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57 Cards in this Set
- Front
- Back
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esomeprazole (Nexium)
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proton pump inhibitor. Interact with warfarin, diazepam, cyclosporine
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lansoprazole (Prevacid)
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proton pump inhibitor. Interact with warfarin, diazepam, cyclosporine
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omeprazole (Prilosec)
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proton pump inhibitor. Interact with warfarin, diazepam, cyclosporine. Can decrease clearance of disulfiram and phenytoin by inhibiting CYP2C19, and increase clearance of imipramine, antipsychotics, tacrine and theophylline by activating CYP1A2
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cimetidine (Tagamet)
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H2 receptor antagonist. Oldest. Can decrease testosterone binding and hydroxylation of estradiol. Decrease pepsin and intrinsic factor output as well (controlled by ECL cells). Tolerance can develop in 3 days.
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famotidine (Pepcid)
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H2 receptor antagonist. Decrease pepsin and intrinsic factor output as well (controlled by ECL cells). Tolerance can develop in 3 days.
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ranitidine (Zantac)
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H2 receptor antagonist. Decrease pepsin and intrinsic factor output as well (controlled by ECL cells). Tolerance can develop in 3 days.
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sucralfate (Carafate)
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forms a sticky neutral pH polymer coating that swells and covers the epithelium. Used for stress ulcers; acid activated. Bad: constipation, blocked absoprtion of other drugs
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aluminum hydroxide
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neutralizing antacid. Slower acting. Delays emptying and slows motility. (constipation) possible phosphate loss. Binds tetracyclines so they cant be absorbed
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calcium carbonate
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neutralizing antacid
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magnesium hydroxide (Milk of Magnesia)
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neutralizing antacid. Faster acting. Stimulated gastric emptying and motility. Contraindicated in renal disease or pts on lithium
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magnesium trisilicate
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neutralizing antacid. Silica is absorbed and may form renal stones. Contraindicated in renal disease or pts on lithium
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pirenzepine (Gastrozepine)
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muscarinic antagonist, selective for M3 receptors. Blocks NT in intramural ganglia, resulting in decreased stimulation of parietal and ECL cells. Also slows down bowel motility.
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bethanechol (Urecholine)
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prokinetic agent. Muscarinic agonist. Does not activate coordinated motility (diarrhea, cramps).
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cisapride (Propulsid)
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prokinetic agent. Not availabel in US, can cause fatal arrhythmias. Serotonin receptor and adenylate cyclase stimulant. Used for GERD.
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erythromycin
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prokinetic agent. macrolide antibiotics imitate motilin - peptide hormone that increases motility; secreted by enterochromaffic cells and M cells in upper small bowel. Use: gastric dumping - improve gastric emptying with ileus, scleroderma and pseudo-obstructions.
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metoclopramide (Reglan)
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prokinetic agent. Dopamine receptor antagonist. Releases dopamines antagonism of ACh release. (enhances normal ACh response). Increased lower esoph.sphincter tone and upper GI motility. Relieve GERD, no healing. Antiemetic. Laxative. Bad: parkinsonian signs (CNS signs)
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neostigmine (Prostigmine)
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prokinetic agent. Acetylcholinesterase inhibitor. Counters ileus, broad stimulation of system.
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tegaserod (Zelnorm)
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prokinetic agent. Serotonin partial agonist. Use: females with irritable bowel syndrome (improves lower bowel motility when theres chronic constipation and bloating). Bad: Diarrhea and HA
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magnesium citrate (MOM)
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osmotic cathartic. Cause water retention. Mg stimulates CCK receptors and increases motility.
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magnesium hydroxide
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osmotic cathartic. Cause water retention. Mg stimulates CCK receptors and increases motility.
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magnesium sulfate
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osmotic cathartic. Cause water retention. Mg stimulates CCK receptors and increases motility.
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polyethylene glycol (PEG) (GoLYTELY)
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osmotic cathartic. Cause water retention.
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lactulose (Cephulac)
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osmotic laxative. Draw water into gut. Use: constipation with opioid use and vincristine. Drops luminal pH by bacerial fermentation, traps NH4 (liver Fx can increase amonia in blood)
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mannitol
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osmotic laxative. Draw water into gut. Use: constipation with opioid use and vincristine
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sorbitol
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osmotic laxative. Draw water into gut. Use: constipation with opioid use and vincristine
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docusate (Colace)
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wetting agent. Docusate salts are sufactans that allow mixing of fatty substances and water in stool. Effective as stool softeners. Do not increase pooping frequency. Not good for pts that are already compacted.
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bisacodyl (Dulcolax)
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irritant laxative, orally or rectally. Overdose causes catharsis. Important not to chew or mix with milk (gastric irritation causes projectile vomiting)
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castor oil
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smooth muscle stimulant (also induces labor). Made from Ricinus communis (castor bean). Oil full of triglyceride and ricinoleic acid. RA speeds motility in small bowel. 4mL=laxative effect in 4 hrs. 16mL=cathartic effect
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glycerin
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osmotic laxative. Suppository acts as hydroscopic agent and lubricant. Softens stool.
