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Tera's Pharm

LP3 Chapters Review

What are the nine categories for gastrointestinal drugs? -Antacids, -Agents for ulcers and GERD, -Gastric mucosal agents, -GI antispasmodic or anticholinergics, -Agents for IBD, -Antidiarrheal, -Antiflatulents, -Laxatives and cathartics, -Antiemetics
What does pyrosis mean? Heartburn
what does dyspepsia mean? acid indigestion
What percent of the population does pyrosis and dyspepsia effect? 40%
How do antacids work? They partially neutralize gastric hydrochloric acid
T or F: antacids are also used at times as supplemental agents in the management of esophageal reflux True
Antacid products may contain....? Aluminum, calcium carbonate, magnesium *most also contain sodium
Antacids should not be taken within __ hrs of taking other medications. 2 hrs
Antacids should not be taken for more than ___ weeks. 2 weeks * may cause GI bleeding, GI malignancy, and increase excess acid in the stomach
What conditions require the avoidance of antacids? Cardiac, renal, liver disease or fluid retention
What should patients with esophageal reflux who are taking medications be instructed to do to relieve their symptoms? Avoid constrictive clothing, treat obesity, reduce meal size, avoid laying down after meals, restrict alcohol use, eliminate smoking, and elevate the head of the bed during sleep.
The histamine receptors found in the stomach are called? H2 receptors
H2 receptor antagonists reduce gastric acid secretion by acting as ______ ______? histamine2 blockers
What does GERD stand for? gastroesophageal reflux disease
contraindications for H2 blockers? Renal disease, pregnancy, lactation
What is GERD caused by? Excessive reflux of acidic gastric into the esophagus, resulting in irritation or injury to the esophagal mucosa characterized by heartburn and acid indigestion.
PPI Proton pump inhibitor (antisecretory agent)
What are proton pump inhibitors used for ? (short term) the short term relief of GERD, the short term treatment of confirmed gastric and duodenal ulcers, and for erosive esophagitis and heartburn
Long term use of proton pump inhibitors? Severe GERD, preventing NSAID-induced ulcers, and hypersecretory conditions.
Patients undergoing ulcer therapy should be instucted regarding? -Avoid cigarettes, importance of communication with physician, reduce stress, take meds on regular basis, take meds as they are instructed.
How should sucralfate be taken? 1 hr before meals, on an empty stomach, and not within 2h of other meds
How should misoprostol be taken? With meals and at bedtime with food, and avoiding magnesium products to lessen the incidence of diarrhea.
How should PPIs be taken? On an empty stomach *rabeprazole and pentoprazole can be taken without regard to meals
Patients treated with bismuth subsalicylate should be instructed regarding: Do not take for longer than 48h or with fever, diet should be bland w/o roughage, get plenty of fluids, do not take if aspirin allergy, or if already taking an aspirin product, contact dr with any issues or blood in stool.
Patient info for antidiarrheal drugs: Short term use only (48h), get plenty of water, bland diet (BRAT)
Patients taking bulk forming laxatives info: Dissolve completely in water, administer immediately before thickening occurs
Patients taking stool softeners info: Discontinue with any diarrhea or abdominal pain, do not use longer than 1 week, interaction with mineral oil, take large quantities of water
Patients taking mineral oil info: Avoid prolonged use, interaction with docusate, never take at bedtime
Patients taking stimulant laxatives info: Strong warning on prolonged use and dependence.
Patient info for constipation issues high fiber diet, plenty of water, develop good bowel habits, exercise, use only mildest laxatives for a short amount of time
Side effects of antacids? constipation, diarrhea, kidney stones, osteoporosis, belching and flatulence
Contraindications of antacids? Hear failure, kidney disease, cirrhosis of liver, dehydration
side effects of h2 blockers? diarrhea, dizziness, rash, headache, mild confusion
Side effects of PPIs? diarrhea, constipation, nausea, vomiting, abdominal pain, increased risk for pneumonia or intestinal infection (C-dif)
How does misoprostol (a gastric mucosal agent) work? It inhibits gastric acid secretion and protects the mucosa from irritants
How does sucralfate (a gastric mucosal agent) work? It reacts with hydrochloric acid in the stomach to form a paste that adheres to the mucosa *taken on empty stomach
Helicobacter pylori plays a major role in the development of what conditions? gastritis, gastric and duodenal ulceration, and gastric cancer
side effects of salicylates anorexia, nausea, vomiting, diarrhea, dyspepsia, abdominal pain, headache, weakness, dizziness, rash
contraindications of salicylates allergy to salicylates, renal and hepatic impairment
glucocorticoids- example and what it is used for prednisone, used to treat IBD patients who are inadequately controlled with salicylates.
Side effects of bismuth subsalicylate constipation, discoloration of tongue and stool (black), ringing in ears
Opiate agonists- how do they work? by slowing intestinal motility
One of the most common causes of infectious diarrhea in the U.S. Clostridium difficile (C-dif)
Laxative used for? promote evacuation of the intestine and are used to treat constipation
