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Chap. - 16
PharmacologyHSC1149
| Question | Answer |
|---|---|
| antacids, drugs to treat ulcers, antispasmodics, management of IBD, antidiarrheal agent, antiflatulents, laxatives/cathartics, & antiemetics | categories of GI drugs based on action |
| act by partially neutralizing gastric hydrochloric acid & available in many OTC preparations for relief of indigestion, heartburn, & sour stomach | antacids |
| antacids are also prescribed to help relieve pain & promote __ of gastric & duodenal ulcers | healing |
| drug that reduces gastric acid secretion, or that acts to prevent/treat gastric or duodenal ulcers | antiulcer agents |
| antacids may contain aluminum, __ __, or magnesium either individually or in combination | calcium carbonate |
| is not recommended alone because of flatulence, metabolic alkalosis, & electrolyte imbalance w/prolonged use | sodium bicarbonate |
| __ carbonate (Tums) may cause constipation | calcium |
| __ alone can cause diarrhea | magnesium |
| __ alone is constipating | aluminum |
| combination antacids are frequently used to control the frequency & __ of bowel movements | consistency |
| Maalox, Gelusil, Mylanta are examples of | combination antacids |
| choice of specific antacids preparation depends on palatability, cost, adverse effects, __ __ __, sodium content, & patient's renal & cardiovascular function | acid neutralizing capacity |
| side effects of frequent use of antacids with aluminum or calcium carbonate is | constipation |
| side effects of frequent use of antacids can include __ __ & renal complications | urinary calculi |
| __ is a side effect of frequent use of antacids w/aluminum | osteoporosis |
| side effects of use of antacids with calcium carbonate & sodium bicarbonate include | belching & flatulence |
| for patient's w/CHF, renal pathology/history of renal calculi, cirrhosis of liver or edema the use of antacids is | contraindicated |
| antacids can cause dehydration or | electrolyte imbalance |
| antacids used w/administration of other drugs, used concurrently, can alter | effectiveness of other drugs |
| antacids should not be taken within 2 hours of | most other drugs |
| antacids may __ __ of the drugs: tetracyclines, quinolones, isoniazid, & other anti-infectives; digoxin, indomethacin & iron; salicylates & thyroid hormones | decrease effectiveness |
| antacids taken with diazepam will | increase sedation |
| antacids taken with amphetamines & quinidine will increase | cardiac irregularities |
| antacids taken with enteric-coated drugs may cause the medications to be released __ __ in the stomach | prematurely |
| enteric-coated drugs should be taken in __ __ from antacids by two hours | separate dose |
| patients taking meds in management of __ __ __ should be instructed regarding avoidance of constrictive clothing, treatment of obesity, avoiding recumbency after meals, & elevating head of the bed | esophageal reflex disease |
| name of antacid w/calcium | Tums |
| name of antacid w/magnesium | Milk of Magnesia |
| name of antacid w/aluminum | Amphojel |
| name of antacid w/combination of both magnesium & aluminum | Maalox |
| H2 blockers reduce gastric acid secretion by acting as __ blockers | histamine2 |
| cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac) are all | H2 blockers |
| H2 blockers are used __ for relief of acid indigestion and heartburn, GERD, & upper GI bleeding/esophagitis | short-term |
| can include diarrhea, dizziness, rash, & headache | side effects from H2 blockers |
| in patient's taking Tagamet there is an infrequent occurrence of __ __, which is reversible | mild gynecomastia |
| H2 blocker side effects can include __ __ in older/debilitated adults, although rarely w/Pepcid | mental confusion |
| in adults >50yrs: reduction of gastric juices w/anti-ulcers agents, on a regular basis for extended periods, can deplete __ __, which is necessary for B12 absorption | intrinsic factor |
| can possibly lead to pernicious anemia, confusion, disorientation, & numbness of extremities; so a supplement may be required | B12 deficiency |
