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33 Cards in this Set
- Front
- Back
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4 H2 blockers
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- cimetidine
- ranitidine - famotidine - nizatidine |
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MOA of H2 blokcers
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reversible block of histamine H2 receptors → ↓H+ secr by PARIETAL CELLS
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clinical use(s) of H2 blockers
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- peptic ulcer
- gastritis - mild esoph reflux |
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cimetidine toxicity
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- 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) |
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2 proton pump inhibitors
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1) omeprazole
2) lansoprazole |
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irreversibly (-) H+/K+-ATPase in stomach parietal cells
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PPI's
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PPI MOA
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irreversibly (-) H/K-ATPase in stomach parietal cells
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PPI clinical use(s)
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- peptic ulcer
- gastritis - esoph reflux - zollinger-ellison synd |
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bind to ulcer base, providing physical protection, & allow HCO3- secr to reestablish pH gradient in mucous layer
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bismuth & sucralfate
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requires an acidic environment to work
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bismuth & sucralfate
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MOA of bismuth
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bind to ulcer base, providing physical protection, & allow HCO3- secr to reestablish pH gradient in mucous layer
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MOA of sucralfate
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bind to ulcer base, providing physical protection, & allow HCO3- secr to reestablish pH gradient in mucous layer
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MOA of Misoprostol
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- PGE1 analog
- ↑ production & secr of gastric mucous barrier - ↓ acid production (by Gi protein) |
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clinical use(s) of misoprostol
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- prevent NSAID-induced peptic ulcers / gastritis
- maintain PDA - induces labor |
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contraindications of misoprostol
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- women of childbearing potential (abortifacient)
- don't use in IBD either |
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pirenzepine / propantheline MOA
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- muscarinic antagonists
- block M1 receptors on EVL cells (↓ histamine secr) - block M3 receptors on parietal cells (↓H+ secr) |
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toxicity of pirenzepine/propantheline
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- 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) |
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aluminum hydroxide (antacid) overuse
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- constipation (aluMINIMUM feces)
- HYPOphosphatemia - HYPOkalemia (all) - prox musc weakness - osteodystrophy - seizures |
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magnesium hydroxide (antacid) overuse
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- diarrhea (Mg = Must Go to the bathroom)
- HYPOreflexia - HYPOtension - HYPOkalemia (all) - cardiac arrest |
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calcium carbonate (antacid) overuse
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- HYPERcalcemia
- HYPOkalemia (all) - rebound acid ↑ (from Ca2+ induced gastrin) - can also CHELATE & ↓ effectiveness of other drugs (like tetracyclines...) |
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monoclonal antibody to TNF & proinflammatory cytokine
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infliximab
(INFLIX pain to TNF) |
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clinical use(s) of infliximab
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- crohn's
- rheumatoid arthritis |
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infliximab toxicity
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- resp infxn (incl reactiv of latent TB)
- fever - hTN |
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MOA of sulfasalazine
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combo of sulfapyridine (anti-bact) & 5-aminosalicylic acid (anti-inflam)
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sulfasalazine is activated by ??
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colonic bacteria
(so only effective in colon!) |
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clinical use(s) of sulfasalazine
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- ulcerative colitis
- crohn's |
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sulfasalazine toxicity
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- malaise
- nausea - sulfonamide tox - reversible oligospermia |
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MOA of ondansetron
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- 5HT3 antag
- powerful CENTRAL acting antiemetic |
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clinical use of ondansetron
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control vomiting post-op & in pts undergoing chemo
(keep ON DANSetron) |
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ondansetron toxicity
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- HA
- constipation (5HT agonist, sumatriptan, cures HA) |
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metoclopramide MOA
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- D2 receptor antag
- ↑ resting tone, dp/dt, LES tone, motility - does NOT infl colon transport time |
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clinical use of metoclopramide
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in DIABETICS & post-op gastroparesis
(diabetics→ stomach not well innerv→ gastroparesis) |
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metoclopramide toxicity
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- ↑ 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 |
