Ashton Shared "GI - Pharmacology" - 26 Picmonics

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GI - Pharmacology

Hepatitis B Virus Characteristics
Hepadnavirus
Enveloped
Circular
Partially Double-stranded DNA
Has Reverse Transcriptase
IV Drug Use
Sex
Maternal fetal routes
3 month incubation period
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2 mins
Hepatitis B Virus Disease
Can turn chronic
< 10% of adults become chronic carriers
90% of newborns become chronic carriers
Cirrhosis
Hepatocellular carcinoma
Membranous Glomerulonephritis
Polyarteritis nodosa
Serum sickness like syndrome
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2 mins
Hepatitis B (HBV) Assessment
Transmission
Bodily Fluids
Blood Transmission
IV Drug Abusers
Incubation
Variable 1-6 Months
Assessment
Fever
Nausea and Vomiting
Hepatomegaly
Chronic Disease
Cirrhosis
Hepatocellular Carcinoma
Considerations
Vaccination
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2 mins
NRTIs for HIV (Drug Names)
Nucleoside Analog
DEALSZ
Didanosine (DDI)
Emtricitabine (FTC)
Abacavir (ABC)
Lamivudine (3TC)
Stavudine (d4T)
Zidovudine (ZDV)
Nucleotide Analog
Tenofovir (TDF)
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NRTIs (Nucleoside Reverse Transcriptase Inhibitors)
Indications
HIV
Pregnancy and Prophylaxis given ZDV
Mechanism
Inhibit Nucleotide Binding to Reverse Transcriptase
Chain Termination
Require Phosphorylation
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1 min
NRTI Toxicity
Bone Marrow Suppression
Reverse with G-CSF and Erythropoietin
Rash
Neuropathy
Anemia
Pancreatitis
Lactic Acidosis
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Hepatitis C
Characteristics
Enveloped
RNA Virus
Flavivirus
Icosahedral
SS positive Linear
Clinical Features
Most Cases are Due to IV Drug Use
Turns to Chronic Hepatitis in Over 70% of Cases
Cirrhosis
Hepatocellular Carcinoma
Most Common Indication for Liver Transplantation
Associated With Type I MPGN
Porphyria Cutanea Tarda
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2 mins
Hepatitis C (HCV) Assessment
Transmission
Blood Transmission
High Risk Sex (rare)
IV Drug Abusers
Incubation
7 Weeks
Chronic Disease
Cirrhosis
Considerations
Barrier Protection
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2 mins
HCV Treatment
Simeprevir
Simeprevir toxicities
Pegylated IFN-a
Ribavirin
Sofosbuvir
Sofosbuvir toxicities
Ledipasvir
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Ribavirin
Mechanism
Hypermutation in RNA Viruses
Inhibits Inosine Monophosphate Dehydrogenase
Indications
Hepatitis C
Viral Hemorrhagic Fevers
Respiratory Syncytial Virus (RSV)
Side Effects
Hemolytic Anemia
Teratogen
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1 min
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
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2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
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H2 Receptor Blocker
"-tidine" Suffix
Indications
Gastroesophageal Reflux Disease (GERD)
Peptic Ulcer
Mechanism
Block Histamine H2 Receptors
Parietal Cells
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Cimetidine and Ranitidine (H2 Receptor Blockers)
-tidine Suffix
Mechanism
H2 Receptor Blocker
Indications
Suppress Gastric Acid Secretion
Side Effects (All)
Pneumonia
Side Effects - Cimetidine
Anti-androgen Effects
CNS Changes
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2 mins
H2 Receptor Blocker Side Effects
Side Effects
Decrease Creatinine Clearance
Cimetidine
Crosses Blood-Brain Barrier
Anti-Androgen
Inhibits Cytochrome P450
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Proton Pump Inhibitors (PPIs)
"-prazole" Suffix
Indications
Zollinger-Ellison Syndrome
Gastritis
Peptic Ulcer
Gastroesophageal Reflux Disease (GERD)
Mechanism
Inhibit H+/K+/ATPase
Side Effects
Hip fracture
Pneumonia
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2 mins
Sucralfate (Carafate)
Mechanism
Creates Protective Barrier
Indications
GI Ulcers
Side Effects
Constipation
Considerations
Require Acidic Environment
Give on Empty Stomach
Oral Suspension Available
May Decrease Absorption of Other Meds
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Dinoprostone and Misoprostol
Mechanism
Prostaglandins
Indications
Promote Cervical Ripening
Prevent GI Ulcers
Medical Abortion
Side Effects
Fetal Distress
Hyperstimulation of Uterus
Considerations
Vaginal Insertion
Give Before Induction of Labor
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2 mins
Helicobacter Pylori
Characteristics
Gram-Negative
Bacilli
Curved
Polar Flagellum
Catalase-Positive
Oxidase-Positive
Disease
Gastric and Duodenal Ulcers
Ammonia
Alkaline Environment
Gastric adenocarcinoma
MALT lymphoma
Diagnosis
Serology IgG antibody
Stool antigen
Urease positive breath test
Biopsy
Treatment
2 ABX and PPI
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2 mins
Ondansetron
Indications
Postoperative Vomiting
Chemotherapy-induced Nausea and Vomiting
Mechanism
5-HT3 Serotonergic Antagonist
Centrally-acting Antiemetic
Side Effects
Headache
Constipation
QT Prolongation
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1 min

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