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26 Cards in this Set
- Front
- Back
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Diphenylmethane Derivatives:
Drug Class MOA AEs |
Stimulant laxative
MOA: promotes water accumuln and electrolytes in lumen; stimulates intestinal motility Inc'd PGs and cAMP to inc secretion of water AEs: Damaging if overused-->hyponatremia/kalemia; CATHARTIC COLON (nerve damage--alter reflexes in defecation reflexes) |
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Bisacodyl:
Drug Class MOA AEs |
Diphenylmethane Deriv; Stimulant laxative
MOA: promotes water accumuln and electrolytes in lumen; stimulates intestinal motility Inc'd PGs and cAMP to inc secretion of water AEs: Damaging if overused-->hyponatremia/kalemia; CATHARTIC COLON (nerve damage--alter reflexes in defecation reflexes) |
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Antraquinone laxatives:
Drug Class MOA AEs |
Stimulant laxative
MOA: promotes water accumuln and electrolytes in lumen; stimulates intestinal motility Inc'd PGs and cAMP to inc secretion of water AEs: Damaging if overused-->hyponatremia/kalemia; CATHARTIC COLON (nerve damage--alter reflexes in defecation reflexes) |
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Octreotide:
Drug Class Indication MOA |
SMS analogue
Use in secretory diarrhea Dec'd release of Ach by acting on enkephalinergic receptors (enteric nerves) |
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5-ASA:
MOA AEs |
Inhibit PGE2 production
Dec Ab secretion, lymph fn (thus, dec'd nphil and mac chemotaxis) Inc'd expression of heat shock proteins AEs: rash, HA, fever, hepatitis (due to hypersens rxn, not sulfa rxn) |
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First-line therapy for Crohn's and UC.
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5-ASA
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Budesonide:
Drug Class MOA |
Corticosteroid
Interfere with NF-kappa beta and prevent production of proinflammatory cyotkines |
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Azothioprine:
Drug Class MOA Time of Onset AEs |
Immunomodulator--Thioguanine derivative
Metabolized to 6-thioguanine (active agent)-->incorporated into nucs and prevents lymphocyte prolifern Also inhibit NKC and T cell fn Takes 3-4 months for effect--NOT FOR FLARE-UPS AEs: Leukopenia |
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Infliximab:
Drug Class MOA AEs |
Biological Response Modifier
MOA: MAb xTNF-alpha Used for severe CD/UC AEs: Opportunistic infections, esp Tb (need TNF-alpha to respond to infections) Hypersens rxn to MAb |
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This biological exhibits LESS antigenicity than infliximab.
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adalimumab
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Natalizumab:
Drug Class MOA Indications AEs |
Biological Response Modifier
MOA: Ab x alpha-4 integrin; blocks adhesion and leukocyte migration into gut (works all over body too) mod to severe CD, UC AEs: progressive multifocal leukoencephalopathy |
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Parietal cells:
Describe activation by: Endocrine stimulation Paracrine stimulation Neural stimulation Include differences in pumps activated. |
Endocrine: gastrin release from G cells; works 2 ways:
1) Stimulates release of histamine from ECL cells 2) Stimulates CCK2 receptors on parietal cells to activate Ca2+ dependent proton pump Paracrine: histamine released from ECL cells: Acts at H2 receptors on parietal cells stimulating cAMP-dep activation of proton pump Neural stimulation via vagus (ACh)-->2 ways: 1) Stimulates release of histamine from ECL cells 2) ACh (from enteric neurons) act directly on parietal cells stimulating M2/M3 receptors and activating Ca2+ dep activation of proton pump. |
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Prostaglandin effects on gastrin secretion.
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1) binds PGE receptors on parietal cells-->inhibits cAMP-dep PW
2) Stimulates secretion of mucus and bicarb from epithelial cells |
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Cimetidine:
Drug class AEs |
H2 antag
AEs: inhibits renal elimination of other basic drugs (procainamide) inhibits cyp450, reducing metabolism of many drugs (phenytoin, theophylline, phenobarb, warfarin, TCA, CCBs) GYNECOMASTIA, impotence, lactation (enhances secretion of PL) note: cyp450 inhibition AND PL secretion (also binds androgen receptors) are unique to cimetidine and does not apply to other H2 antags |
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What drug is contraindicated with clopidogrel?
Why? |
Omeprazole:
inhibits cyp450 enzyme that activates clopidogrel, thus reducing clopidogrel's inhibitory effect on platelet aggregation. |
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Omeprazole:
Drug Class |
Proton Pump Inhibitor
RACEMIC MIXTRUE of R and S isomers (S = esomeprazole) |
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This antacid is contraindicated with tetracycline.
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Al(OH)3; inhibits tetracycline's absorption
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Sucralfate:
Drug Class MOA AEs |
Sucralfate = Al(OH)3 + sulfated sucrose
Cytoprotective Agent MOA: binds protein components of ulcer to form protective coating; this prevents degradative activity of pepsin and acid. May also stimulate mucus and bicarb secretion, and may increase PG synthesis. AE: Constipation (contains Al(OH)3) Dec'd bioavail of teatracycline, phenytoin, digoxin, cimetidine |
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Misoprostol:
Drug Class MOA Indications AEs |
Misoprostol = PGE2 analog
Cytoprotective agent Acts as PGE2 analog and inhibits acid secretion; stimulates bicarb and mucus secretion Indicated in pts who require NSAID tx AEs: Cramping and diarrhea due to inc'd GI secretion and motility Contraction of uterine SM-->abortion |
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What are the effects of prokinetic agents?
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Increase LES pressure, enhance esophageal peristalsis
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Metoclopromide:
Drug Class MOA |
Prokinetic AND ANTIEMETIC
Enhanced release of ACh from nerves innervating GI tract smooth muscle Also: 5HT4/ agonist (release ACh to enhance more ACh release), 5HT3 antag (suppress NANC), D2 antag--provides antiemetic effect (blocks D2 receptors in chemoreceptor trigger zone, solitary tract nucleus) |
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Cisapride:
Drug Class MOA AEs |
Enhances release of ACh from nerves innervating SmoothM of GI tract
Also 5HT4 agonist, 5HT3 antag FATAL ARRHYTHMIAS due to prolongation of QT interval. |
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Lesogaberan:
Drug Class MOA Effect |
Motility altering agent
GABA-B agonist that inhibits signaling from vagal afferents in stomach and esophagus to reduce mechanosensitivity Also inhibits vagal efferents Effect: dec'd postprandial, tLESR, inc'd basal LES pressure STILL IN CLINICAL TRIALS |
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Chlorpromazine:
Drug Class MOA AEs |
Antiemetic
Muscarinic and histaminergic antagonist ALSO ACTS AS NEUROLEPTIC AEs: hypotn, sedation, tardive dyskinesia! |
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Haloperidol:
Drug Class AEs |
Antiemetic and neuroleptic
Sedation (less so than chlorpromazine); hypotn (less so than chlorpromazine) |
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Scopolamine:
Drug Class Indications AEs |
Antimuscarinic
Motion sickness (not for emesis due to chemotx) AE: dry mouth, sedation Note: delivered transdermally |
