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26 Cards in this Set

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Calcium carbonate
Class - nonsystemic Antacid
Indication - PUD, reflux esophagitis
SE, Tox - hypercalcemia (esp. with dairy products), renal stones, Ca stimulates secretion of gastrin and HCl --> acid rebound
Aluminum hydroxide
Class - nonsystemic Antacid
Indications - PUD
SE, Tox - *constipation*, hypophosphatemia, proximal myopathy, encephalopathy in pts on dialysis
Magnesium salts
Class - nonsystemic Antacid
Indication - PUD
SE, Tox - *diarrhea*, milk-alkali syndrome with dairy products, metabolic *alkalosis* esp. in renal insufficiency. exacerbation of CHF, edema because of sodium intake.
CI - HTN
Antacids
All can cause hypokalemia.
Cimetidine
Class - H2 blockers (block parietal cell histamine receptors)
Indications - Tx/prevent PUD, ZE, gastritis, mild GERD
Properties - acid secretion inhibited for 4 hours
SE, Tox - only H2 blocker to inhibit P450 system --> increase serum levels of EtOH, warfarin, digitoxin, TCA, phenytoin, carbamazepine, β-blockers, benzos. antiadrogenic, decreased renal excretion of creatinine.
Ranitidine
Class - H2 blockers (block parietal cell histamine receptors)
Indications - Tx/prevent PUD, ZE, gastritis, mild GERD
Properties - more potent than cimetidine. 1-2x daily.
SE, Tox - less than cimetidine, doesn't penetrate CNS as much, no P450 effect.
H2 Blockers
cimetidine, ranitidine, famotidine, nizatidine
Omeprazole, Lansoprazole
Class - PPI
Indications - GERD, PUD, ZE, gastritis. esp. when refractory to H2 blockers.
Properties - irreversible inhibition, prodrug that diffuses into acid space of secretory canaliculus where it is protonated to active form.
SE, Tox - overgrowth of bacteria
Sucralfate
Indications - PUD
Properties - activated in acid environment. negative charges bind to positively-charged proteins in ulcerated tissue. Provides physical protection.
SE, Tox - minor. mostly constipation. decrased absoprtion of ciproflaxin, norflaxin. because it needs acid to be activated, do not give with antacids, H2 blockers, PPIs.
Bismuth
Indications - PUD
Properties - binds to ulcerr providing physical protection. possible antimicrobial activity against H. pylori.
Misoprostol
Class - PGE₁ analog
Indications - prevent gastric ulcers caused by NSAIDS.
SE, Tox - Diarrhea.
CI - potentially childbearing women (induces labor).
Antibiotics for PUD
Tetracycline, Metronidazole, Clarithromycin, plus H2 blocker drastically reduces recurrence compared to H2 blocker alone.
Ipecac
Class - Emetic
Properties - irritates GI tract, stimulates chemoreceptor zone. Onset = 15-30 min.
Prochlorperazine, chlorpromazine, metoclopramide
Class - Dopamine receptor antagonists.
Properties - Act at D2 receptors at chemoreceptor trigger zone --> antiemesis.
Ondansetron
Class - Antiemetic
Properties - 5-HT3 antagonist
Indications - control vomiting postop and during chemotherapy.
SE, Tox - headache, constipation.
Bulk-forming Laxatives
Examples - dietary fiber, semisynthetic polysaccharides/cellulose (methylcellulose).
Properties - osmotic effect --> fluid/electrolyte renetion in intestinal lumen. increased fecal mass/softness --> accelerated transit. Works within 1-3 days after PO administration.
Indications - diverticular disease, IBS.
SE, Tox - flatulance, electrolyte imbalances, esophogeal/intestinal obstruction therefore take with fluids
Castor Oil
Class - Stimulant laxative
Properties - hydrolyzed in small intestine to active ingredient --> decreased reabsorption of electrolytes/fluids and stimulates peristalsis. works within 1-3 hours after PO administration.
SE, Tox - chronic use impairs absorption of essential nutrients, excacerbates dehydration and electrolyte disturbances.
Bisacodyl
Class - Stimulant laxative
Properties - onset of action (oral) = 6-12h, (rectal) = 1h.
SE, Tox - fluid/electrolyte deficiencies, rash, rectal burning
Anthroquinones
Class - Stimulant Laxative. (cascara and senna, eg)
Properties - effect at large intestine. Increase peristalsis.
Docusates
Class - Stimulant Laxative
Properties - anionic surfactant. Softens stool by emulsifying water, fat, and feces. Onset of action = 1-3d.
Indications - used after abdominal surgery and postMI.
SE, Tox - nausea, cramping. Don't use with mineral oil.
Salt-containing Osmotic Laxatives
Properties - contain Mg, phosphate, sulfate salts. fluid retention --> increased motility. Onset of action = 2h, semifluid stools.
Indications - bowel evacuation prior to surgery/imaging.
SE, Tox - Mg salts --> hypermagnesemia in pts with renal insufficiency. Na salts exacerbate CHF, cause dehydration.
Lactulose
Class - nonsalt Osmotic Laxative
Properties - semisynthetic disaccharide. Traps ammonia as NH4+, enhances excretion of nitrogenous wastes in hepatic insuffiency. Onset of action = 1-3d.
Indications - laxative and in hepatic encephalopathy
SE, Tox - N/V, flatulence, diarrhea, dehydration, hypokalemia.
Mineral Oil
Class - Surfactant Laxative
Properties - softens stool
SE, Tox - limiting. pneumonitis after aspiration, imparied absorption of fat-soluble nutrients, pruritus ani (ew.)
Loperamide
Class - Opiate
Indications - Diarrhea
Properties - since it poorly crosses BBB, it has few side effects and low potential for abuse. decreases GI motility.
Infliximab
Class - monoclonal Ab to TNF-α (a proinflammatory cytokine)
Indications - Crohn's Disease, rheumatoid arthritis.
SE, Tox - respiratory infection, fever, hypotension
Sulfasalazine
Class - combo of sulfapyridine (antibacterial) and mesalamine (anti-inflmmatory).
Indications - Ulcerative colitis, Crohn's disease
SE, Tox - Malaise, nausea, sulfonamide toxicity (hypersensitivity rxn, hemolysis in G6PD deficient pts, nephrotoxicity, kernicterus, displacing drugs (warfarin) from albumin)