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Pharmacology (Dale Turley) > Octreotide, Loperamide, Creon, URSO, Ribavirin, Rifaximin, Hemorrhoid agents > Flashcards

Octreotide, Loperamide, Creon, URSO, Ribavirin, Rifaximin, Hemorrhoid agents Flashcards

(55 cards)

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1
Q

Octreotide class?

A

Sandostatin

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2
Q

Octreotide sub-class?

A

diarhea, other endocrine / metabolism

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3
Q

What is Octreotide?

A

Man-made protein that is similar to a natural hormone in the body called somatostatin

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4
Q

Octreotide MOA?

A

Somatostatin antagonist

inhibits multiple hormones including growth hormone, glucagon, insulin, LH, and vasoactive intestinal polypeptide (VIP)

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5
Q

Octreotide MOA cont..?

A

Reduce blood flow

Inhibit gastric acid secretion

May have gastric cytoprotective effects

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6
Q

Indications for Octreotide?

A

Management of variceal bleeding

Used as adjunctive therapy before endoscopy, or when endoscopy is unsuccessful, contraindicated, or unavailable

Also used for acromegaly, carcinod tumor symptoms, diarrhea

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7
Q

Octreotide pharmacokinetics?

A

Metabolized liver CYP450

Half-life 1-2 hrs (increased by age, liver disease) cirrhosis

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8
Q

Octreotide cautions and interactions that must be considered?

A

Hepatic, Renal, Biliary disease

Arrhythmias, HTN, CHF exacerbation

Diabetics – hyperglycemia (endocrine and VIP actions)

Many drug-drug interactions

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9
Q

Octreotide pregnancy cat?

A

B

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10
Q

Octreotide facts?

A

Means to help stabilize patients before definitive therapy can be performed

Given IV 50mcg/hr

Unknown lactation

Peds with close monitoring

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11
Q

loperamide (Imodium)
 Class?

A

Anti-diarrheal’s

Opiate

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12
Q

Indictions for loperamide (Imodium)
?

A

diarrhea

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13
Q

loperamide (Imodium)
 MOA?

A

Inhibits peristalsis by direct effect on circular and longitudinal muscles of the intestinal wall

Increases viscosity and bulk

Diminishes loss of fluid and electrolytes

Increases sphincter tone

No analgesic opioid effect

Anticholinergic effects

**low K you need to check magnesium level , K based medications watch drug interactions *

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14
Q

loperamide (Imodium)
 dosing?

A

2 mg PO per dose
Start: 4 mg PO x1, then 2 mg PO after each loose stool; Max: 16 mg/day

Peds dosing by age

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15
Q

loperamide (Imodium)
 Pharmacokinetics?

A

Metabolized by Liver CYP450

Half-life 10 hr

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16
Q

loperamide (Imodium)
 interactions and cautions?

A

Toxic megacolon / paralytic ileus

Avoid with potassium based
drugs

Many drug-drug interactions

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17
Q

loperamide (Imodium) pregnancy cat?

A

C

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18
Q

loperamide (Imodium) special populations?

A

Lactation probably safe

Monitor in lever disease – toxicity

Peds dosing based on age parameters over 2 years old

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19
Q

Drugs Treating Pancreatic Insufficiency?

A

Pancrelipase (Creon, Pancreaze)

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20
Q

Pancrelipase (Creon, Pancreaze)

class?

A

Digestive Enzymes

pancreatic enzyme replacement products (PERPs)

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21
Q

Pancrelipase (Creon, Pancreaze)
 MOA?

A

commercial mixture of pig-derived pancreatic amylase, lipase and chymotrypsin

Pills disintegrate into trypsin, amylase, and lipase, which break down proteins, carbohydrates, and fats

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22
Q

Pancrelipase (Creon, Pancreaze)
 indications?

A

Exocrine pancreatic insufficiency

Chronic pancreatitis

Cystic fibrosis have increased incidence of pancreatic insufficiency

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23
Q

Pancrelipase (Creon, Pancreaze) story?

Study These Flashcards
A

Along with food, the CREON capsule enters the stomach.

Capsule releases enteric-coated spheres sized between 0.7 and 1.6 mm in diameter.

Enteric coating allows the spheres to travel beyond the low pH of the stomach through the pylorus, releasing enzymes into the small intestine at a pH ≥5.5.

CREON enteric-coated spheres dissolve in the small intestine, releasing pancreatic enzymes to mix with food.