Bulk forming laxatives work by? softening stool by absorbing water and increase fecal mass to facilitate defecation
Emollients work by? promoting stool movement through the intestines by softening and coating the stool
Saline laxatives work by? promote the secretion of water into the intestinal lumen
Stimulant laxatives work by? producing strong peristaltic activity, and may also alter intestinal secretions
Osmotic laxatives work by? drawing water from tissues into the feces and stimulates evacuation
Chloride channel activators are? a unique oral agent for the treatment of constipation. It increases intestinal fluid secretion by activating chloride channels in the intestinal epithelium
What are antiemetics used for? the prevention or treatment of nausea, vomiting, vertigo, or motion sickness
what are anticholinergics used for? prophylaxis of motion sickness
antidopaminergics are used for? nausea and vomiting
What does CTZ stand for? chemoreceptor trigger zone
serotonin-receptor antagonists are used for? control emesis, (pre-op and post-op), cancer patients
What does PONV stand for? post-operative nausea and vomiting
What does CINV stand for? chemotherapy-induced nausea and vomiting
What does MOM stand for? milk of magnesia
what does PEG stand for? polyethylene glycol
T or F, diphenoxylate with atropine (Lomotil) is a controlled substance? True
Most common antacids? calcium carbonate (Tums)
T or F: antacids decrease the absorption of other meds? True
H2 blockers have what common suffix? -tidine
PPIs should be taken how? before meals and swallowed whole
What comes first, H2 blockers or PPIs? H2 blockers
T or F: PPIs do not interact with cardiac meds? False
PPIs should be taken on an ____ stomach empty
What is the type of med used mainly for ulcers, and it inhibits pepsin? gastric mucosal agents
four main categories of reproductive hormones? gonadotropic, androgens, estrogens, progestins
reproductive hormones are secreted by? the pituitary gland
gonadotropic hormones include? (3) -follicle stimulating hormone (FSH) -luteinizing hormones (LH) -luteotropic hormone (LTH)
what do follicle stimulating hormones do? -stimulates the development of ovarian follicles in the female -stimulates sperm production in the testes
What do luteinizing hormones do? works with FSH to induce secretion of estrogen, ovulation and development
What do luteotropic hormones do? stimulate secretion of progesterone by the corpus luteum and secretion of milk by the mammary gland
androgens include? (2) testosterone and androsterone
routes for administering testosterone? buccal, parenteral, and transdermal ----topical is used first, and injection is used if topical doesn't work
androgens are used for? replacement, congenital and aquired hypogonadism, treatment of endometriosis and breast diseases
side effects of local testosterone? skin irritation, acne
where is local testosterone administered? inner thigh, tricep
follow up testing after testosterone administration? every 6 weeks
contraindications of androgens cardiac, renal, and liver dysfunction,diabetes
all non-combination products in the androgens class are classified as....? Clll controlled substances
phosphodiesterase inhibitors (PDE) are? a class of drugs given orally for the treatment of male ED, they work by relaxing smooth muscle increasing blood flow to the area
PDEs should not be used with what? nitrates or alpha-blockers(this combined with PDEs lower blood pressure)......also grapefruit juice
Estrogen is? the female sex hormone. produced in the ovaries and secondary in adrenal glands. responsible for secondary sexual characteristics, and secretion of hormones FSH and LH from pituitary gland
What is used to treat menopausal symptoms? Estrogen, along with progesterone( HT= hormone therapy)
ET stands for? Estrogen therapy
Estrogen alone has been linked with the risk of what condition? endometrial carcinoma
EPT stands for? estrogen and progestin therapy
Side effects of estrogen? thromboembolic disorders, hypertension, myocardial infarction, stroke
Progesterone is secreted by? the corpus luteum and adrenal glands
progestins are used? in the treatment of amenorrhea, endrometriosis, and functional uterine bleeding...also contraceptives
contraceptives work how? suppressing the release of the pituitary hormones (FSH and LH)
progestin only contraceptives work by? inhibiting ovulation, changing the amount of thickness of the cervical mucus to inhibit sperm transport
Patient education for contraceptives? backup needed within 1st month of oral and first two weeks with depo...take at same time everyday, use back ups with antibiotics, and ACHES
What does ACHES stand for? A-abdominal pain C-chest pain H-headaches E-eye problems S-severe leg pain
progestin-only contraceptives are recommended for patients who......? do not tolerate estrogen or in whom it is contraindicated.
progestin-containing IUD- example and coverage lasts for ___ years? Mirena, 5years
postcoital contraception must be administered within...? 72 hours
There are three ways to start contraception. list them. first day start, sunday start, today start. *most physicians do the sunday start
estrogen and progestin is used for....? birth control, replacement therapy, and certain cancers
How do you know that a med is a contraceptive? it has the term "estradiol" on the label
Created by: JenSaw77



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