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methylcellulose
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bulk-forming laxative. Fiber based. Regular, soft stools. Exacerbate intestinal obstrucions? Adsorb other drugs? Wall paper paste, hydroxycut.
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polycarbophil
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bulk-forming laxative/antidiarrheal. Fiber based. Regular, soft stools. Exacerbate intestinal obstrucions? Adsorb other drugs?
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psyllium
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bulk-forming laxative. Fiber based grass seed husk. Regular, soft stools. Exacerbate intestinal obstrucions? Adsorb other drugs?
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bismuth subsalicylate (Pepto-Bismol)
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antidiarrheal agent - with magnesium aluminium silicate and oil of wintergreen. Naturally pink. Salicylate (anti prostaglandin) released in stomach and absorbed systemically
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diphenoxylate (Lomotil, Motofen)
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antidiarrheal agent, opioid. Piperidine derivative. Can have CNS effects. Packaged with atropine to discourage abuse.
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loperamide (Imodium)
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antidiarrheal agent, opioid. 40-50X more potent than morphine. Does not enter blood, CNS.
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octreotide (Sandostatin)
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antidiarrheal agent, somatostatin. Parenteral. Combats secretory diarrhea of hormone secreting tumors. Use: post-surgical gastric dumping syndrome, diarrhea from chemo, rest pancreas in pancreatitis. Bad: nausea, bloating, gallstones w/longterm therapy
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diphenhydramine (Benadryl)
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antiemetic agent, antihistamine (H1). Dosed as dimenhydrinate (salt of diphenhydramine and chlorotheophyllinate)
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dimenhydrinate (Dramamine)
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antiemetic agent, antihistamine (H1). Use: motion sickness, post-op emesis. Act on brainstem and vestibular apparatus. Salt of diphenhydramine
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dolasetron (Anzemet)
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antiemetic agent, serotonin receptor antagonist. Oral/parenteral. Excreted by liver. Lasts 9-11hrs. Act at CTZ and STN, small intestine
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hydroxyzine (Vistaril)
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antiemetic agent, antihistamine (H1). Use: motion sickness, post-op emesis. Act on brainstem and vestibular apparatus.
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granisetron (Kytril)
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antiemetic agent, serotonin receptor antagonist. Oral/parenteral. Excreted by liver. Lasts 7-9 hrs. act at CTZ and STN, and small intestine.
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metoclopramide (Reglan)
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antiemetic agent, dopamine receptor antagonist. Affect CTZ, increase forward motility. Use: chemo induced nausea.
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ondansetron (Zofran)
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antiemetic agent, serotonin receptor antagonist. Oral/parenteral. Excreted by liver. Lasts 4 hrs. act at CTZ and STN, and small intestine. Chemo induced emesis/nausea.
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palonosetron (Aloxi)
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antiemetic agent, serotonin receptor antagonist. Parenteral only, excreted by kidney, liver. Lasts for 40 hours.
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promethazine (Phenergan)
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antiemetic agent, antihistamine (H1). Use: motion sickness, post-op emesis. Act on brainstem and vestibular apparatus.
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apomorphine (Apokyn)
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emetic agent. Acts on CTZ and locally. Given sub-Q.
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ipecac
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emetic agent. Acts on CTZ.
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6-mercaptopurine (Purinethol)
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bowel disease Tx. Immunosuppressive. Prodrug converted to 6-thioguanine which inhibits DNA synthesis
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budesonide (Entocort)
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bowel disease Tx. Glucocorticoid, target immune response. For flare-ups/severe disease. 200x more potent than hydrocortisone, but only 10% bioavailbe and most removed in hepatic first pass. Used as topical Tx inside the bowel.
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alosetron (Lotronex)
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Irritable bowel syndrome TX. Used for diarrhea predominant IBS. Seretonin receptor antagonist
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azathioprine (Imuran)
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bowel disease Tx. Immunosuppressive. Prodrug converted to 6-mercaptopurine.
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mesalamine (Rowasa)
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bowel disease Tx. 5-aminosalicylic acid (ASA). Sulfasalazine, olsalazine, balsalazide are cleaved to mesalamine. Inhibit TNFalpha, not COX. Use: acute flare-ups.
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olsalazine (Dipentum)
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bowel disease Tx. Activated in colon by cleavage to mesalamine. Diarrhea in 10-20% of pts. Newer than sulfasalazine, and better tolerated.
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prednisone (Deltasone)
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bowel disease Tx. Prototype glucocorticoid targeting general immune response. IV or oral. Bad: immunosuppression, endocrine disruption, steroid psychoses.
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sulfasalazine (Azulfidine)
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bowel disease Tx. Activated in colon by cleavage to mesalamine. Most side effects of mesalamine's because of sulfa group. HA, nausea, fatigue, allergic rxns, contraindicated in pregnancy.
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H.Pylori Tx
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combo of acid neutralization (PPI, H2RA), cytoprotection(bismuth) and antibacterial agents (tetracycline, clarithromycin, metronidazole, amoxicillin)
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simethicone
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surfactant sometimes added to antacids; "allows foam to break up"
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