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Unit 12 Drugs
Gastrointestinal Drugs
Question | Answer |
---|---|
What is the most common cause of PUD? What is the second most common cause of PUD? | H. pylori; use of NSAIDs |
What drug therapies are used to treat PUD? | Antibiotics, antisecretory agents, mucosal protectants, antisecretory agents that enhance mucosal defenses, and antacids. |
What is the best therapy for "curing" PUD? | Antibiotics (they can eliminate H. pylori and prevent recurrence of PUD) |
What antibiotics are used to treat PUD? | Amoxycillin (best),clarithromycin, bismuth (turns stool black), tetracycline (avoid with pregnancy and discolors teeth), and metronidazole (disulfiram-like reactions with alcohol use) |
To minimize emergence of resistance, what should be done when treated with antibiotics? | At least two antibiotics, and preferably three antibiotics, should be used simultaneously. This can prevent antibiotic resistance. |
Why should the use of Tagamet be used cautiously in older adults? | Can produce CNS effects, and it is more likely to occur in the elderly. The reactions can include confusion, halllucinations, CNS depression, and CNS excitation. |
How do antacids work to reduce PUD symptoms? | Neutralizes acid in the stomach. |
What are antacids primarily used for? | Used for the treatment of PUD and GERD. |
What drug is prescribed for treatement of gastric ulcers caused by long-term therapy with NSAIDs? | Misoprostol (Cytotec) |
What is a very serious adverse reaction to Misoprostol (Cytotec) is some patients? | This drug can stimulate uterine contractions and cause partial or complete expulsion of developing fetuses. |
How does Sucralfate (Carafate) promote healing of ulcers? | This drug creates a protective barrier against acid and pepsin. |
How often should antacids be taken and when? | Seven times a day (one hour and three hours after each meal) and once before bedtime. They should be taken separately of other medications (they can influence the dissolution and absorption of other drugs). |
Aluminum compounds have what effect on bowels? | Constipation |
Magnesium compounds have what effect on bowels? | Diarrhea |
Magnesium compounds can pose a risk in patients with ...? | Renal impairment |
What is the most common adverse effect when using Pirenzepine (Gastrozepine)? | Dry mouth |
What are the most common causes of constipation (i.e., in a person's diet)? | Insufficient fiber and fluids |
What drugs contribute to constipation? | Opiods, anticholinergics, and some anticids |
When are laxatives contraindicated? | Patients with abdominal pain, cramps, nausea, and conditions such as diveticulitis, ulcerative, colitis, regional enteritis, and appendicitis. Avoid in patients with impaction or obstruction -- can perforate. |
Why should laxatives not be used long-term? | Can easily habitually abuse them |
Why should pregnant women avoid laxatives? | May induce labor. |
Which clas of laxatives acts like dietary fiber? | Bulk-forming laxatives |
Bulk-forming and surfactant laxatives should be taken with what? | A full glass of water |
Treatment of opioid-induced constipation is a legitimate reason for use of ...? | Stimulant laxatives |
What is the risk of taking high doses of osmotic laxative (which is often done to empty bowel for diagnostic and surgical procedures)? | Dehydration (patient should increase fluid intake) |
Magnesium laxatives pose risk of magnesium toxicity in patients with ...? | Renal impairment |
What are significant adverse effects associated with the use of dopamine antagonists (e.g., Haldol)? | Hypotension, sedation, exrapyramidal symptoms, anti-cholinergic effects (dry mouth, urinary retention, constipation) |
Which drug class is most effective for treating emesis? | Serotonin antagonists |
What are the adverse effects of Scopolamine? | Dry mouth, blurred vision, drowsiness |
When should Nexium be taken? | 1 hour before a meal |
When should Prilosec be taken? | Just before first meal of the day |
When should Protonix be taken? | Can be taken without regard to food |