| H2 blockers are __ for patients with impaired renal function, liver dysfunction, children or pregnant/nursing | contraindicated |
| Tagamet & high doses of Zantac may cause __ __ __ in patients already taking Coumarin anticoagulants | increased blood concentrations |
| Tagamet may cause increased blood concentrations in patients already taking phenytoin, propranolol, diazepam, lidocaine, & | tricyclic antidepressants |
| Tagamet & high doses of Zantac may cause increased blood concentrations in patients already taking | theophylline |
| antacids may interfere with absorption of __ & __; separate administration by at least one hour | Tagamet & Zantac |
| H2 blocker with less drug interactions | Pepcid |
| synthetic analog of prostaglandin E1; inhibits gastric acid secretion & protects mucosa from irritant effect of certain drugs (such as NSAIDs), especially in older adults & those w/history of gastric ulcers | misoprostol (Cytotec) |
| misoprostol (Cytotec) in not FDA-approved for treatment of | gastric/duodenal ulcers |
| diarrhea, nausea, & abdominal pain may occur early in treatment w/misoprostol (Cytotec) & is usually __; can be taken with food to minimize side effect | self-limiting |
| begin misoprostol (Cytotec) therapy on 2nd-3rd day of next normal menstrual period in order to attempt prevention of | menstrual irregularities |
| misoprostol (Cytotec) can cause __ __, possibly incomplete, w/potentially dangerous uterine bleeding, maternal, or fetal death | spontaneous abortion |
| for women of child bearing age, pregnant woman, & children under 21yr misoprostol (Cytotec) is | contraindicated |
| misoprostol (Cytotec) taken w/ antacids can decrease | rate of absorption |
| antacids taken w/misoprostol (Cytotec) should be given at least 2h away & should not be a __ __, which exacerbates diarrhea | magnesium type |
| gastric antisecretory agent; proton pump inhibitor (PPI); used for short-term(4-8wk) relief of GERD, confirmed gastric/duodenal ulcer, & erosive esophagitis & "heartburn" | omeprazole (Prilosec) |
| omeprazole (Prilosec) is __ to the H2-receptor antagonists | unrelated |
| lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), & esomeprazole (Nexium) all belong to the category of | proton pump inhibitors (PPIs) |
| H2-blockers will decrease __ effectiveness | PPIs |
| will delay absorption of most PPIs | sucralfate |
| diazepam, phenytoin, & warfarin will __ __ levels in patients taking PPIs | increase serum |
| ampicillin, ketoconazole, & iron results in poor __ of PPIs | bioavailability |
| Nexium, Prevacid, & Prilosec should be given on a(n) | empty stomach |
| Aciphex & Protonix can be given __ __ to meals | without regard |
| PPIs in SR form can be opened & sprinkled over applesauce or yogurt, given w/fruit juices & swallowed immediately, but should not be | chewed, broken, or crushed |
| antiulcer agent that inhibits pepsin; therapuetic effects are from local rather than systemic activity | sucralfate (Carafate) |
| sucralfate (Carafate) should be taken on empty stomach because reacts w/ __ __ in stomach to form paste that adheres to mucosa | hydrochloric acid |
| side effects from sucralfate (Carafate) are __, but may include constipation occasionally | rare |
| sucralfate (Carafate) can alter __ so other drugs should be given after 2h of administration | absorption |
| antacids may decrease __ __ of sucralfate (Carafate), separate administration times by 30 minutes | mucosal binding |
| patients w/ recurrent/refractory peptic ulcer disease, w/failure to heal w/in 12 weeks or w/frequent recurrences unrelated to NSAIDs may suffer from infection w/ | Helicobacter pylori |
| Helicobacter pylori infections have been treated successfully w/ __ __ over 14 days | multi-drug (3) regimens |
| Helicobacter pylori treatment containing amoxicillin w/clarithromycin & lansoprazole (Prevacid) | Prevpac |
| Helicobacter pylori treatment containing tetracycline w/metronidazole & bismuth salicylate | Helidac pack |
| Helidac pack contains | antibacterial & antiprotozoal w/an antiemetic |
| Prevpac contains | antibiotics & PPI |
| four pills in each __ of Helidac | dose |
