GI pharm

Question 1

what is the side effects associated with aluminum as an antacid?

Answer 1

constipation

Question 2

what is the side effects associated with calcium as an antacid?

Answer 2

constipation

Question 3

what is the side effects associated with magnesium as an antacid?

Answer 3

diarrhea

Question 4

what is the side effects associated with aluminum + magnesium as an antacid?

Answer 4

not constipation or diarrhea - just a balanced approach

Question 5

what are two examples or antacids that are aluminum + magnesium?

Answer 5

Maalox, Mylanta

Question 6

why is it ideal to use a combination approach to treat h. pylori?

Answer 6

to minimize resistance and because h. pylori loves an acidic environment but we can’t get antibiotics to work in a highly acidic environment

Question 7

what class is cimetidine / famotidine?

Answer 7

H2 receptor antagonist

Question 8

what class is omeprazole / pantoprazole / esomeprazole?

Answer 8

PPI

Question 9

what class is sucralfate?

Answer 9

mucosal protectant

Question 10

what class is ondanestron?

Answer 10

serotonin blocker

Question 11

what class is dimenhydramine, meclizine, and hydrozyzine?

Answer 11

antihistamines

Question 12

what class is metoclopromide?

Answer 12

dopamine antagonists / prokinetic agent

Question 13

what class is sulfasalazine?

Answer 13

5-aminosalicylate

Question 14

what class is infliximab?

Answer 14

disease modifying anti-rheumatic drug (DMARD)

Question 15

what is the MOA of H2 receptor antagonists?

Answer 15

blocks H2 receptors in the stomach, which reduces acid secretion by 60-70%, which increases gastric pH

Question 16

what are the indications for H2 receptor antagonists?

Answer 16

PUD, GERD, prophylaxis, heartburn/dyspepsia

Question 17

what are the side effects for H2 receptor antagonists?

Answer 17

generally well tolerated - except in elderly, then can have CNS alteration and an increased risk of pneumonia

Question 18

what is the route for H2 receptor antagonists?

Answer 18

IV and PO

Question 19

how long should you wait in between giving a H2 receptor antagonist and an antacid?

Answer 19

~ 1 hours

Question 20

are H2 receptor antagonists CYP inhibitors or agonists?

Answer 20

inhibitors

Question 21

what 3 medications can H2 receptor antagonists increase the levels for?

Answer 21

warfarin, phenytoin, theophylline

Question 22

if pushed too fast what can H2 receptor antagonists cause?

Answer 22

bradycardia

Question 23

what is the MOA of PPIs?

Answer 23

inhibiting the proton pump by binding directly to it, this irreversibly inhibits the HCl secretion

Question 24

what are PPIs used for?

Answer 24

short term treatment of GERD and PUD (if long term usually are rx)

Question 25

what are the short term and long term side effects of PPIs?

Answer 25

short term - generally nothing long term - increased risk of pneumonia, bone loss / hip fracture, stomach cancer

Question 26

are H2 receptor antagonists or PPIs generally more effective?

Answer 26

PPI

Question 27

what is the MOA of mucosal protectants?

Answer 27

they change into a thick gel when in contact with gastric acid - this provides a barrier to the stomach

Question 28

what are mucosal protectants used for?

Answer 28

ulcers

Question 29

what are the side effects of mucosal protectants?

Answer 29

generally nothing, maybe some constipation

Question 30

how are mucosal protectants taken?

Answer 30

PO

Question 31

when should you take mucosal protectants in relation to other meds?

Answer 31

~ 2 hours before (it decreases the absorption of other drugs because it coats the stomach)

Question 32

what are the side effects of antacids?

Answer 32

diarrhea / constipation, rebound acid

Question 33

why do antacids need to be spaced out from other drugs?

Answer 33

they generally have a chelating effect which pulls the drugs out of the system and causes them to not be absorbed as well

Question 34

what is the MOA of ondansetron?

Answer 34

blocks serotonin receptors in the brain and in afferent vagal nerves in the stomach and intestines to decrease N/V

Question 35

what are the side effects of serotonin blockers?

Answer 35

headache, diarrhea, dizziness, serotonin syndrome

Question 36

how is ondansetron given?

Answer 36

PO , IV

Question 37

what medications must a nurse know about before giving ondansetron?

Answer 37

SSRI, SNRI, MAOI, TCA, buspirone, tramadol

Question 38

antihistamines increase fall risk - true or false?

Answer 38

true

Question 39

what is the MOA of metoclopramide?

Answer 39

blocks dopamine receptors which increase the tone of the LES while also increasing peristalsis

Question 40

what are the side effects of metoclopramide?

Answer 40

sedation, extrapyramidal symptoms (dystonia, pseudoparkinsonism, akathisia (inability to remain still), tardive dyskinesia, restlessness, neuroleptic malignant syndrome (fever, altered LOC, muscle rigidity, and autonomic dysfunction)

Question 41

what population of people are more at risk of developing EPS with metoclopramide?

Answer 41

those taking anti-psychotic medications

Question 42

what are the side effects of diphenoxylate with atropine or loperamide?

Answer 42

drowsiness, constipation anticholinergic bradycardia cardiac arrest / arrhythmia

Question 43

what are the side effects for sulfasalazine?

Answer 43

fever, nausea, rash, HA, hematologic disorders

Question 44

what groups of patients does the nurse need to be cautious giving sulfasalazine to?

Answer 44

anemia, lots of comorbidities

Question 45

what is the MOA of infliximab?

Answer 45

monoclonal antibodies neutralize TNF alpha which causes a decreased inflammatory response

Question 46

what is infliximab used for?

Answer 46

IBD

Question 47

what are the side effects for infliximab?

Answer 47

immunosuppression cancer, HF, infusion reactions

Question 48

what monitoring needs to be done while taking infliximab?

Answer 48

therapeutic dose monitoring and CRP