Therapeutics: PUD 2

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kyleannkelsey
ID:
270388
Filename:
Therapeutics: PUD 2
Updated:
2014-04-12 23:22:07
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Therapeutics PUD
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Therapeutics: PUD 2
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Therapeutics: PUD 2
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  1. What should you monitor after treatment with a PPI?
    • CBC
    • Serum Electrolyte
    • Renal function
    • Liver function
  2. What are patients at a greater risk for when taking PPIs?
    • Fractures
    • Pneumonia
    • C diff
  3. What is the less common PPI AE?
    Thrombocytopenia
  4. What are the common PPI AEs?
    • N/V
    • Diarrhea
    • Flatulance
  5. 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
  6. What is the brand name for Misoprostal?
    Cytotec
  7. What dose of misoprostal is normal?
    • 200 mcg PO BID-QID
    • Must have 400 mcg on board to convert to cytoprotective effect
  8. What is Arthrotec?
    • Diclofenac/Misoprostal
    • 50mg or 75mg/200mcg
  9. What is Misoprostal CI in?
    Preganancy = uterotropic
  10. What are the AE for misoprostal?
    • Abdominal pain, flatulence and diarrhea (last = 10-30%)
    • Hypophosphatemia
    • Dysmennorhea
  11. Which H2RAs are available IV?
    All
  12. What type of ulcers does NSAID + H2RAs inhibit?
    Duodenal only
  13. What is the brand name for Cimetidine?
    Tagamet
  14. What is thebrand name for Famotidine?
    Pepcid
  15. What is the Brand name for Nizatidine?
    Axid
  16. What is the Brand name for Ranitidine?
    Zantac
  17. What is the generic name for Tagamet?
    Cimetidine
  18. What I steh generic name for Pepcid?
    Famotidine
  19. What is the generic name for Axid?
    Nizatidine
  20. What is the generic name for Zantac?
    Ranitidine
  21. What is the initial dose for Cimetidine (Tagamet)?
    • 300 mg QID
    • 400 mg BID
    • 800 mg QHS
    • Usual: 1800-1600 divided
  22. What is the initial dose for Famotidine (Pepcid)?
    • 20 mg BID
    • 40 mg QHS
    • Usual: 40
  23. What is the initial dose for Nizatidine (Axid)?
    • 150 mg BID
    • 300 mg QHS
    • Usual: 300
  24. What is the initial dose for Ranitidine (Zantac)?
    • 150 mg BID
    • 300 mg QHS
    • Usual: 300
  25. What are the pregnancy catagories for H2RAs?
    B
  26. What should you monitor for H2RA use?
    • CBC
    • Serum Electrolytes
    • Renal function
    • Liver function
  27. What are the cons of H2RAs?
    • Less effective than PPIs
    • Tolerance develops
    • Cimetidine inhibits CYP450s
  28. 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
  29. How long does a PPI regimen take to heal a small uncomplicated duodenal ulcer?
    4 weeks
  30. How long does a PPI regimen take to heal a small uncomplicated gastric ulcer?
    4-6 weeks
  31. How long does a H2RA regimen take to heal a small uncomplicated duodenal ulcer?
    6-8 weeks
  32. How long does a H2RA regimen take to heal a small uncomplicated gastric ulcer?
    8 weeks
  33. What drug is 1st line for idiopathic ulcer?
    PPI
  34. What drug is 2nd line for Idiopathic ulcers?
    H2RAs

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