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33 Cards in this Set

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4 H2 blockers
- cimetidine
- ranitidine
- famotidine
- nizatidine
MOA of H2 blokcers
reversible block of histamine H2 receptors → ↓H+ secr by PARIETAL CELLS
clinical use(s) of H2 blockers
- peptic ulcer
- gastritis
- mild esoph reflux
cimetidine toxicity
- potent (-) of CYP-450
- anti-androgenic effects (prolactin release, gynecomastia, impotence, ↓ libido)
- CAN cross BBB → confusion, dizziness, HA's
- CAN cross placenta (but safe in preg)
- ↓ renal excr of CREATININE (as does ranitidine)

(other H2 blockers are relatively free of these effects)
2 proton pump inhibitors
1) omeprazole
2) lansoprazole
irreversibly (-) H+/K+-ATPase in stomach parietal cells
PPI's
PPI MOA
irreversibly (-) H/K-ATPase in stomach parietal cells
PPI clinical use(s)
- peptic ulcer
- gastritis
- esoph reflux
- zollinger-ellison synd
bind to ulcer base, providing physical protection, & allow HCO3- secr to reestablish pH gradient in mucous layer
bismuth & sucralfate
requires an acidic environment to work
bismuth & sucralfate
MOA of bismuth
bind to ulcer base, providing physical protection, & allow HCO3- secr to reestablish pH gradient in mucous layer
MOA of sucralfate
bind to ulcer base, providing physical protection, & allow HCO3- secr to reestablish pH gradient in mucous layer
MOA of Misoprostol
- PGE1 analog
- ↑ production & secr of gastric mucous barrier
- ↓ acid production (by Gi protein)
clinical use(s) of misoprostol
- prevent NSAID-induced peptic ulcers / gastritis
- maintain PDA
- induces labor
contraindications of misoprostol
- women of childbearing potential (abortifacient)
- don't use in IBD either
pirenzepine / propantheline MOA
- muscarinic antagonists
- block M1 receptors on EVL cells (↓ histamine secr)
- block M3 receptors on parietal cells (↓H+ secr)
toxicity of pirenzepine/propantheline
- tachy
- dry mouth
- difficulty focusing eyes

(think hot as a hare, etc... b/c they are musc antags; don't really use them for peptic ulcers b/c of this)
aluminum hydroxide (antacid) overuse
- constipation (aluMINIMUM feces)
- HYPOphosphatemia
- HYPOkalemia (all)
- prox musc weakness
- osteodystrophy
- seizures
magnesium hydroxide (antacid) overuse
- diarrhea (Mg = Must Go to the bathroom)
- HYPOreflexia
- HYPOtension
- HYPOkalemia (all)
- cardiac arrest
calcium carbonate (antacid) overuse
- HYPERcalcemia
- HYPOkalemia (all)
- rebound acid ↑ (from Ca2+ induced gastrin)
- can also CHELATE & ↓ effectiveness of other drugs (like tetracyclines...)
monoclonal antibody to TNF & proinflammatory cytokine
infliximab
(INFLIX pain to TNF)
clinical use(s) of infliximab
- crohn's
- rheumatoid arthritis
infliximab toxicity
- resp infxn (incl reactiv of latent TB)
- fever
- hTN
MOA of sulfasalazine
combo of sulfapyridine (anti-bact) & 5-aminosalicylic acid (anti-inflam)
sulfasalazine is activated by ??
colonic bacteria
(so only effective in colon!)
clinical use(s) of sulfasalazine
- ulcerative colitis
- crohn's
sulfasalazine toxicity
- malaise
- nausea
- sulfonamide tox
- reversible oligospermia
MOA of ondansetron
- 5HT3 antag
- powerful CENTRAL acting antiemetic
clinical use of ondansetron
control vomiting post-op & in pts undergoing chemo
(keep ON DANSetron)
ondansetron toxicity
- HA
- constipation

(5HT agonist, sumatriptan, cures HA)
metoclopramide MOA
- D2 receptor antag
- ↑ resting tone, dp/dt, LES tone, motility
- does NOT infl colon transport time
clinical use of metoclopramide
in DIABETICS & post-op gastroparesis

(diabetics→ stomach not well innerv→ gastroparesis)
metoclopramide toxicity
- ↑ parkinsonian effects
- restlessness
- drowsy, fatigue, depression
- nausea, diarrhea
- drug interaction w/DIG & diabetic agents
- contraind in pts w/small bowel obstrxn (don't try to force it out!)
- also ↓'s seizure threshold