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27 Cards in this Set
- Front
- Back
What is the only "systemic" antacid? What does this mean (like you know what i'm asking)?
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Sodium-salts
S-odium.....S-ystemic.. see? this = greater absorption |
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What is the MOA of magnesium hydroxide? calcium carbonate?
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Trick! same MOA
Carbonate molecules capture loose hydrogen atoms to make a different molecule (ie water, CO2, chloride salts) Can increase LES tone |
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How do you measure potency of antacids?
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ANC (acid neutralization... constant?)= amt of stomach acid neutralization that occurs per does over a period of time
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What is the rule for taking antacids and other meds?
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take all antacids 1-2 hours before other meds or 2-4 hours after other meds.... period.
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Which antacids can cause constipation? Diarrhea?
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Constipation: Aluminum, calcium
Diarrhea: magnesium (like a laxative) |
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What antacids can be used to treat hyperphosphatemia?
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calcium and aluminum ones
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What are the 5 categories of anti-ulcer agents?
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H2- receptor blockers
proton pump inhibitors surface-acting agents PGE-1 analogs Bismuth compounds |
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What is the MOA of famotidine?
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reversibly inhibit H2-receptors on basolateral membrane of parietal cells (anything ending in -tidine)
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Which H2 blocker is a potent inhibitor of P-450?
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cimetidine (randitidine... 10% of cimetidine's affects)
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How long does it take for an ulcer to heal w/ PPI or H2-blocker treatments?
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4-8 weeks
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Which anti-ulcer category of drugs is most effective acid-inhibitor?
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PPI's
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Which anti-ulcer drugs would you choose for zollinger-ellison syndrome?
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PPI's
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What is the MOA of omeprazole?
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Irreversibly inhibit H/K ATPase within stomach parietal cells (activated w/in the cells)
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What is the MOA of sucralfate? Indications?
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MOA: inhibits pepsin-mediated hydrolysis of mucosal proteins, protects ulcer base from acid
Indication: DU (other off-label uses) |
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What is the MOA of misoprostol?
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A PGE1 analog: inc. production of gastric mucous barrier (stim mucous/bicarb prod, inc mucosal blood flow, dec pepsin)
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What is the most appropriate use for misoprostol?
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prevention of NSAID-induced gastric ulceration
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What is the MOA of bismuth?
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inc production of bicarb and mucous, may bind to ulcer site; antibacterial actions
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What are the characteristic AE's of metronidazole?
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metallic taste....
Disulfram-like reaction (like alcohol w/drawal symptoms) |
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What is a standard treatment for H. pylori?
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Triple therapy (b.i.d. 10-14 days): PPI, clarithromycin, amoxicillin or metronidazole
-or- Quadruple therapy: PPI/H2block, Metro/Clarithro, Amox/Tetracycline, & Bismuth (subsalicylate) Also.... continue PPI/H2 2-6 wks post-regimen for healing |
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Pt. has H. Pylori infection that is determined to be metronidazole-resistant. Pt mentions they are allergic to amoxicillin. What is your best treatment regimen?
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Quad therapy:
PPI/H2blocker Clarithromycin Tetracycline Bismuth |
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What is the sequential therapy for H. pylori?
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1. PPI + amoxicillin for 5 days
2. PPI + clarithromycin + tinidazole for 5 days |
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Rank onset of action of H2-blockers, PPIs, and antacids?
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Quickest to slowest
Antacids>H2>PPI |
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What do you use first for treating pregnant patients who have H. pylori?
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antacids or sucralfate
Ranitidine & lansoprazole Mod disease: H2 Severe: PPI |
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What is in prevpac?
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amoxicillin, clarithromycin, lansoprazole (ACL)
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What is in Helidac?
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Bismuth
Metronidazole Tetracycline (BMT) |
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H. pylori infection. First go-to if metronidazole-resistant?
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tetracycline... consider Quad therapy
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H. pylori infection. First go-to if clarithromycin-resistant?
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Either amoxicillin or tetracycline (consider Quad therapy)
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