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Pharmacology II > Quiz 4 > Flashcards

Quiz 4 Flashcards

(48 cards)

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1
Q

Describe intermittent dyspeptic symptoms & Tx

A

Occasional bloating, fullness, abd pain or heartburn
May be assoc. w/ overeating/drinking or consumption of certain foods
Tx - antacids, H2 antagonists

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2
Q

Describe non-ulcer dyspepsia & Tx

A

Abd pain similar to gastritis
Gastric ulcers/duodenal ulcers w/o demonstrable ulceration
GI motility abnormalities likely
Tx - Antacids, H2 antagonists

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3
Q

Describe gastritis & Tx

A

Epigastric pain maybe w/ N&V
From diffuse inflammation in the stomach
H. Pylori likely involved
Tx - Stop NSAIDS, antacids, H2 antagonists, antibacterial regimen

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4
Q

Describe gastric uclers & Tx

A

Diffuse gastric pain usually 1-3 hrs after eating
Distinct ulcerations in stomach
N&V, belching, anorexia
Tx - stop NSAIDS, H2 antagonists, PPI, Antibacterial, Misoprostol(if Pt can’t stop NSAIDS)

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5
Q

Describe duodenal ulcers & Tx

A

Diffuse epigastric pain typically w/ empty stomach, relieved by eating
Distinct ulcerations in duodenum
Tx - stop NSAIDS, H2 antagonists, PPI, antibacterial, sucralfate

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6
Q

Describe GERD & Tx

A

Occasional heartburn to persistent burning substernal pain
Occurs in recumbent position
Tx - antacids, H2 antagonists, PPI, prokinetic agents

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7
Q

What is the #1 best selling drug in the US?

A

Nexium (Esomeprazole)

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8
Q

Where do PPIs work?

A

on parietal cells
Shuts cell down for 18-24 hours
All prodrugs
Metabolized by CYP450

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9
Q

ADRs w/ PPIs

A
  1. Fx
  2. Interference w/ clopidogrel (Inc. risk of clot)
  3. Inc. risk of C. diff
  4. Diarrhea
  5. Abd pain
  6. HA
  7. Dizziness
    Long Term
  8. Inhibition of Ca absorption
  9. Rise in gastrin levels
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10
Q

Name the PPIs

A
  1. Nexium
  2. Prevacid
  3. Protonix
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11
Q

Name the H2 receptor antagonists

A
  1. Pepcid
  2. Zantac
  3. Tagamet

Renally dosed - 50

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12
Q

What do H2 receptor blockers work best with?

A
  1. GERD

2. Peptic ulcer disease

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13
Q

ADRs H2 receptor antagonist

A
  1. Mental status changes
  2. Thrombocytopenia
  3. Endocrine issues
    Maybe drug interactions
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14
Q

How do gastric protectants work?

A

Complexes w/ protein-like exudate located at ulcerations
Covers ulcer area
Activated in acidic medium
Not abs. systemically

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15
Q

ADRs gastric protectant

A
  1. Constipation
  2. Rash
  3. Vertigo
  4. HA
  5. Insomnia
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16
Q

MOA antacids

A
  1. Neutralize/reduce gastric acidity
  2. Protects gastric mucosa
  3. Inc. gastric pH, inactivates pepsin
  4. Stimulates production of prostaglandins
    Very short 1/2 life
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17
Q

Types of antacids

A

NaCO3 - provides bicarb ion to neutralizes H+
Forms CO2 & NaCl
Can affect blood pH, sodium levels

CaCO3 - neutralizes gastric acid like Al &/or Mg
Less soluble
Slower reacting than NaCO3

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18
Q

MOA prostaglandins

A

Synthetic prostaglandin E1 analog that replaces gastric prostaglandin
Dec. gastric acid secretion
Avoid in pregnancy

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19
Q

What type of ulcers does H. pylori cause?

A

Duodenal

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20
Q

Tx of H. pylori

Study These Flashcards
A
  1. PeptoBismol
  2. Metronidazole
  3. H2 blocker
21
Q

Which antinauseants prolong the QT interval?

Study These Flashcards
A
  1. Prochlorperazine (Compazine)

2. Droperidol (Inapsine)

22
Q

MOA antihistamines

Study These Flashcards
A

Reversible competitive H1 receptor antagonists strongly bind to central muscarinic receptor sites to produce an antiemetic effect

23
Q

ADRs antihistamines

Study These Flashcards
A
  1. Sedation
  2. Anticholinergic effects
  3. Local effects on injection
  4. Death in kids?
24
Q

Which drugs can cause extravation?

