NSG 533 - Advanced Pharmacology
Exam 1
Question:
Histamine-2 Receptor Antagonists (cimetidine, famotidine, Nizatidine,
ranitidine)
Answer:
Decrease acid secretion by blocking histamine receptors in gastric parietal
cells
Relief from typical acute GERD symptoms and prophylactic
More effective than antacids for chronic GERD but less effective than PPIs
May be dosed intermittently or on schedule
Famotidine is most effective in class for acid suppression and ulcer healing
Question:
PPI (omeprazole, pantoprazole, lansoprazole)
Answer:
Block gastric acid secretion by inhibiting gastric H+/K+-ATP in gastric
parietal cells, producing profound long lasting antisecretory effect which
maintains gastric pH above 4
Treats frequent GERD symptoms, heals gastric and esophageal ulcerations
,Greatest results for relief of symptoms and acid relief, esp for patients with
moderate-severe symptoms. High rates of healing erosive disease
Esomeprazole is said to be most effective but jury is out
Maintenance therapy: on-demand PPI therapy consists of stopping PPI when
GERD symptoms stop and starting again for 2-4 weeks if symptoms occur
two or more times within 7 days while off therapy
Question:
PUD causes
Answer:
H. pylori infection through fecal-contaminated food or water
chronic NSAID use, risk increases with combined corticosteroid use +
NSAID (but not just steroids by themselves),
stress-related mucosal damage in critically ill patients caused by gastric
mucosal ischemia and intraluminal acid
Zollinger-Ellison syndrome: caused by a gastrin-producing tumor
(gastrinoma) which leads to hypersecretion causing diarrhea and
malabsorption
Question:
Scopolamine
Answer:
Anticholinergic
Blocks muscarinic receptors in vestibular system - halts signal to CNS
,For preventing and treating motion sickness & PONV
Transdermal patch for up to 72 hours
Typical anticholinergic SEs: dizzy, dry mouth, visual disturbances, sedation
Question:
antihistamines (nausea, vomiting)
Answer:
Prevent and treat N/V, vomiting due to motion sickness, vertigo, migraine
High concentrations of Histamine1 in muscarinic cholinergic receptors in
vestibular system
First generation SE: drowsy, blurry vision, urinary retention
1st gen is effective, 2nd gen is not due to BBB
*Combo of doxylamine and Vitamin B6 (pyridoxine) for NVP pregnancy
Question:
Phenothiazines (promethazine, -zine)
Answer:
Severe motion sickness, NVP, PONV, CINV
dopamine antagonist to receptors in CTZ
SE: EPS, sedation, orthostatic hypotension
Question:
, Butyrophenone (droperidol, haloperidol)
Answer:
PONV, CINV
Black Box warning for prolonged QT interval
Question:
Prokinetic agents (metoclopramide, domperidone)
Answer:
Increase LES tone, promote gastric motility for PONV, CINV, gastroparesis,
GERD
Crosses BBB
Question:
Corticosteroids
Answer:
Dexamethasone, methylprednisolone
Alone or in combination with antiemetics for preventing and treating PONV,
CINV, radiation induced N/V
Question:
Serotonin antagonists (ondansetron, -setron)
Answer:
Exam 1
Question:
Histamine-2 Receptor Antagonists (cimetidine, famotidine, Nizatidine,
ranitidine)
Answer:
Decrease acid secretion by blocking histamine receptors in gastric parietal
cells
Relief from typical acute GERD symptoms and prophylactic
More effective than antacids for chronic GERD but less effective than PPIs
May be dosed intermittently or on schedule
Famotidine is most effective in class for acid suppression and ulcer healing
Question:
PPI (omeprazole, pantoprazole, lansoprazole)
Answer:
Block gastric acid secretion by inhibiting gastric H+/K+-ATP in gastric
parietal cells, producing profound long lasting antisecretory effect which
maintains gastric pH above 4
Treats frequent GERD symptoms, heals gastric and esophageal ulcerations
,Greatest results for relief of symptoms and acid relief, esp for patients with
moderate-severe symptoms. High rates of healing erosive disease
Esomeprazole is said to be most effective but jury is out
Maintenance therapy: on-demand PPI therapy consists of stopping PPI when
GERD symptoms stop and starting again for 2-4 weeks if symptoms occur
two or more times within 7 days while off therapy
Question:
PUD causes
Answer:
H. pylori infection through fecal-contaminated food or water
chronic NSAID use, risk increases with combined corticosteroid use +
NSAID (but not just steroids by themselves),
stress-related mucosal damage in critically ill patients caused by gastric
mucosal ischemia and intraluminal acid
Zollinger-Ellison syndrome: caused by a gastrin-producing tumor
(gastrinoma) which leads to hypersecretion causing diarrhea and
malabsorption
Question:
Scopolamine
Answer:
Anticholinergic
Blocks muscarinic receptors in vestibular system - halts signal to CNS
,For preventing and treating motion sickness & PONV
Transdermal patch for up to 72 hours
Typical anticholinergic SEs: dizzy, dry mouth, visual disturbances, sedation
Question:
antihistamines (nausea, vomiting)
Answer:
Prevent and treat N/V, vomiting due to motion sickness, vertigo, migraine
High concentrations of Histamine1 in muscarinic cholinergic receptors in
vestibular system
First generation SE: drowsy, blurry vision, urinary retention
1st gen is effective, 2nd gen is not due to BBB
*Combo of doxylamine and Vitamin B6 (pyridoxine) for NVP pregnancy
Question:
Phenothiazines (promethazine, -zine)
Answer:
Severe motion sickness, NVP, PONV, CINV
dopamine antagonist to receptors in CTZ
SE: EPS, sedation, orthostatic hypotension
Question:
, Butyrophenone (droperidol, haloperidol)
Answer:
PONV, CINV
Black Box warning for prolonged QT interval
Question:
Prokinetic agents (metoclopramide, domperidone)
Answer:
Increase LES tone, promote gastric motility for PONV, CINV, gastroparesis,
GERD
Crosses BBB
Question:
Corticosteroids
Answer:
Dexamethasone, methylprednisolone
Alone or in combination with antiemetics for preventing and treating PONV,
CINV, radiation induced N/V
Question:
Serotonin antagonists (ondansetron, -setron)
Answer:
