioresal | Baclofen
RENAL DOSE ADJUST CI: do not DC abruptly = hallucinations/seizures DDI: CNS depressants AE: URINARY RETENTION

Pharmacy Practice V (19 decks)

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