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30 Cards in this Set

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Increase gastric pH to above 4 so that pepsin is inactivated
ANTACIDS
calcium-containing s/e - hypercalcemia w/ renal impairment
Aluminum - constipation, hypophosphatemia
Magnesium - hypermagnesemia, diarrhea
Sodium - instigate CHF
Inhibit histamine at H2 Receptor --> reduced basal and food stimulated gastric acid secretion and volume
Associated w/ hypersensitivity, confusion in elderly, gynecomastia and infertility in males
Cimetidine (tagamet)
also increases levels of drugs P450 system
Omeprazole
Proton-pump inhibitor - irreversibly inhibits the H+/K+ ATPase pump of the parietal cell
Well tolerated
Effective for GUs and DUs, esophagitis, healing of ulcers assoc with NSAIDs, Zollinger-Ellison Syndrome, used in combination with antibiotics for H. pylori
Proton Pump Inhibitors
Sucralfate (carafate)
Surface protective agent
forms ulcer adherent complex
inhibits pepsin activity, absorbs bile salts, may stimulate PG secretion
-short term treatement of DU
- requires acidic envt
Bismuth Salts
binding to ulcers, may stimulate PG synthesis, increase mucous production, inhibit pepsin
Used in combination with antibiotics to decrease H pylori
Bismuth salts
analog of PGE1- used for NSAID induced ulceration
Misprostol
CONTRAINDICATED IN PREGNANCY
causes abdominal pain and diarrhea
Increases GI motility
Mimics cholinergic action but is a dopamine antagonist
Metoclopramide
(can cause somnolence, nervousness, dystonia, parkinsonism, tardive dyskinesia)
Antiemetic with cholinergic and serotenergic activity
can cause fatal arrythmias
Cisapride
(off the market)
Block Dopamine receptors in chemoreceptor trigger zone
Phenothiazines
Serotonin receptor antagonist used to treat nausea associated with cancer therapy
Onsdansetron
Dronabinon
marijuana derivative
antiemetic
Opioid derivative used in treatment of diarrhea
usually used with atropine
Diphenoxylate
(metabolized to active product)
contraindicated in ulcerative colitis b/c of toxic megacolon
Loperamide
inhibits Ach release through presynaptic opioid receptors in gut
First line therapy for IBD
antiinflammatory agent - inhibits cyclooxygenase and lipoxygenase
sulfasalazine
side effects:(20%)malaise, nausea, abdominal discomfort anorexia, folate malabsorption, hypersensitivity, many others
Tolerated by 80-90% of those who cant tolerate 5-ASA
Olsalazine (dipentum)
contains 2 molecules of 5-ASA and is broken down in colon to release 5-ASA
Resin coated 5-ASA - released in a pH dependent manner in distal ileum and colon
Mesalamine (Asacol)
Ethycellulose coated 5-ASA - time dependent release from jejenum to colon
Mesalamine (Pentasa)
best formulation for small bowel disease
immunomodulator that inhibits purine metabolism.
6-MP (purinethol)
steroid sparing
slow onset - 3 months
bone marrow suppression, pancreatitis
Inhibits IL-2 - used as a temporary measure in severe colitis
Cyclosporine
onset 1-2 weeks
side effects: HTN, Seizures, Parasthesias, tremor, cholestasis, others
Folic acid antagonist most effective in crohn's disease.
Methotrexate
steroid sparing
chimeric antibody against TNF-alpha. Used for moderate, severe or fistulizing crohn's disease
Infliximab
s/e: increased risk of infection, infusion reaction, tachyphylaxis, nausea, serum sickness
Non-selective B-blocker
decreases renin, CO, and peripheral resistance
proponolol
can cause bronchial constriction
Most popular selective B-blocker
Metoprolol
(atenolol - similar but longer acting)
alpha1 and Beta blocker
Labetalol
(carvedilol is another drug with combined a/B effects)
Peripheral A1 blocker - causes vasodilation without reflex cardiac stimulation
Used in HTN with benign prostatic hypertrophy
Prasozin
Doxazosin
S/E: Orthostasis - first dose effect - helped by taking at night
Central A2 agonist - decreases peripheral autonomic tone
Clonidine
S/E - sedation, rebound HTN, dry mouth
Arterial vasodilator that works directly on smooth muscle
Hydralazine
S/E: reflex tachycardia, Na retention and edema
always use with B-blockers and furosemide
Potent arterial vasodilator that opens K channels- relaxation of smooth muscle cells but not used except for as a topical treatment for BALDNESS
Minoxidil