CREON replaces enzymes missing in patients with EPI. In the small intestine, these enzymes work to break down fats, proteins, and carbohydrates in food.

24
Q

Pancrelipase (Creon, Pancreaze) dosing?

Study These Flashcards
A

Dosing

500-2500 lipase units/kg PO w/ meals/snacks
Peds dosing by age / weight

25
Pancrelipase (Creon, Pancreaze) pharmacokinetics?
Metabolized in GI tract, minimal systemic Half-life unknown
26
Pancrelipase (Creon, Pancreaze) interactions and cautions?
Pork allergy (Porkinetics aka Prokenetics) Gastric pH sensitive ( voided by concomitant use acid reducers) Caution with Gout, Renal Dz, Crohns Dz
27
pancrelipase (Creon, Pancreaze) pregnancy cat?
C
28
pancrelipase (Creon, Pancreaze) special populations?
Lactation safety unknown Peds dosing by age including infants
29
Ursodiol (Urso 250) class?
Hepatobiliary
30
Ursodiol (Urso 250) MOA?
decreases cholesterol synthesis, secretion, and absorption alters bile cholesterol composition (dissolve gallstones)
31
Indications for using Ursodiol (Urso 250)?
primary biliary cirrhosis steatohepatitis, non-alcoholic primary sclerosing cholangitis
32
Ursodiol (Urso 250) dosing?
Primary biliary / sclerosing cirrhosis Steatohepatitis (non-alcoholic)
33
Pharmacokinetics for Ursodiol (Urso 250)?
Metabolized by liver CYP450 | Half-life unknown
34
Ursodiol (Urso 250) interactions and cautions?
jaundice LFTs elevated leukopenia thrombocytopenia
35
Ursodiol (Urso 250) pregnancy category?
B
36
Ursodiol (Urso 250) special populations?
Pregnancy Cat. B Lactation unknown Ped’s not available
37
Treatment of HCV Infection?
Ribavirin (RBV, Rebetol)
38
Ribavirin (RBV, Rebetol) | MOA?
Inhibits viral RNA polymerase inhibiting protein synthesis Combined with interferon therapy Not for monotherapy
39
Ribavirin is often combined with ?
interferon therapy Not for monotherapy
40
BBW for Ribavirin (RBV, Rebetol)?
Hemolytic anemia May worsen cardiac disease teratogenic
41
Ribavirin (RBV, Rebetol) | pharmacokinetics?
Metabolized CYP450
42
_________ must be used together with an_______________ (such as Pegasys, PegIntron, Sylatron, or Intron A) to treat chronic hepatitis C.
Ribavirin interferon alfa product
43
Ribavirin (RBV, Rebetol) | for HCV information?
Dose: 400-700 mg PO bid dose may depend on wt; AASLD/IDSA hepatitis C guidelines Give w/ food peginterferon alfa 2a combo Caution with pts w/ CrCl <30 Refer to AASLD/IDSA hepatitis C guidelines
44

Rifaximin (Xifaxan)
 class?
anti-diarrheal, other antibacterial
45

Rifaximin (Xifaxan)
 MOA?
bacteriostatic; inhibits DNA-dependent RNA polymerase
46
Indications to use 
Rifaximin (Xifaxan)
?
Travelers diarrhea, E. coli-induced IBS, diarrhea-predominant
47
Pharmacokinetics of 
Rifaximin (Xifaxan)
?
Liver CYP450 Half-life 6 hr
48
Interactions and cautions that use be considered if using Rifaximin ( Xifaxam)?
C. difficile-assoc. diarrhea (optional) Superinfection peripheral edema Nausea, dizziness, fatigue, ascites, headache, muscle spasms, pruritus, abdominal pain *can create another suer infection in the gut *
49

Rifaximin (Xifaxan)
 pregnancy category?
Avoid 1st trimester otherwise probably safe Lactation unknown
50
Hemorrhoid Care medication example?
Anusol
51
What form does Anusol come in?
creams, ointments, and the suppository form
52
Active ingredient in Anusol ointment and suppositories is __________________.
zinc sulfate monohydrate
53
Anusol plus is zinc sulfate monohydrate and pramoxine HCL which is _________
antipruritic
54
Anusol HC suppositories?
added steroid
55
hydrocortisone/ lidocaine topical dose for hemorrhoid care?
Dosage forms:  0.5%/3%,1%/3% crm; 2.5%/3% gel

Pharmacology (Dale Turley) (31 decks)

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