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ABSN NUR 326 > Week 5: GI Pharmacology > Flashcards

Week 5: GI Pharmacology Flashcards

(55 cards)

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1
Q

What is the drug therapies for GERD and PUD?

A

H2 receptor antagonists
Proton pump inhibitors
Mucosal protectants
Antacids
Antiemetics

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2
Q

What is the main goal of antacids and sucralfate?

A

increase protective factors

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3
Q

What is the main goal of H2 blockers, proton pump inhibitors and the treatment of H. pylori ?

A

decrease aggressive factors

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4
Q

Treatment got H. pylori

A

several antibiotics and gastric acid inhibitor for 10-14days

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5
Q

Why do we do combination therapy when treating H. pylori?

A

to minimize resistance

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6
Q

Why is it difficult for patients to adhere to the treatment of H. pylori?

A

because it is expensive! $200 for 12 pills

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7
Q

What drugs are H2 receptor antagonists?

A

cimetidine, and famotidine

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8
Q

H2 receptor antagonists MOA

A

block H2 receptors in the stomach, which reduces gastric acid by 60-70% causing stomach pH to increase

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9
Q

Indications for H2 receptor antagonist

A

GERD, PUD, ulcer prophylaxis, heartburn/dyspepsia

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10
Q

S/E of H2 receptor antagonist

A

well tolerated, CNS effects in elderly and slight increase risk for pneumonia in elderly

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11
Q

Drug interactions with H2 receptor antagonists

A

INHIBITS CYP450 enzyme (older agents NOT pepcid)

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12
Q

Safety considerations for H2 receptor antagonist

A

can increase levels of warafrin, phenytoin, and theophylline

Give IV form slowly to avoid bradycardia

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13
Q

What drugs are proton pump inhibitors?

A

omeprazole, pantoprazole, esomeprazole magnesium

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14
Q

MOA of proton pump inhibitors

A

binds to proton pump inhibiting the proton pump which inhibits the secretion of HCl

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15
Q

Indications for taking proton pump inhibitors

A

short term treatment of PUD and GERD

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16
Q

S/E of proton pump inhibitors

A

short term- relatively safe
long term- increased risk dor pneumonia, bone loss/ hip x, and stomach cancer

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17
Q

What class is sucralfate?

A

Mucosal protectant

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18
Q

MOA of mucosal protectants

A

alters when exposed to gastric acid to a sticky thick gel, working as a protective barrier for the stomach

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19
Q

Indication for mucosal protectants

A

duodenal and gastric ulcers

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20
Q

S/E of sucralfate

A

nothing major, some constipation

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21
Q

Drug interactions with sucralfate

A

decreased drug absorption, take meds 2 hours AFTER taking sucralfate

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22
Q

What are the 4 major forms of antacids?

A
  1. Aluminum (amphojel)
  2. calcium (tums/calcium carbonate)
  3. Magnesium (Milk of magnesia)
  4. Aluminum + Magnesium (Maalox/Mylanta)
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23
Q

MOA for antacids

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A

neutralize acid in the stomach by approximately 50%

e.g.
MgOH +HCl —-> MgCl +H2O

24
Q

Indications for antacids

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A

PUD (healing), GERD (symptoms), stress ulcers (prophylaxis)

25
S/E of antacids
diarrhea, constipation, and acid rebound
26
drug interactions with antacids
chelation, altered gastric absorption of many drugs
27
What are the 5 classes antiemetic (nausea) medications
1. serotonin blockers 2. antihistamines 3. anticholinergics 4. dopamine antagonists 5. prokinetics
28
What drugs are serotonin blockers?
ondansetron
29
What is the MOA of a serotonin blocker
blocks serotonin receptors in the trigger zone in the b brain and in the afferent vagal nerves in the stomach and small intestine serotonin causes nausea
30
What are the indications for taking a serotonin blocker?
N/V, especially if chemo/radiation induced
31
s/e of serotonin inhibitors
Common= mild headache, diarrhea, dizziness severe= serotonin syndrome (so be aware of drugs that affect serotonin)
32
What drugs effect serotonin? So must be careful with serotonin inhibitors
SSRI (citalopram), SNRIs (duloxetine), TCAs (amitriptyline), MAIs. buspirone, and tramadol
33
What drugs are antihistamines?
dimenhydrinate, meclizine, and hydroxyzine
34
MOA for antihistamines
blocks the release of histamine H1 receptors in the inner ear
35
Indications for antihistamines
dizziness and nausea. usually associated with motion sickness
36
S/E of antihistamines
sedation, drowsiness, dizziness and anticholinergic effects FALL RISK
37
What drugs are dopamine antagonist?
metoclopramide
38
MOA of dopamine antagonists: prokinetic agent
blocks dopamine receptors increases the tone of the lower esophageal sphincter increasing peristalsis in both the stomach and duodenum
39
Indications for dopamine antagonists: prokinetic agent
N?V associated with chemo/radiation/opioids, GI motility issues, and paralytic ileus
40
S/E of dopamine antagonists
sedation, extrapyramidal symptoms, restlessness, neuroleptic malignant syndrome
41
What are extrapyramidal symptoms?
-akathisia: may feel restless -acute dystonia: involuntary muscle contractions - parkinsonism -tardive dyskinesia -Neuroleptic malignant syndrome
42
What are the antidiarrheal medications?
diphenoxylate with atropine, and loperamide
43
what is the MOA for diphenoxylate with atropine, and loperamide
decrease intestinal peristalsis reducing the intestinal effluent
44
S/E of diphenoxylate with atropine, and loperamide
drowsiness and constipation, fall and drive risk, anti-cholinergic effects of the atropine SERIOUS: cardiac arrest/arrhythmias
45
What drugs are in the class 5-aminosalicylates?
sulfasalazine
46
Indications for taking sulfasalazine
mild to moderate IBD
47
MOA of sulfasalazine
coverts the intestine into 5-aminsalicyclic acid and sulphapyridine
48
Why do some with IBD prefer to take just mesalamine?
because sulphapyridine does nothing for IBD and has s/e that pt don't like
49
S/E of sulfasalazine
nausea, fever, rash, headache, hematologic disorders
50
Who can NOT take sulfasalazine?
those with sulfa allergies and those with certain anemias
51
What drug is a DMARD?
infliximab
52
MOA for DMARDs
monoclonal antibody which neutralizes TNF-alpha
53
Indications for taking DMARDs
There are lots but for this section IBD
54
S/E of DMARDs
IMMUNE SUPPRESSION, infection, heart failure, infusion reactions, and neutropenia
55
What is often required when taking DMARDs?
therapeutic drug monitoring and biomarker monitoring for inflammation

ABSN NUR 326 (10 decks)

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