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39 Cards in this Set

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What drugs are H2 blockers? (4)
Cimetidine, ranitidine, famotidine, nizatidine.
MOA of H2 blockers?
Reversible block of histamine H2 receptors →↓H+ secretion by parietal cells.
Clinical uses of H2 blockers? (3)
Peptic ulcer, gastritis, mild esophageal reflux.
Toxicity of H2 blockers?
Cimetidine is a potent inhibitor of P-450; it also has an antiandrogenic effect and
↓ renal excretion of creatinine. Other H2 blockers are relatively free of these effects.
What drugs are proton pump inhibitors? (2)
Omeprazole, lansoprazole.
MOA of proton pump inhibitors?
Irreversibly inhibit H+/K+ ATPase in stomach parietal cells.
Clinical uses of proton pump inhibitors? (4)
Peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syndrome.
MOA of bismuth and sucralfate?
-Bind to ulcer base, providing physical protection, and allow HCO3 – secretion to reestablish pH gradient in the mucus layer.
Clinical uses of bismuth and sucralfate? (2)
↑ ulcer healing, traveler’s diarrhea.
What is the triple therapy used for H. pylori?
-Metronidazole
-Bismuth
-Amoxicillin (or tetracycline)
MOA of Misoprostol?
A PGE1 analog. ↑ production and secretion of gastric mucous barrier, ↓ acid production.
Clinical use of Misoprostol?
Prevention of NSAID-induced peptic ulcers; maintenance of a patent ductus arteriosus. Also used to induce labor.
Toxicity of Misoprostol?
Diarrhea. Contraindicated in women of childbearing potential (abortifacient).
What drugs are muscarinic antagonists? (2)
Pirenzepine, propantheline.
MOA of muscarinic antagonists?
Block M1 receptors on ECL cells (↓ histamine secretion) and M3 receptors on
parietal cells (↓ H+ secretion).
Clinical Use of muscarinic antagonists?
peptic ulcers
Toxicity of muscarinic antagonists? (3)
Bradycardia, dry mouth, difficulty focusing eyes.
What may result from antacid overdose?
can affect absortion, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying
What specific problems can be caused by aluminum hydroxide (antacid)?
-constipation and hypophosphatemia
-proximal muscle weakness
-osteodystrophy
-seizures
What specific problems can be caused by overdose of magnesium hydroxide? (4)
-diarrhea
-hyporeflexia
-hypotension
-cardiac arrest
How do you remember if aluminum or magnesion hydroxide causes diarrhea?
AluMINIMUM amount of feces.

Mg = Must go to bathroom
What problems result form calcium carbonate overdose? (2)
-hypercalcemia
-rebound increase in acid
What problem may be caused by all antacids?
Hypokalemia
MOA of Infliximab?
A monoclonal antibody to TNF-α, proinflammatory cytokine.
Clinical use of Infliximab? (2)
-Crohn's disease
-Rheumatoid arthritis
Toxicity of Infliximab? (3)
-Respiratory infection
-Fever
-Hypotension
MOA of Sulfasalazine?
A combination of sulfapyridine (antibacterial) and mesalamine (anti-inflammatory). Activated by colonic bacteria.
Clinical use of Sulfasalazine? (2)
-Ulcerative colitis
-Crohn’s disease.
Toxicity of Sulfasalazine? (4)
Malaise
nausea
sulfonamide toxicity
reversible oligospermia
MOA of Ondansetron?
5-HT3 antagonist. Powerful central-acting antiemetic.
Clinical use of Ondansetron?
Control vomiting postoperatively and in patients undergoing cancer chemotherapy.
Toxicity of Ondansetron?
-headache
-constipation
Mneumonic for Ondansetron?
"You will not vomit with ONDANSetron so you can go ON DANCing"
What drugs are considered "prokinetic agents"?
-Cisapride
-Metoclopramide
MOA of Cisapride?
-Acts through serotonin receptors to ↑ ACh release at the myenteric plexus
-↑ esophageal tone
-↑ gastric and duodenal contractility, improving the transit time (including through the colon)
Toxicity of Cisapride?
-no longer used
-serious interactions (torsades de pointes) with erythromycin. ketoconazole, nefazodone, fluconazole
MOA of Metoclopramide?
-D2 receptors antagonist
-↑ resting tone, contractility, LES tone, motility
-does not increase the transit time thru the colon
Clinical use of Metoclopramide? (2)
-Diabetic gastroparesis
-Post-surgery gastroparesis
Toxicity of Metoclopramide?

Drug interactions?

C/I?
-↑ parkinsonian effects
-restlessness, drowsiness, fatigue, depression, nausea, constipation

-D/I: digoxin and diabetic agents

-C/I: small bowel obstruction