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30 Cards in this Set

  • Front
  • Back
Antacids can treat....but not...
Duodenal ulcers and GERD but not Gastric ulcers
Which antacids use aluminum and magnesium hydroxides to bind gastric acid?
Maalox, Mylanta, Gaviscon
Which antacid uses calcium carbonate to neutralize acid.
At what pH should the stomach be at for adequate therapy
> 4
Neutralizing capability of Al(OH)3, Mg(OH)2, and NaHCO3 vs. CaCO3
What effect does Al(OH)3 have on gastric motility?
How about Mg(OH)2

Sucraflate MA
forms protein crosslinks at ulcer site--Mucosal protectant
Bismuth Subsalicylate(Pepto) MA
Binds to ulcer site and binds bile acid- Mucosal protection
*also (-) PGs and alkali secretion
H2 receptor antagonists
(there are 4)
Cimetidine (Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)
Nizatidine (Axid)
Use of H2RA
Treatment of GERD, gastric ulcers, ZES, and H. pylori(used in combo w/antibiotics)
MA of H2RA
Analog of histamine, (-) bindnig of histamine to H2 receptors of parietal cells
Metabolism and excretion of H2RA
Excreted in urine mostly unmetabolized
Toxicities of Cimetidine
Gynecomastia (increased Prl)
Toxicities of Famotidine and Ranitidine
Drug interxn with cimetidine
Inhibits P450--prolongs 1/2 life of phenobarbital (anti-epileptic), theophylline (asthma), diazepam (anti-anxiety)
Proton Pump Inhibitors (PPIs)
(there are 5)
Omeprazole (Prilosec)
Esomeprazole(S enatiomer of Ome.)
Which PPI is available OTC
PPI use
Treatment of duodenal and gastric ulcers, ZES, and severe GERD
MA of PPIs
Covalently bind and irreversibly inhibit proton pumb on parietal cells
Activity of PPIs
Inactive at neutral pH, activated by low pH
When should you take PPIs for maximal effect
30-60 min before eating
Why so long for PPI action?
Absorbed in duodenum FIRST then circulate to stomach
How long do PPIs work
Several days--due to irreversible binding
Why does Esomeprazole have a longer half life than Omeprazole
Hepatic metabolism is slower
PPI toxicities
Nausea, diarrhea, abdominal pain/constipation
*Increased risk of resp. infection w/prolonged use
PPI drug interxns
Reduce absorption of drugs that need acidic environment: iron, ketconazole, ampicillan
How is PPI metabolism affected by those with CYP2C19 deficiency
Slow metabolizers of all PPIs except Rabeprazole
Misoprostol (Cytotec)
Prostaglandin E1 analog (-) acid secretion from parietals and (+)mucin secretion
Use of Misoprostol and side effects
Exclusively to prevent NSAIDs induced ulcers

Contraindications of Misoprostol