Therapeutics: PUD 2

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What should you monitor after treatment with a PPI?
- CBC
- Serum Electrolyte
- Renal function
- Liver function
What are patients at a greater risk for when taking PPIs?
- Fractures
- Pneumonia
- C diff
What is the less common PPI AE?

Thrombocytopenia
What are the common PPI AEs?
- N/V
- Diarrhea
- Flatulance
What is the MOA of Misoprostal (Cytotec)
- Provides “gastromucosal defense” by increasing mucosal prostaglandins
- Moderately inhibits acid secretion
- Reduces ulcer formation (gastric/duodenal) in patients taking NSAIDs OR COX-2 Inhibitors
What is the brand name for Misoprostal?

Cytotec
What dose of misoprostal is normal?
- 200 mcg PO BID-QID
- Must have 400 mcg on board to convert to cytoprotective effect
What is Arthrotec?
- Diclofenac/Misoprostal
- 50mg or 75mg/200mcg
What is Misoprostal CI in?

Preganancy = uterotropic
What are the AE for misoprostal?
- Abdominal pain, flatulence and diarrhea (last = 10-30%)
- Hypophosphatemia
- Dysmennorhea
Which H2RAs are available IV?

All
What type of ulcers does NSAID + H2RAs inhibit?

Duodenal only
What is the brand name for Cimetidine?

Tagamet
What is thebrand name for Famotidine?

Pepcid
What is the Brand name for Nizatidine?

Axid
What is the Brand name for Ranitidine?

Zantac
What is the generic name for Tagamet?

Cimetidine
What I steh generic name for Pepcid?

Famotidine
What is the generic name for Axid?

Nizatidine
What is the generic name for Zantac?

Ranitidine
What is the initial dose for Cimetidine (Tagamet)?
- 300 mg QID
- 400 mg BID
- 800 mg QHS
- Usual: 1800-1600 divided
What is the initial dose for Famotidine (Pepcid)?
- 20 mg BID
- 40 mg QHS
- Usual: 40
What is the initial dose for Nizatidine (Axid)?
- 150 mg BID
- 300 mg QHS
- Usual: 300
What is the initial dose for Ranitidine (Zantac)?
- 150 mg BID
- 300 mg QHS
- Usual: 300
What are the pregnancy catagories for H2RAs?

B
What should you monitor for H2RA use?
- CBC
- Serum Electrolytes
- Renal function
- Liver function
What are the cons of H2RAs?
- Less effective than PPIs
- Tolerance develops
- Cimetidine inhibits CYP450s
In general how should you TREAT NSAID PUD?
- D/C NSAID
- Reduce dose of NSAID
- Switch to CO-2
- Cotherapy of NSAID with PPI or misoprostal
How long does a PPI regimen take to heal a small uncomplicated duodenal ulcer?

4 weeks
How long does a PPI regimen take to heal a small uncomplicated gastric ulcer?

4-6 weeks
How long does a H2RA regimen take to heal a small uncomplicated duodenal ulcer?

6-8 weeks
How long does a H2RA regimen take to heal a small uncomplicated gastric ulcer?

8 weeks
What drug is 1st line for idiopathic ulcer?

PPI
What drug is 2nd line for Idiopathic ulcers?

H2RAs

Author

kyleannkelsey

270388

Card Set

Therapeutics: PUD 2

Description

Therapeutics: PUD 2

Updated

2014-04-13T03:22:07Z

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