pharm gi 5

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  1. Fun fact #3 --
    you are going to rock this pharm test.
  2. Pancreatic Enzymes drugs
    pancrelipase, pancreatin
  3. Pancreatic Enzymes MOA
    supplement pancreatic enzymes (amylase, lipase, proteases) when pancreas is not up to snuff
  4. Pancreatic Enzymes pharmacokinetics
    would be destroyed by gastric acids, so often are encapsulated or co-administered with acid suppressants. titrate dosing to patient, administer with meals or snacks, never crush or chew (mucosal/gastric irritation)
  5. Pancreatic Enzymes indications
    pancreatic enzyme deficiency (secondary to CF, chronic pancreatitis, pancreatectomy, GI bypass, duct obstruction)
  6. Pancreatic Enzymes contraindications
    pts hypersensitive to pork (they are enzymes from pigs)
  7. Pancreatic Enzymes side effects
    diarrhea, hyperuricosuria or renal stones (supplements have a high purine content, uric acid is the byproduct of the breakdown of purines)
  8. Serotonin Antagonists drugs
    "setrons" -- ondansetron, granisetron, alosetron, tropisetron, ramosetron, dolasetron, palonosetron
  9. Serotonin Antagonists MOA
    5-HT3 receptors in the gut mediate contraction of various segments of the GI tract, and their activation can signal nausea. antagonists decrease receptor stimulation on vagal sensory afferent neurons projecting to emetic center in the brainstem. central 5-HT3 receptors that also help mediate nausea are antagonized as well. other consequences include decreased small bowel motility, decreased colonic compliance.
  10. Serotonin Antagonists pharmacokinetics (T 1/2)
    prolonged biological half-life -- effect lasts well past the drug's elimination from the circulation.
  11. Serotonin Antagonists indications
    nausea, vomiting (especially useful with chemo)
  12. Serotonin Antagonists side effects
    constipation (more common) or diarrhea, HA, light-headedness. rare but serious effects include QT prolongation and other EKG changes, alosetron may also cause ischemic colitis.
  13. Antacids strength by class
    buffers weakest, H2 blockers middle, PPIs strongest.
  14. Antacids pharmacological approaches
    "step up" (start low, go high if no relief) or "step down" (start high, lower until sx return) approaches
  15. Trial off acute antaicid tx -- if sx return within __ months, pt should be put on maintenance therapy (of previously effective tx).
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pharm gi 5
pharm gi 5
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