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44 Cards in this Set

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H2 Blockers named
for acid secretion
Tidines......cimetidine
rani, famo, niza
H2 Blockers Moa uses
the "tidines"
decr acid (NOT BASAL)
blocks Gs----cAMP----H/K atpases cascade
Partial antag of vagal acid(?)
uses---PU,G-itis,eso reflux(mild) part of H.pyl. triple therapy----a
DoA, and SEs only big diff between
Cimetidine SEs
**inhibits CYP450 3A4/2D6 ****
CNS pen.----Confuse (esp with renal Prob)
STEROID PROBS----antiandrogenic)= Gynecomastia (pain)
milk women
other tidines milder Se profile
Antacids SE
Alum
Mg
Ca
Na
Alum---need good renal
constipation,(Ca also) can get Al encephalopathy in dialysis patients
all cause hypokalemia
Ca-can get wierd hypercalcemia and met alkalosis
Al acidifies urine (decr aspirin secretion)
Na citrate is DOC (esp to avoid reflux in preg)
drugs that help with the mucus
Bismuth Subsalicylate
Misoprostol
Misoprostol MoA
USES
PGE1 analog---increases cytoprotection----increased mucus secretion
increased bicarn secretion
decreased acid prod(?)
(good for PU, prevent NSAID induced ulcers, MAINTAIN PDA)
induce labor
PPI named
PRAZOLES (ome, lanso,esomer,rabe)
Omeprazole Moa
irreversible block of H/K PUMP in parietal cells inhibits BASAL BASAL and gastric acid secretion
this is the GUY for PUD, GERD, ZE Syn, G-itis
Misoprostol SEs
PREG X-------stim uterine contraction,,,,abort..
and diarr,abd pain,flatu, endo bleed
Omeprazole SEs
headache nausea, diarr,
inhibits CYP450----
(increased warf,benzodiaz,Phenytoin)
decreased abs acid requi drugs
Sucralfate Moa,indications,SEs
in acid becomes crazy gel
GOOD for smokers****** Preg
Aluminum......not in renal probs
meeses with absorp of tons oral drugs
increased constipation
Gastric emptying drugs
Metoclopramide(+chol,-dop) also antiemetic (SE =steroid probs)
Cisapride(myenteric Ach--removed from market)
diarrhea drugs mechanisms
opioids,adsorbants,bind and coat,inhibit PGs, bind bile acids, somatostatin analogue,anti-5HT-3, pro-5HT-4(tegaserod)(IBS)
diphenoxylate w/ atropine
uses, mOA, SE
nonspecific antidiarrhea
Opioid and antichol (atrop min abuse)
SEs- constpation--can get TOXIC megacolon, interact with CNS depress (alcohol)
(avoid in Infectious of bowel wall, poison induced diarrhea, not recomended in kids (resp depression)
Loperamide
mOA, uses, SE
=immodium)
OPioids, slow motility,
uses-chr/acute infectious Diarrhea W/O BLOOD FEVER, + other chronic diarrhea ibs etc.
the most prompt and effective nonspecific
SE-big first pass(avoid w/ hepatic dys), lower cns than diphenoxylate, constipation main problem
Opioids for diarrhea
was DIPHENOXYLATE W/ATROPine and my LOPERAMIde
adsorbants for diarrhea
named
moa
use
kaolin,pectin ,methylcellulose, activated charcoal
adsorbs toxins bugs...plus coat and protect
.......also stops absorbe drugs
Bismuth subsalicylate
use
mOA
SE
pepto bismol
symptoms of diarrhea, prophylaxis of travelers
mOA- COAT protect, inh PGs =antiinflam,antisecrete, increased e-lyte absorb))
antimicrobial, part of H.P> triple therapy
SE- Const(impaction in old young) radiopaque, salicysm, dec abs. some drugs
nsaids antidiarrhea properties
SE
inhibit PGs-= -inflam,-motile,+ reabsorb fluid
Gi bleed, Salicylism (tinnitus,vomit,
cholestyramine resins
moa
uses in diarrhea
diarrhea due to increased BILE ACIDS in colon mild c.diff. (binds toxins)(metro and vanco preffered)
SE- with sucrose (dm caut,)
constipations, gritty poop, careful with crohns with strictures, may decrease folate
Octreotide
mOA
uses
HORMONAL diarrhea (good in carcinoid tomur)BUY time till figure out problem, good in HIV diarrhea
Somatostatin analog-inhibits release of many GI hormones
SE- inject pain flatu steatorrhea
IBD drugs
5-asa drugs Ol/Me/BAL sulfaSALAzine(this one also with antimicrobial), inh. AA cascade =anti INflam.
