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D&T 4: Exam 2 > Pharm > Flashcards

Flashcards in Pharm Deck (36)
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1
Q

H2RA excreted exclusively by the kidney

A

Nizatidine

2
Q

Lanosoprazole

A

PPI indicated for use in pts. who have an NSAID-induced gastric ulcer BUT require the NSAID still

3
Q

Omeprazole ADRs

A

Mild; CYP-inhibitor

*Inhibits fnxn of clopidogrel though so possibility of thrombi

4
Q

Who should you avoid giving misoprostol to?

A

Pregnant women; it is a PGE2 analog so it can induce uterine contractions

5
Q

Bismuth compounds

A

MOAs: Coats ulcers, increases mucous and HCO3- secretion, inhibits pepsin activity, AND antibacterial towards H. pylori
-Heals ulcers much better than H2RAs

ADRs: Darkens oral cavity due to formation of H2S

6
Q

Metoclopromide

A

MOA: Combined cholingergic agonist and dopaminergic antagonist
=»Increased esophageal contractions and increased LES tone

-Used for symptomatic GERD but not good if ulcerative

ADRs: Tardive dyskinesia; hyperprolactinemia

7
Q

3 stages of GERD tx

A

I: Sporadic- tx w/ lifestyle modifications and possibly H2RAs or antacids

II: Frequent- 2-3 episodes/week; tx w/ PPIs

III: Chronic: - >3 episodes/week; PPIs daily

8
Q

Laxation

A

Evacuation of formed fecal material from the rectum

9
Q

Catharsis

A

Evacuation of unformed, water fluid from the entire colon

10
Q

Lactulose

A

Non-absorbable sugar that induces osmotic effects in the SI lumen to retain water

Sorbitol and mannitol can also do this

11
Q

Bisacodyl

A

Stimulant laxative that upregulates mucosal water and electrolyte secretion

12
Q

Castor oil

A

Surfactant laxative that decreases he surface tension of the stool causing mixing Of aqueous and fat substances in the stool to soften the stool

***Is cleaved to ricinoleic acid that decreases the net absorption of fluid/electrolytes and stimulates peristalsis (not commonly used because of this)

-Docusate works the same way

13
Q

Lubiprostone

A

Metabolites of PGE1 that acts to open Cl- channels on the GI epithelium; accelerates the transit time of stool

-Can be used to tx opioid induced constipation

14
Q

Linaclotide

A

Guanylate cyclase C-substrate that results in the increased activity of CFTR channels on the luminal membrane

*Black box warning =» diarrhea, abdominal pain, flatulence

15
Q

Loperamide

A

u-receptor activity that increases stool transit time and decreases passage of stool; works like diphenoxins

DOC for moderate-severe traveler’s diarrhea in conj. w/ antimicrobial

-Poor CNS penetration

16
Q

Bismuth Subsalicylate

A

Pepto-bismol; used for mild traveler’s diarrhea

Bismuth=antibacterial

Salicylate=anti-inflammatory

17
Q

Octreotide

A

Used to tx. secretory diarrheas brought on by hormone secreting tumors of the pancreas and GI tract

-Also for AIDs, chemotherapy diarrhea

18
Q

IBD Treatment

A

Mild: Topical corticosteroids, Antibiotics

Moderate: Oral corticosteroids, methotrexate (immune modulators), anti-TNF

Severe: IV-corticosteroids, anti-TNF, cyclosporine, Natalizumab (anti-alpha4 integrin)

19
Q

Simethicone

A

Surfactant that is administered alongside antacids to decrease foaming and esophageal reflux

20
Q

Candidates for weight loss medication

A

BMI > 30

BMI > 27 w/ risk factors (DM, HTN)

21
Q

Orlistat

A

Gastric and pancreatic lipase inhibitor; will cause malabsorption symptoms but safer for pts. w/ HTN than amphetamines

22
Q

Liraglutide

A

GLP-1 receptor agonist; only injectable FDA-approved non-amphetamine weight loss drug

ADRs: ***Colon cancer, nephrotoxicity, thyroid cancer (black box)

23
Q

Locaserin

A

5-HT3 agonist used for weight loss; can cause serotonin syndrome, neuroleptic malignant syndrome, but more commonly N/V and dry mouth, possibly euphoria

24
Q

Phentermine/topiramate

A

Increases HR, insomnia, suicidal ideation, dizziness

-Do not use in HTN, CVD

25
Q

Naltrexone/buproprion

A

Only weight loss drug w/ black box warning for suicide, HTN, seizures, vomiting, dry mouth

-Can’t give to narcotic abusers

26
Q

Candidates for gastric bypass

A

BMI >35 w/ comorbidities (DM, HTN, Sleep apnea)

BMI >40

-Can receive gastric sleeve, lap band, Roux en Y (in which esophagus basically diverts so SI), and biliary diversion

27
Q

Vbloc Maestro

A

Generates electrical pulse that blocks vagal stimulation of hunger

28
Q

Al(OH)3 and Mg(OH)2 effects

A

Al=constipation

Mg=diarrhea

  • Can cause hypophosphatemia
  • Can cause renal dysfnxn due to altered electrolyte levels
  • Decreased bioavailability of some durgs (iron, isoniazid, ketoconazole, theophylline)
29
Q

H2RAs benefit

A

Very good at inhibiting nocturnal gastric acid secretion

30
Q

Sucralfate

A

Forms a sticky coat on existing peptic ulcers and forms a protective barrier; also stimulates some PGE2 prod.

***Must have a ph

31
Q

Mineral Oil

A

Non-absorbed lubricant oil that softens the stool BUT can cause deficiency of fat-soluble vitamins

*If aspirated, can cause pneumonitis

32
Q

Parasite infection often confused w/ TB

A

Paragonomus westermani; is contracted by eating shellfish in Japan or some shit like that (Man-snail-crab-man)

  • Parasite is absorbed, coughed up, and swallowed to pass more eggs
  • While in the lungs, it can form an abscess that appears similar to TB and pt. will cough up rust-colored sputum

Tx: Praziquantel

33
Q

Parasite that increases risk of cholangiocarcinoma

A

Clinorchis sinensis; man-snail-freshwater fish-man (typically in east asia as well as paragonimus)

Clinical: Ascites, edema, cholangiocarcinoma, cirrhosis, epigastric pain

Egg has an operculum on it

34
Q

Amebic liver abscess

A

Caused by E. histolytica; typically produces a single abscess w/ increased AP and transaminases

***Appears as an elevated diaphragm on X-ray

*CAN rupture and produce pulmonary infxn (pleuritic pain, dyspnea, rusty sputum)

35
Q

If you hear something about beavers, campers, or St. Petersburg, Russia…

A

Giardia lamblia; you know what the poop is like and you know what the parasite looks like

Can possibly lead to reactive arthritis, lactose intolerance, diarrhea,

Tx: Metronidazole or promycin (pregnant)

36
Q

Nitazoxanide

A

Used to tx. crytposporidium infxn in immunocompetent pts.