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Flashcards in Jen's GI pharm Deck (52):
1

Bind bile acids and inhibit peptic activity. Promote angiogenesis in injured mucosa. Heavy metals suppress H. pylori

antacids

2

General class of pharm treatment that antacids interfere with

antibiotics

3

Inhibit acid secretion by blocking histamine H2 receptors on the parietal cell

MOA of H2 blockers

4

Can rarely cause gynecomastia and impotence, oolymyositis, Interstitial nephritis. Cleared through the P450 system so has multiple drug interactions

Cimetidine

5

Prevents chemical induced mucosal damage. Heals chronic ulcers

Sulcralfate (Carafate)

6

Binds to the ulcer base best at a pH below 3.5 so should be administered 30-60 min prior to meals

Sulcralfate (Carafate)

7

Should not be administered in combination with aluminum antacids in patients with renal failure. No administration w/citrate containing compounds

Sulcralfate (Carafate)

8

What is the suffix for all proton pump inhibitors?

-azole

9

What are the generic names for the proton pump inhibitors?

Prilosec, prevacid, protonix, nexium, kapidex, aciphex

10

MOA of proton pump inhibitors

blocks acid secretion of parietal cells

11

At what time of day should PPIs be admininstered?

before the first meal of the day

12

PPI with the lowest potential for P450 drug interactions

Pantoprazole (Protonix)

13

PPIs metabolized via CYP2C19 and have the greatest potential for drug interactions

Omeprazole (Prilosec, Zegrid) and esomeprazole (Nexium)

14

Common blood thinner that has a significant interaction with omeprazole

clopidogrel (Plavix)

15

Long term administration of PPIs may increase the incidence of what two infections

c. difficile and pneumonia

16

Long term administration of PPIs may lead to the malabsorption of what dietary elements?

B12, Mg+ (magnesium), and Fe (iron)

17

Suppresses H. pylori infection. Not helpful in treatment of non H pylori induced ulcers

Bismuth

18

Inhibition of peptic activity but not pepsin secretion. Recruits macrophages to the edge of the ulcer crater to promote healing

Bismuth

19

First line therapy for gastroparesis for no longer than 12 weeks unless benefits outweigh risks

Metaclopramide (Reglan)

20

Improves gastric emptying by increasing gastric antral contractions and decreasing postprandial fundus relaxation

Metaclopramide (Reglan)

21

Dopamine receptor antagonist. 5-HT4 agonist. Weak 5-HT3 receptor antagonist

Metaclopramide (Reglan)

22

Extrapyradimal side effects associated with metaclopramide (Reglan)

dystonia and tardive dyskinesia

23

Name the phenothiazines that can be used as antiemetics because of their effects as dopamine receptor antagonists

Prochlorperazine (Compazine) and Promethazine (Phenergan)

24

What is the treatment for EPS side effects that can be caused by phenothiazines?

Benadryl or Cogentin

25

Which phenothiazein has a higher incidence of EPS side effects?

Prochlorperazine (Compazine)

26

Great for postoperative and chemotherapy induced emesis. Does poor job with vestibular system etiology. Commonly given 30" prior to chemo tx.

Serotonin 5-HT3 Antagonists

27

What is the suffix for Serotonin 5-HT3 Antagonists?

-setron

28

What are the generic names for Serotonin 5-HT3 Antagonists?

Zofran, Kytril, Anzemet, Aloxi

29

caution for serotonin syndrome, QT prolongation, monitor liver function tests if prolonged use

Odansetron (Zofran)

30

What is the antiemetic that is also good for treating pruritis?

Hydroxyzine (Atarax, Vistaril)

31

Contraindications for the use of Antihistamines/Anticholinergcs as antiemetics

narrow angle glaucoma, asthma, prostatic hypertrophy

32

Only for symptomatic treatment of patients with acute diarrhea in whom fever is absent or low grade and the stools are not bloody

Loperamide (Imodium)

33

Bile acid-binding agent used for hyperlipidemia. Good for diarrhea post-cholecystectomy

Cholestyramine (Questran)

34

First line pharmacotherapy for the treatment of constipation

Psyllium (Metamucil) and
Ducosate sodium (Colace)

35

First line pharmacotherapy for the treatment of constipation used for infants

Glycerin

36

Not systemically absorbed. Bind to the fecal contents and pull water into the stool. Softens and lubricates the stool. NEEDS TO BE TAKEN WITH WATER

Bulk forming agents (ie Metamucil)

37

What bulk forming agent can decrease absorption of tetracycline and quinolones?

Fibercon

38

Surfactant laxatives. Reduces the surface tension of the liquid contents of the bowel. Commonly referred to as “stool softeners”

Ducusate derivatives

39

Use for patients who should not strain with bowel movements and for those on narcotics. Only prevent constipation – don’t treat

Ducusate derivatives

40

Is a saline laxative. Draws water into the bowel through osmosis. Increases intraluminal pressure & motility.

milk of mangesia

41

Use if failed bulk forming agents, mangnesium hydroxide (MOM). Hyperosmotic laxatives. Use with caution in diabetics

Lactulose or sorbitol

42

Not for long term use. Increase peristalsis through direct effects on the smooth muscle of the intestines. Promote fluid accumulation in the colon and small intestine

Senna (Senokot) and Bisacodyl (Dulcolax)

43

Contraindications to Senna (Senokot) and Bisacodyl (Dulcolax)

surgical abdomen, fecal impaction

44

Used for bowel prep for endoscopy procedures

Magnesium citrate

45

Considered best for colonic disease, although also considered 1st line therapy for Crohn’s

Sulfasalazine (Asulfidine)

46

Often used with proximal intestinal Crohn’s

Mesalamine (Asacol, Pentasa)

47

Blocks prostaglandin production. Perhaps interferes with production of inflammatory cytokines. May inhibit natural killer cells, lymphocytes and macrophages

aminosalicylates

48

Immune modulator with short half life that is pregnancy category D

6-mercaptopurine

49

Has drug toxicity with concurrent use of Allopurinol

immune modifiers

50

Immune modifier that is pregnancy category X and Inhibits the metabolism of folic acid

methotrexate

51

Name the TNF inhibitor that neutralizes TNF that is a last ditch effort in severe Crohn's

Infliximab (Remicade)

52

Black box warning of Infliximab (Remicade)

Reactivation of latent TB