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FNP Pharmacology Final 5
FNP pharmacology Final, section 5 - GI
34
Medical
Graduate
04/20/2009

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Term
When treating GERD, what drug class should be started initially?
Definition
H2 bloacker X 1 month.
Term
After one month of treating GERD with an H2 blocker without success, what drug class should be used next?
Definition
PPI
Term
After initiating PPI therapy in a pt with GERD without successful alleviation of symptoms, what drug class should be used next?
Definition
A different PPI.
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
3=6 months.
Term
What's the common difficulty with antacids that contain aluminum?
Definition
constipation
Term
When should antacids be taken (disregarding symptomatic use).
Definition
one hour before food.
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
Diarrhea.
Term
What condition is absolutely contraindicates cytotec (misoprostol) use?
Definition
Pregnancy.
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
Less CNS side effects.
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
Not necessarily.
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
Prevpack.
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
Mineral oil.
Term
Name an example of a hyperosmotic laxative.
Definition
Lactulose.
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
Serotonin.
Term
What drug is a 5-HT3 receptor antagonist used to treat n/v?
Definition
Zofran.
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
3 days; alcohol
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
Decadron.
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).
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