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38 Cards in this Set

  • Front
  • Back
H2 receptor antagonists end in
toxicities associated with cimetidine
altered estrogen met in men
prl increase
slows hepatic metabolism of some drugs
toxicities associated iweth famotidine and ranitidine
what is the rule for combining drugs with H2
Don't do it
How is refractory ulcer disease treated with H2
combine with AB and bismuth
PPI endings
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
what can antacids be combined with to reduce GERD sx
alginic acid
adverse effects of antacids
Mg containing compounds have cathartic effect

Al --> constipation
Types of mucosal protective agents
bismuth compounds
PG analogs
MOA of sucralfate
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
MOA of bismuth compounds
selective binding to an ulcer
inhibits pepsin
stimulates mucous
increases PG synth
when combined with AB , 98% healing rates!
MOA of carbenoxolone
increased production, ecretion and viscosity of intestinal mucous
adverse effects of carbenoxolone
aldoesterone like side effects
MOA of misoprostol
analog of PG E1
prevents ulcers induced by NSAID use
inhibits gastric secretion through inhibiting histamine stimulated cAMP production
adverse effects of misoprostol
contraindication of misoprostol
women of childbearing age b/c of stimulant effects on uterus
general MOA of prokinetic agents
stimulation of cholinergic neurons na dinhibiting adrenergic neurons
antagonism of D2 and 5HT3 abd 5HT4 agonists --> gastric motility
MOA of metoclopramide
hastens esophageal clearance
raises LES pressur e
accelerates gastric emptying
shortens bowel transit time
D2/5HT3 antagonist
applications for metoclopramide
decreases heartburn
antiemetic for chemo
adverse effects of metoclopramide
increased lactin release
menstrual d/o
erythromcin effect on GI
motilin receptor agonist
effective in treating diabetic gastroparesis
5HT3 antagonist to treat IBS
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
classes of anti-emetic drugs
H1 antihistamines
5HT3 antagonists
MJ derivatives
H1 antihistamines
effects on GI tract
diphenhydramine and hydrixyzine
H1 blocking effect, antimuscarinic effect, sedation
possibly depresses vestibulocerebellar pathway, causign decreased motion sickness
MOA phenothiazene
blocks DA receptors in chemoreceptor trgger zone
adverse effects of phenothiazenes
5HT3 antagonists end in
uses of 5HT3 antagonists
prevention of chemo induced N/V
antidiarrheal drugs
MOA of antidiarrheals
diphenoxylate (prodrug) is activated to difenoxin
loperamide doesn't need to be activated
both inhibit ACh release through presynaptic opioid receptors
which antidiarrheal has less adverse effects
loperamide, b/c it doesn't x BBB
Contraindication of antidiarrheals
UC --> toxic megacolon
binds intestinal toxins
binds intestinal toxins
types of laxatives
stool softeners
ex of bulking laxatives
hydrophilic coloids
saline cathartics