-
a pt with GERD would most likely experience reflux when?
- laying flat
- stooping after a meal
-
what position would you want to place a pt with GERD
semisupine
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t/f seeing a pt with GERD after a meal is best
false-want to see before meal
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are there oral signs related to GERD?
teeth may be affectd by chemical erosion
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describe the medical treatment of GERD. Which therapy is most effective for esophagitis?
- neutralizing stomach contents or reducing gastric acid secretion
- omeprazole alone or comb iwth cisapride for esophagitis
-
what is the mechanism of action for the H2 receptor blocking agents
- antihistamines block receptors in GI tract
- inhibit action of histamine at receptors of parietal cells
-
describe the strategy for reducing the drug-drug interactions when one drug affects the absorption of another
stagger administation
-
describe the mechanism of action of PPIs and their effects
binds to proton pump of parietal cells and inhibts final step in secretion of hydrogen ions into gastric lumen
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why should enteric coated asprin be avoided if PPIs are taken
PPIs may cause enteric coated salicylates to dissovle rapidly, increasing gastric side effects
-
list potential drug interactions or oral effects of interactions with PPIs
- dental drug diaxepam, fluaxepam and trazolam toxicity with omeprazole or esomeprazole
- black tongue, glossitis and stomatitis
-
what is the drug that prevents ulcers when NSAIDS are needed on a chronic basis?
misoprostol
-
what is the principal symptom of PUD
pain
-
describe the medical treatemtn for PUD
- antibacterial chemotherapy, administration of H2 receptor blocking agents and antacidds
- agents that increase gastric emptying rate, preventative coating of the stomach, anticholinergic agents, endogenous prostaglandins
-
what are the antacids used to treat PUD
- magnesium hydroxide
- aluminum hydroxide
- calcium carbonate
- sodium bicarbonate
-
what is the anticholinergic drug used to treath PUD and what is the mechanism of action
- propantheline (pro-banthine)
- inhibits muscarinic actions of acetylcholine at prostganglionic PANS neuroeffector sites
-
identify a risk associated with the use of calcium carbonate antacids
hypercalcemia
-
wha tis commonly used to prepare for colonoscopy
magnesium citrate
-
identify agents used in the medical management of constipation
- bulk-forming agents and saline laxatives
- irritants(danthron, castor oil, senna, bisacodyl and phenolphthalein)
-
identify an agent in this group that is used to prepare for colonoscopy
magnesium citrate
-
list irritants used to manage constipation
- danthron
- castor oil
- senna
- bisocodyl
- phenolphthalein
-
list agents used to manage symptoms associated with diarrhea and IBS
- clear liquid diet and increased fluid intake
- opiates
- absorbents
- hypolipoproteinemia
- anti-inflammaotry agents
- IBS-fibers for constipation and diphenoxylate or loperaminde for diarrhea
-
a drug used to control nausea and emesis associated with general anesthesia
promethazine
-
identify the area of the brain that controls vomiting
medulla
-
what are the most common agents used to reduce vomiting
- promethazine
- metoclopramide
-
describe the mechanism of action of phenothiazines
block dopamine receptors in the chemoreceptor trigger zone of medulla
-
list a cannabinoid used in emesis management. is it a scheduled drug?
- dronabinol (marinol)
- controlled substance schedule III
-
identify a drug of choice for first trimester nausea associated with pregnancy
-
cetirizine, chlorpheniramine, loratadine and diphenhydramine
-
list examples of agents used to prevent motion sickness
- scopolamine (transderm-scop)
- propantheline bromide (pro banthine)
-
what are the ADEs associated with drugs used for urinary incontinence
xerostomia, dry eyes, tachycardia, dyspepsia, constipation, headache, congnitve impairment and urinary retention
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