| Helidac: two pink tablets __ __ should be chewed and swallowed | bismuth subsalicylate |
| Helidac: white tablet (metronidazole) and the orange and white capsule (tetracycline) should be | swallowed whole |
| Helidac: Be sure to drink at least 8 ounces of fluid with each dose—and especially at bedtime—to | prevent irritation |
| consists of all four Helidac pills which are taken 4 times each day for 14 days | one dose |
| Helidac regimen should include an __ __ such as cimetidine, famotidine, or ranitidine | acid blocker |
| Prevpac packet consists of a __ __ which should be taken 10-14 days | daily dose |
| each Prevpac packet contains the __ & __ doses of this medication | morning & evening |
| PREVPAC pink and black capsule | Prevacid |
| PREVPAC yellow tablet | clarithromycin |
| PREVPAC two capsules of same coloring | amoxicillin |
| each PREVPAC dose should be taken twice per day before | eating |
| PREVPAC pills __ __ swallowed whole | must be |
| have chemical structures similar to those of aspirin & exhibit anti-inflammatory activity in the GI tract; used in management of Crohn's & ulcerative colitis | mesalamine (Asacol, Rowasa) & sulfasalazine (Azulfidine) |
| mesalamine (Asacol, Rowasa) & sulfasalazine (Azulfidine) are __ designed to reach ileum & colon, bypassing stomach & upper intestines | salicylates |
| mesalamine (Asacol, Rowasa) & sulfasalazine (Azulfidine) are safe for __ use and well tolerated in most patients | long-term |
| intolerance to sulfasalazine can be minimized by taking the __ product | enteric-coated |
| sulfasalazine can cause anaphylaxis or asthma attacks in those allergic to | sulfonamides |
| caution: those allergic to __ for Rowasa enema | sulfites |
| sulfasalazine should be administered with __ for those with hepatic impairment | caution |
| sulfasalazine interactions w/warfarin increase risk of | hemorrhage |
| sulfasalazine interactions w/methotrexate increase | bone marrow suppression |
| sulfasalazine interactions w/cyclosporin will cause | decreased efficacy |
| sulfasalazine interactions w/oral diabetic agents can lead to | hypoglycemia |
| used to treat moderate-severe forms of IBD in patients who a inadequately controlled w/salicylates | glucocorticoids |
| prednisone, prednisolone, & hydrocortisone enemas are glucocorticoids used to treat | moderate-severe IBD |
| oral glucocorticoids do not require direct contact w/__ __ __ to be effective | inflamed intestinal tissue |
| act in various ways to reduce number of loose stools | antidiarrhea agents |
| act as adsorbents & protectants to achieve a drying effect | kaolin & pectin preparations |
| kaolin & pectin preparation | Kapectolin |
| transient __ is a side effect of kaolin & pectin preparations | constipation |
| kaolin & pectin preparations can cause impaired absorption is taken with | Digoxin |
| kaolin & pectin preparations are contraindicated for infants & older adults, as well as those | with bowel obstruction |
| laxative works on intestinal wall increasing amount of fluid & electrolytes within intestinal lumen & causes release of prostaglandins, increasing peristalsis | stimulant laxatives |
| laxative helps water & lipids combine w/stool resulting in softer fecal mass | stool softeners |
| laxative coats surface of stool & intestine w/film, decreasing water reabsorption, allowing stool to pass through intestine | emollients |
| laxative combines w/water in intestine to forms emollient gel/viscous solution resulting in peristalsis | bulk-forming laxative |
| laxative combines w/water in intestine to forms emollient gel/viscous solution resulting in peristalsis | bisacodyl (Dulcolax) |
| laxative coats surface of stool & intestine w/film, decreasing water reabsorption, allowing stool to pass through intestine | mineral oil (Kondremul, Fleet) |
| laxative helps water & lipids combine w/stool resulting in softer fecal mass | docusate sodium (Colace, Dialose, Surfak) |
| laxative combines w/water in intestine to forms emollient gel/viscous solution resulting in peristalsis | psyllium (Metamucil, Konsyl-D, Fiberall, etc.) |
Created by:
lfrancois
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