START LOW GO SLOW
Sulfasalzine SEs
for IBD
mostly common headache nausea
some allergic Rxs
oligasperm
hepatitis
rare sever blooddyscriasis
drugs for Crohn's
Infliximab
Budesonide
Infliximab
use
SE
mouse Ab to TNF-alpha
mod to sever crohn's, and RA
SE-Ab so think HYPERSENSITIVITY can get reaction reactivate TB********MUST PRETEST screne
Budesonide
use
SE
Crohn's
Systemic corticosteroid (more Gluco than Mineralo)
low bioavailable (GOOD stays in lumen)
Tx IBS
Diarrhea
constipation
dia-ALosetron (anti5ht-3) (in women)
COnst-tegaserod(pro5ht-4) (IN WOMEN)
alosetron
uses
mOA
SEs
Tx-diar pred IBS in WOMEN without anat/metab abnorm
5HT-3 antag-=inhibit secret/motil/affernet pain signals
SE-RESTRICTED ACCES DRUG NEED TO BY IBS CERTIFIED....OBSTRUCTS THE BOWEL,PERF,TOX.MEGACOLON,ISCHEMIA DEATH
tegaserod--sE
OFF MARKET FOR CV PROBS
INCREASED ABD SURGERY AND PAIN....ACTUALLY STILL USED OFF LABEL WHEN NO OTHER OPTION AVAILABLE
BULK FORMING LAXATIVES
CARBOXYMETHYLCELLULOSE,METHYLCELLULOSE,KARAYA GUM, PSYLLIUM HYDROPHILIC COLLOID(metamucil) CA POLYCARBOPHIL
PSYLLIUM
MOA
SE
USES
A GOOD BULK FORMING LAX (FIBER) DILUTE FOR FULL BENIFIT
CONTIPATION AND DIARRHEA(MILD) MGMT
SE-POSSIBLE ALLERGIC,BLOAT FLATULENCE WITH BULK (LESS WITH PSYLLIUM)
CAN DECR ABS OTHER DRUGS
LAXATIVES WITH PAF ACTIVITY
PLATELET ACTIVATING FACTOR
TISSUE DISTRUCTIVE
BISACODYL AND CASTOR OIL
(THEY HAVE NITRIC OXIDE ALSO)
LAXATIVES WITH NITRIC OXIDE ACTIVITY
BISACODYL AND CASTOR OIL
(THEY HAVE PAF ALSO)
CASCARA (MILD)SENNA
BISACODYL
USE
MOA
SE
FOR CONSTIPATION----RECTAL (1 HR) ORAL 6 HRS SOFT STOOL
SE-PAIN IF RECTAL, TISSUE DAMAGE (paf)
SE- TISSUE DAMAGE
CASCARA
USE
MOA
NO
MILD
SOFT 6 HRS
CASTOR OIL
mOA
USE
SE
OUCH
CONSTIPATIO....WATERY EVAC VERY FAST THOUROUGH
NO & PAF
CATHARTIC---CONV TO RICINDEIC ACID BY GUT FLORA
SE- TOO POWERFUL,ENeMA GOOD
DOCUSATE
USE
MOA
MARGINALLY EFFECTIVE
SOFT STOOL 1-2 DAYS
DETERGENT EMULSIFIES FAT, RETAIN FLUID
IN CA,K,NA FORMS
SENNA
MOA
USE
MORE POTENT THAN CASCARA..DISCONT W/ NORMAL
NO MECH
SENNA POD PHYSIOLOGIC IS BEST
NOT FOR EXTREME.....SOME HEPATOTOX
SALINE CATHARTICS
Mg, K, Ca
Mg most common
osmotic attract h2o
fast
DEhydration must give with tons water
mg, k not in renal dis
na not in HF edema (not used much)
Mineral Oil
uses
SE
good rectal for compaction
no TOLLERANCE good
SE---lipid pneumonia...stand for two hours
LYMPH nodes Inflamation( granulomas)
don't take with docusate(LN scene worse from bigtima absorption)
Polyethylene glycol
use
mech
se
Bowel cleansing agent
pretreat with metaclopramide for nausea.................
salt water osmotic scene
se---gross....gi distress
safe and hated
Lactulose
uses
SE
COnstipation
HEPATIC ENCEPHALOPATHY (OR CHRONIC PORTAL HTN) HELPS GET AMMONIA OUT OF BLOOD
SYNTHETIC DISSACHARIDE NON DIGESTED = OSMOTIC SCENE
SE- BACTERIAL OVERGROWTH, FLATULENCE, AVOID IN DM
GALL STONE TX
CHENODIOL URSODIOL
THESE ARE NATURAL BILE ACIDS-----DECREASE THE SATURATION INDEX
SHOCK WITH LITHOTRIPSY
CHENODIOL INCREASES AST
PANCREATIC ENZYME REPLACEMENT
NOT SUPPLEMENT--YES REPLACE
CAN HAVE ALLERGIC REACTION
TX STEATORHEA SCENE