Study These Flashcards
A

Antihistamines

If inject outside of vein it will destroy the surrounding tissue

25
MOA Dopamine blockers
Blocks dopamine in chemoreceptor trigger zone
26
ADRs of dopamine blockers
1. Extrapyrimidal side effects (ex. torticollis) 2. Sedation 3. Anticholinergic effects 4. Reye's syndrome in kiddos
27
MOA 5HT3 blockers
Block serotonin at the 5HT3 receptor sites in the CTZ & peripheral sites
28
ADRs 5HT3 blockers
1. HA 2. GI (diarrhea, dyspepsia, constipation) 3. Brady/tachycardia
29
Name the antihistamines for N&V
Phenergan (Promethazine)
30
Name the dopamine blockers for N&V
1. Compazine (Prochlorperazine) | 2. Reglan (Metoclopramide)
31
Name the 5HT3 blockers
1. Zofran (Ondansetron)
32
MOA Neurokinin 1 antagonists
Inhibition of the substance P/neurokinin 1 (NK1) receptor Many drug interactions
33
ADRs Neurokinin 1 antagonists
1. Fatigue 2. Nausea, constipation 3. Weakness 4. Hiccups
34
Name the Neurokinin 1 antagonists
1. Emend (aprepitant)
35
Which antinauseant is used long-term?
Decadron (dexamethasone) | Corticosteroid
36
What is the Rome III criteria?
If 2/+ Sx occur for the most recent 3 mo period & Sx onset at least 6 months prior to Dx: 1. Straining for 25% or + of defecations 2. Lumpy or hard stools in 25% or more of defecations 3. Sensation of incomplete evacuation in 25% or more of defecations 4. Sensation of anorectal obstruction/blockade in 25% or more defecations 5. Manual maneuvers to facilitate 25% or more 6. <3 defecations per week
37
MOA, ADR, Onset of action of Bulk-forming laxativess
ex. Metamucil - psyllium Fiber draws liquid into fecal mass & inc. bulk, bulk stimulates evac Abd. cramping, GI plugging, distention, flatulence 12-72h
38
MOA, ADR, onset of action of detergent laxatives
ex. Colase - docusate sodium Detergent action allows mvmt of water into fecal mass Rare ADRS, diarrhea, abd cramping 12 hours to 5 days
39
MOA, ADR, onset of action for stimulant laxatives
Ex. Dulcolax (Bisacodyl) Senokot-S (Senna) Irritation of musculature or colonic intramural plexus, stimulation of secretion of water & electrolytes Perianal irritation, severe cramping, incontinence, malabsorption, elecrolyte/fluid disturbances Oral - 6-10h Rectal 15-60 min
40
MOA, ADR, onset of action of hyperosmolars
Ex. Miralax (Polyethylene glycol) Pull water into gut lumen Abd cramping, bloating, flatulance, rectal irritation, incontinence Oral - 48-96h
41
MOA, ADR, onset of action saline laxatives
Ex. Fleets enema Draws water into intestine, inc. intraluminal pressure, mechanical stimulus to inc. intestinal motility Excessive diuresis, N&V, dehydration, incontinence, electrolye disturbance Oral - 3-6h Rectal 2-5mins
42
MOA, ADR, contraindication, use guanyl cyclase-C agonist
``` Linaclotide (Linzess) Local action that inc. levels of cCMP Severe diarrhea Contraindicated w/ known/suspected mechanical GI obstruction Used w/ IBS (laxative) ```
43
How do you treat opiod-induced constipation?
Methylnaltrexone (Relistor) | Injectable, SubQ w/in 24h
44
What is diarrhea?
Inc. in frequency of defecation (>3/day) assoc w/ 1. Inc. stool vol (>300 mL) 2. Inc. fluidity 3. Abnormal sensations such as urgency/pain
45
FDA standards for diarrhea
1. PeptoBismol 2. Imodium 3. Kaolin
46
MOA, ADR bismuth salts
Ex. PeptoBismol (bismuth subsalicylate) Antisecretory effects (salicylate) & antimicrobial effect (bismuth), anti-diarrheal Abs. of salicylate is very good, risk of Reyes
47
MOA, ADRs of opiates for anti-diarrheals
Ex, Opium tincture, paregoric, diphenoxylate w/ atropine Dec. in digestive secretions, inc. in GI muscle Drowsiness, dizziness, N&V, respiratory depression, HOTN
48
MOA, ADRs or opiod-like agents
Ex. Loperamide (Imodium) Dec. motility of the GI tract through a depressant effect on the longitudinal & circular muscles of the intestinal wall CNS effects, Dry mouth, hypersensitivity rxns, Constipation

Pharmacology II (10 decks)

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