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