GERDFC Flashcards

1
Q

what is the MOA of alteplase?

A

causes fibrinolysis by binding to fibrin in a thrombus and coverts entrapped plaminogen to plasmin.

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2
Q

what is the dose of alteplase?

A

0.9 mg/kg IV (max 90 mg) IV over 60 mins with 10% of dose given as a bolus over 1 minute.

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3
Q

what is the timeframe for alteplase administration?

A

within 3 hours of of symtom onset

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4
Q

what is the role of antihypertensive therapy in stroke?

A

to decrease BP and qualify patients for alteplase therapy - decrease BP gradually

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5
Q

what is the MOA of osmotic diuretics such as mannitol?

A

increases the osmotic pressure to reduce intracranial pressure associated with cerebral edema.l

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6
Q

what routes of administration are approved for nimodipine?

A

Oral only

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7
Q

what are agents used for secondary prevention in pts with previous stroke?

A

ASA, Plavis, Aggrenox

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8
Q

what is the dose of aggrenox?

A

dipyrimadole/asa 200/25

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9
Q

what is the CYP interaction with clopidogrel?

A

it is a prodrug metabolized by CYP2C19. avoid with 2C19 inhibitors (azole, omeprazole)

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10
Q

what are some drugs that can decrease LES pressure?

A

anticholingerics, barbituates, dihydropyridine CCBs, estrogen, nitrates, NSAIDS

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11
Q

what is a side effect of aluminum found in some antacids?

A

can cause constipation

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12
Q

what is side effect of magnesium in antacids?

A

can cause diarhea

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13
Q

when should PPIs be taken?

A

30 minutes before breakfast because they inhibit proton pumps that are actively secreting acid.

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14
Q

omeprazole - Brand

A

Prilosec=

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15
Q

esomeprazole - Brand

A

Nexium

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16
Q

esomeprazole + naproxyn

A

vivomo

17
Q

rabeprazole brand

A

aciphex

18
Q

what are side effects of long term PPI use?

A

increase risk of osteoporosis/fracture, can increase risk of pneumonia in hospitalized pts, can increase risk of c.diff infections

19
Q

which PPIs can be opened and mixed with apple juice or put down tube?

A

lansoprazole, esomeprazole, omeprazole

20
Q

what drugs require an acidic pH and might have decreased absorption with PPIs?

A

azoles, calcium carbonate, iron

21
Q

what are two cytoprotective agents used for GERD?

A

misopostol(Cytotec) and sucralfate (Carafate)

22
Q

What is prego category of misoprostol?

A

Cat X - used for medical termination of preganancy

23
Q

what is a common side effect of sucralfate?

A

constipation

24
Q

why is metoclopramide sometimes used for GERD?

A

dopamine antagonist that enhances motility and accelerates gastric emptying and increases LES tone.

25
Q

what pt population should avoid using metoclopramide?

A

parkinsons pts

26
Q

what are the 3 common peptic ulcers?

A

H. pylori, NSAID-inuced ulcers, stress ulcers

27
Q

duodenal ulcers are ____________ by eating while gastric ulcers are _____________ by eating.

A

duodenal = relieved

28
Q

what is triple therapy for H. pylori?

A

PPI+ 2 antibiotics

29
Q

What is quadruple therapy for H.pylori?

A

PPI + bismuth+ metronidazole + tetracycline

30
Q

what is a major side effect of clarithromycin?

A

abnormal metallic taste