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Flashcards in Pharm Deck (50):
1

H2 blockers MOA

reversibly inhibit H2 receptors of gastric parietal cells (decrease acid secretion)

2

mild and intermittent GERD first line tx

OTC PPI, H2RA, antacid

3

you should consider rx strength PPI if GERD lasts longer than how long?

how long do they take it initially?

2 weeks

4-8 weeks

4

antacids MOA

increase pH of stomach (neutralize existing acid); decreased activation of pepsinogen

5

can calcium carbonate be used in preggers?

yep

6

you might not want to give sodium bicarb to patients with heart failure. why?

can cause Na overload, fluid retention

7

which antacid has the longest duration but slightly slower onset

calcium carb

8

H2 receptor antagonist place in therapy

mild/moderate and FREQUENT sxs

9

what H2 receptor blocker should you NEVER use d/t drug-drug interactions

cimetidine (CYP inhibitor)

10

do you need to adjust H2 receptors for renal function

sure do

11

PPIs MOA

irreversibly inhibit H+/K+ ATPase pump in parietal cells

12

what should you use for frequent GERD and erosive disease?

PPI

13

PPIs are enteric coated. what pt education relates to this?

do NOT crush tablets

14

what risks are associated with PPIs (newer data)

1. fractures
2. c.diff infections
3. pneumonia
4. hypo-Mg

15

what's a big drug-drug interaction with omeprazole & esomeprazole?

clopidogrel !

16

antacids, H2RA, PPI ... which class is associated with constipation & diarrhea

antacids

17

if patient has ESRD, what should you be worried about with antacids?

metal accumulation

18

your pt is on daily PPI, but he is having sxs at night. what can you tell him?

take it BID

19

1st line for PUD?

PPI
Bismuth subsalicylate
Metronidazole
Tetracycline
(PBMT)
OR
PPI
amoxicillin
metronidazole
clarithromycin
(PAMC)

x 14 days

20

if positive h.pylori dx, do you have to treat?

oh yeah

21

your pt is being treated for heliobacter and has dark tongue and stool. what med is responsible?

bismuth subsalicylate

22

pt education for metronidazole?

avoid ETOH during and 72 hours AFTER (disulfiram rxn)

23

pt takes nsaids chronically. are they more at risk for duodenal or gastric ulcers?

gastric

24

when should you consider adding a PPI for pts taking NSAIDs?

moderate risk (age >65, high dose of NSAID, hx ulcer, concurrent ASA, steroids, anticoags)
high risk: hx of ulcer and multiple risk factors, steroids, anticoags

25

sucralfate (carafate) MOA and indication

forms complex that covers ulcer; indicated ONLY for duodenal ulcers

26

main ppx drug for stress ulcer prophylaxis (esp in ICU)

H2RA

27

heart AE of clarithromycin

QTc prolongation

28

what meds can cause constipation?

opioids
anticholinergics
CCBs
iron
aluminum antacids
5-HT3 antagonists

29

can saline laxatives be used on a daily basis?

no (can cause dependency, esp. if enema route)

30

what might occur if mineral oil is routinely used (especially in elderly or children <6)?

aspiration and lipoid pneumonia risk

31

emollient laxative: mush or push?

only a mush (ie, prevent constipation, but doesn't move poo along)

32

bulk laxatives MOA

1. increase stool bulk
2. decrease transit time
3. increase motility

retain water

33

saline/osmotic laxatives MOA

pulls water into intestines along osmotic gradient

34

stimulant laxatives MOA

increase motility
increase secretion
direct agitation

35

docusate MOA

surfactant action; secretion

36

antimotility agents should not be used for what type of diarrhea?

acute bacterial due to toxic megacolon risk

37

what is the MOA of loperamide, diphenoxylate/atropine, paregoric

works like an opioid; slows intestinal transit

38

what is the MOA of dicyclomine and hycoscyamine?

anti-cholinergic/ antimuscarinic; blocks activity

39

with N/V, what types of meds are good for motion sickness?

antihistamines/ anticholingerics

40

phenothiazines MOA

block D2 receptors

41

is IV preferred with phenothiazines? why or why not?

NO
severe tissue damage risk

42

phenothiazines AEs

extrapyramindal sxs, sedation, anticholinergic effects, QTc prolongation, neuroepiletic malignant syndrome, seizure

43

what are 4 5HT3 receptor antagonists?

granisteron (PO), ondansetron (PO), palonosteron (IV),
dolastron (IV)

44

what N/V treatment is SOC for CINV, PONV, RINV?

5HT3 receptor antagonists

45

what is useful in delayed CINV (3)

1. steroids
2. neurokinin-1 antagonists
3. serotonin inhibitors

46

what N/V drug is best in gastroparesis?

metoclopramide (reglan)

47

what N/V drugs are good for anticipatory N/V?

benzodiazepines

48

how does famotidine work?

reversibly inhibit H2

49

what does clopidogrel interact with?

PPIs

50

what medication should be avoided in patient taking Harvoni?

PPIs