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38 Cards in this Set
- Front
- Back
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H2 receptor antagonists end in
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-tidine
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toxicities associated with cimetidine
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gynecomastia
altered estrogen met in men prl increase slows hepatic metabolism of some drugs |
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toxicities associated iweth famotidine and ranitidine
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HA
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what is the rule for combining drugs with H2
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Don't do it
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How is refractory ulcer disease treated with H2
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combine with AB and bismuth
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PPI endings
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-prazole
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MOA of PPI
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binds to H/K pump on surface of gastric parietal cells, inhibiting secretion of H into lumen
Binds irreversibly! requires activiation in acidic environment to convert from prodrug to active form |
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what can antacids be combined with to reduce GERD sx
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alginic acid
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adverse effects of antacids
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Mg containing compounds have cathartic effect
Al --> constipation |
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Types of mucosal protective agents
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sucralfate
bismuth compounds carbenoxolone PG analogs |
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MOA of sucralfate
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creastes a barrier to acid, pepsin, and bile by coating necrotic tissue
can also bind directly to bile salts stimulates mucous and HCO3 secretion requires acidic conditions to be activated |
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MOA of bismuth compounds
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selective binding to an ulcer
inhibits pepsin stimulates mucous increases PG synth when combined with AB , 98% healing rates! |
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MOA of carbenoxolone
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increased production, ecretion and viscosity of intestinal mucous
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adverse effects of carbenoxolone
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aldoesterone like side effects
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MOA of misoprostol
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analog of PG E1
prevents ulcers induced by NSAID use inhibits gastric secretion through inhibiting histamine stimulated cAMP production |
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adverse effects of misoprostol
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diarrhea
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contraindication of misoprostol
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women of childbearing age b/c of stimulant effects on uterus
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general MOA of prokinetic agents
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stimulation of cholinergic neurons na dinhibiting adrenergic neurons
antagonism of D2 and 5HT3 abd 5HT4 agonists --> gastric motility |
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MOA of metoclopramide
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hastens esophageal clearance
raises LES pressur e accelerates gastric emptying shortens bowel transit time D2/5HT3 antagonist |
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applications for metoclopramide
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decreases heartburn
antiemetic for chemo |
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adverse effects of metoclopramide
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increased lactin release
galactorrhea menstrual d/o |
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erythromcin effect on GI
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motilin receptor agonist
effective in treating diabetic gastroparesis |
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alosteron
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5HT3 antagonist to treat IBS
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where is the vomiting center
what does it do |
reticular formation in medulla
coordinates motor activity of stomach and ab muscles receives input from chemoreceptor trigger zone on floor of 4th ventricle |
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classes of anti-emetic drugs
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H1 antihistamines
phenothiazenes 5HT3 antagonists MJ derivatives corticosteroids |
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H1 antihistamines
effects on GI tract |
diphenhydramine and hydrixyzine
H1 blocking effect, antimuscarinic effect, sedation possibly depresses vestibulocerebellar pathway, causign decreased motion sickness |
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MOA phenothiazene
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blocks DA receptors in chemoreceptor trgger zone
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adverse effects of phenothiazenes
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EPS
sedation |
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5HT3 antagonists end in
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-steron
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uses of 5HT3 antagonists
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prevention of chemo induced N/V
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antidiarrheal drugs
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diphenoxylate
loperamide |
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MOA of antidiarrheals
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diphenoxylate (prodrug) is activated to difenoxin
loperamide doesn't need to be activated both inhibit ACh release through presynaptic opioid receptors |
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which antidiarrheal has less adverse effects
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loperamide, b/c it doesn't x BBB
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Contraindication of antidiarrheals
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UC --> toxic megacolon
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Kaolin
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binds intestinal toxins
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pectin
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binds intestinal toxins
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types of laxatives
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irritants
bulking stool softeners |
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ex of bulking laxatives
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hydrophilic coloids
saline cathartics lactulose |
