Term
| When treating GERD, what drug class should be started initially? |
|
Definition
|
|
Term
| After one month of treating GERD with an H2 blocker without success, what drug class should be used next? |
|
Definition
|
|
Term
| After initiating PPI therapy in a pt with GERD without successful alleviation of symptoms, what drug class should be used next? |
|
Definition
|
|
Term
| After using an H2 blocker X 1 month, and then cycling through 2 different PPI's, if the pt with GERD continues to be symptomatic, then what is the next therapeutic step? |
|
Definition
| Screen for H. pylori and eradicate. Then wait for one month and reassess. |
|
|
Term
| If you've eradicated a pt's H. pylori, but they continue to have GERD symptoms without alleviation, then what is the general practitioner's next step? |
|
Definition
| Referral to GI specialist. |
|
|
Term
| How long are H2 blockers or PPIs used if you do not wish to keep pt on either indefinitely? |
|
Definition
|
|
Term
| What's the common difficulty with antacids that contain aluminum? |
|
Definition
|
|
Term
| When should antacids be taken (disregarding symptomatic use). |
|
Definition
|
|
Term
| What 3 drugs do aluminum-containing antacids have significant interactions with? |
|
Definition
| Tetracycline, Coumadin, Digoxin. |
|
|
Term
| What GI adverse effect can magnesium-containing antids cause? |
|
Definition
|
|
Term
| What condition is absolutely contraindicates cytotec (misoprostol) use? |
|
Definition
|
|
Term
| Name a common H2 receptor antagonist. |
|
Definition
| Ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet) |
|
|
Term
| What's the big advantage of using H2 receptor antagonists of nonspecific histamine receptor antagonists? |
|
Definition
|
|
Term
| What time of day should H2 receptor antagonists be administered? |
|
Definition
| At night b/c most acid secretion occurs between 0200 and 0400. |
|
|
Term
| Does the presence of H. pylori mean the pt will develop a gastric ulcer? |
|
Definition
|
|
Term
| What does a clinician order to eradicate H. pylori? |
|
Definition
| clarithromycin macrolide, flagyl + PPI/H2; or you can do pepto bismal QID +flagyl + tetracycline x 7-14 days; or Amoxicillin TID, clarithromycin TID with optional pepto bismol. |
|
|
Term
| What combination product is specially packaged to simplify the eradication of H. pylori? |
|
Definition
|
|
Term
| What's the mechanism of action for stimulant laxatives? |
|
Definition
| They facilitate prostaglandin secretion & increase cAMP, which increases secretion of selectrolytes and stimulates peristalsis. |
|
|
Term
| What's an example of a lubricant laxative? |
|
Definition
|
|
Term
| Name an example of a hyperosmotic laxative. |
|
Definition
|
|
Term
| What's the mechanism of action of docusate sodium (Colace)? |
|
Definition
| It facilitates mixture of stool fat and water. |
|
|
Term
| What neurotransmitter does 5HT3 refer to? |
|
Definition
|
|
Term
| What drug is a 5-HT3 receptor antagonist used to treat n/v? |
|
Definition
|
|
Term
| Why shouldn't clinicians give dopamine receptor antagonists, such as compazine, to pts with tremors. |
|
Definition
| It can worsen their tremors. |
|
|
Term
| How long are Scopolamine patches good for & what shouldn't patients be consuming while on scopolamine patches? |
|
Definition
|
|
Term
| What drug classes should be used in irritable bowel syndrome? |
|
Definition
| Antispasmodics/anticholinergics & 5HT4 receptor agonists. |
|
|
Term
| What drug can help prevent dizziness when initiating scopolamine therapy? |
|
Definition
|
|
Term
| What does sulfasalazine (Azulfidine) treat? |
|
Definition
| Inflammatory bowel/ulcerative colitis |
|
|
Term
| If you have a patient on sulfasalazine (Azulfidine), initiated by another provider, what rare, life-threatening complication can occur (& what lab do you order to monitor for it)? |
|
Definition
| Agranulocytosis - if you're re-ordering it, then check yearly CBC |
|
|
Term
| What condition indicates the use of ursodiol (Actigall)? |
|
Definition
| cholelithiasis in patients who cannot tolerate surgery, but the gallbladder must be functioning for this med to work. |
|
|
Term
| What is the effect of ursodiol (Actigall) on the body? |
|
Definition
| Actigall reduces elevated liver enzyme levels by facilitating bile flow through the liver and protecting liver cells. |
|
|
Term
| What patient population, as a whole, will generally use exogenous pancreatic enzymes? |
|
Definition
| CF patients, but also sometimes in pancreatitis patients. |
|
|
Term
| In regards to pancreatic enzymes, what nutrients do lipase, protease and amylase work on? |
|
Definition
| Lipase for lipidsl; protease for proteins; amylase for carbohydrates. |
|
|
Term
| What allergy should make practitioners more cautious to use pancreatic enzymes? |
|
Definition
| Pork allergies (it's a porcine derivative). |
|
|
