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Pharm Midterm 2
Zollinger-Ellison Syndrome Disease
Pathophysiology
Gastrin-Secreting Tumor
Increased Gastric Acid
Recurrent Peptic Ulcers
MEN Type 1
Symptoms
Abdominal Pain
Heartburn (Pyrosis)
Diarrhea
3 mins
Zollinger-Ellison Syndrome Diagnosis and Treatment
Diagnosis
Gastrin > 1000 pg/mL
Positive Secretin Stimulation Test
Treatment
High-Dose PPI
Octreotide
Surgical Resection
3 mins
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
2 mins
Octreotide
Indications
Acute Variceal Bleeds
Pituitary Tumors
GH Secreting Tumors
Carcinoid Tumors
VIPoma
Mechanism
Somatostatin Analog
2 mins
Acute Pancreatitis Interventions
NPO with NG Tube to Suction
Pain Management
Albumin
Lactated Ringers Solution
Proton Pump Inhibitor (PPI)
Antibiotics
Surgery
Nutrition
2 mins
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
NSAIDs
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
2 mins
Warfarin
Mechanism of Action
Interferes with Vitamin K-dependent Clotting Factors
Extrinsic Pathway
Bridge with Heparin
Indications
Chronic Anticoagulation
Side Effects
Bleeding
Necrosis
Cytochrome P450
Contraindications
Pregnancy
Antidote
FFP + Vitamin K
2 mins
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
2 mins
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
59 secs
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
3 mins
INR Lab Value
0.8-1.2 Normal Range
Warfarin
2.0-3.0
1 min
Deep Vein Thrombosis (DVT) Management
Diagnosis
Compression Ultrasound (CUS) with Doppler
D-Dimer
Contrast Venography
Treatment
IVC Filter
Heparin for Acute Management
Warfarin for Long-term Management
Thrombectomy/Thrombolysis
Stockings
Walking
4 mins
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
25-35 seconds
1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
H2 Receptor Blocker
"-tidine" Suffix
Indications
Gastroesophageal Reflux Disease (GERD)
Peptic Ulcer
Mechanism
Block Histamine H2 Receptors
Parietal Cells
52 secs
Cimetidine and Famotidine (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
2 mins
H2 Receptor Blocker Side Effects
Side Effects
Decrease Creatinine Clearance
Cimetidine
Crosses Blood-Brain Barrier
Anti-Androgen
Inhibits Cytochrome P450
1 min
P450 Inhibitors
Quinidine
Ciprofloxacin
Isoniazid
Grapefruit Juice
Acute Alcohol Use
Erythromycin (Macrolide)
Indinavir
Cimetidine
Sulfonamides
Ketoconazole
Amiodarone
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
2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
1 min
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