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35 Cards in this Set
- Front
- Back
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Generic Name and Drug Class?
Tagamet |
Cimetidine; H2 antagonist
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Generic Name and Drug Class?
Zantac |
Ranitidine ; H2 antagonist
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Generic Name and Drug Class?
Axid |
Nizatidine; H2 antagonist
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Generic Name and Drug Class?
Pepcid |
Famotidine; H2 antagonist
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H2 antagonist MOA and pharmacological effect?
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Mechanism of Action
Competitive equilibrium antagonist at the H2-receptors Pharmacological effect Blocks the acid secreting effects of histamine Also reduces the acid secreting response to ACh and gastrin |
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H2 antagonist s/e?
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Few s/e, but main ones are HA, dizziness, nausea and skin rashes
At high doses, when give IV or pts w/ renal failure, elderly: somnolence, hallucinations and confusion specifically for high dose cimetidine: loss of libido, impotence, gynecomastia, glactorrhea and breast soreness (b/c it has antiandrogenic/antitestosterone effect) |
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What is the generic name and the drug class?
Prilosec |
Omeprazole; PPI
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What is the generic name and the drug class?
Prevacid |
Lansoprazole; PPI
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What is the generic name and the drug class?
Protonix |
Pantoprazole; PPI
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What is the generic name and the drug class?
Aciphex |
Rabeprazole; PPI
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What is the generic name and the drug class?
Nexium |
Esomeprazole; PPI
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What is the generic name and the drug class?
Zegrid |
Omeprazole + Na bicarbonate; PPI (omeprazole) and Antacid (Na bicarbonate)
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What is the generic name and the drug class?
Kapidex |
Dexlansoprazole; PPI
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What is the MOA of the PPIs and the pharmacological effect?
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MOA: Two molecules form an irreversible covalent disulfide bond w/ the H+/K+ ATPase proton pump
b/c its covalent bond formation this is irreversible Pharmacological Effect: Produces a dose-dependent inhibition of gastric acid secretion |
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What impt about the drug binding specificity in PPI?
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1. Selective distribution of the H+/K+ ATPase pump in the parietal cells
2. All PPIs are pro-drugs and need to be cleaved by acids to form the covalent bonds w/ the pumps this the reason these drugs work so well and have few s/e |
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What are the s/e from PPIs?
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Nausea, diarrhea, cramping
Hypergastrinemia (excess of gastrin production) Vitamin B12 deficiency (if use greater than 3 months due to acid requirement for b12 absorption |
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What is the generic name and drug class?
Cytotec |
Misoprostol; Prostaglandin analog
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What is the MOA and pharmacological effect of cytotec?
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MOA: Synthetic prostaglandin E1 agonist
Pharmacological Effect: Inhibition of acid secretion through EP3 receptors AND Stimulates mucus bicarbonate secretion and blood flow |
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What are the s/e of Cytotec?
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-30% of patients experience diarrhea
-Abdominal cramping -Potential abortifacient (can induce early labor b/c prostaglandins contract the uterus, this is the reason they may use this drug post partum) |
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What is the generic name and drug class?
Reglan |
Metoclopramide; prokinetic agent
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MOA of Metoclopramide?
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Increases release of Ach from neurons
Increases the sensitivity of the muscarinic receptors to Ach Dopamine (D2) antagonist |
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What is the function of dopamine in the GI tract?
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In GI tract, dopamine acts as an inhibitory neurotransmitter
Dopamine decreases esophageal contractions, relaxes the proximal stomach and reduces gastric acid secretions |
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What are the pharmacological effects of Metoclopramide on the GI tract? What does it not secretions does it not stimulate and why is this strange?
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1. Accelerates gastric emptying and intestinal transit
-->Increases amplitude and duration of esophageal contractions (gets the food out of the esophagus) -->Increases amplitude and tone of antral contractions (moves the food out of the stomach and allows the stomach to empty) -->Increases peristalsis of duodenum and jejunum 2. Changes sphincter tone -->Increases resting tone of lower esophageal sphincter -->Relaxes pyloric sphincter and duodenal bulb (this opens the stomach and allowing the food to more quickly exit the stomach and decrease the possibility of acid going back into the esophagus) 3. Does not stimulate gastric, biliary or pancreatic secretions- this strange b/c it works through increase release of ACh |
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What are the s/e from Metoclopramide?
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CNS- restlessness, drowsiness (main s/e)
Rare s/e- depression w/ uncontrolled crying and suicidal ideations, delirium, severe dysphoria, obsessive ruminations and mania Extrapyramidal rxns: akathisia, Dystonic reactions Tardive dyskinesia (Orobuccolingual dyskinesia) Parkinsonian symptoms (Tremors, Rigidity, Bradykinesia, Akinesia) Gastrointestinal (Diarrhea, Xerostomia) Hypersensitivity reaction Increased release of prolactin (Galactorrhea, gynecomastia and amenorrhea) |
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Why do you get EPS s/e w/ Reglan?
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Blockade of central DA receptors in motor centers of the brain
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What drug class, MOA and s/e of domperidone? is this available in the US and why is it better than reglan?
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prokinetic agent
MOA: D2 antagonist s/e: Does not cross BBB like metoclopramide thus Fewer central movement disorders--> this is the reason it would be better than reglan May increase prolactin but it is not available in the US |
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What is the generic name and drug class? Propulsid
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Cisapride, prokinetic agent
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What is the MOA of Cisapride?
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-5HT4 receptor agonist on prostganglionic cholinergic nerves which enhances release of Ach
-Weak 5HT3 antagonist NOTE: using the 5ht rec but its main action is through the release of ACh thus speeding up the gi tract |
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What are the pharmacologic effects of cisapride that are similar to metoclopramide?
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Increases lower esophageal sphincter pressure by 20% to 50%
Increases esophageal motility Accelerates gastric emptying Increases transit from duodenum to ileocecal valve |
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What are the pharmacologic effects of cisapride that are NOT similar to metoclopramide
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Increase cecal and ascending colonic motility
Increases stool frequency Reduces anal sphincter tone |
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What are the s/e of Cisapride?
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Diarrhea
Abdominal pain Nausea Constipation Flatulence Borborygmi (stomach rumbling) CNS - Headache Respiratory - rhinitis No hormonal effects (b/c not a DA antagonist) QT longation (Many drug interactions, Congenital heart arrhythmias)- problem and reason why it requires regulation (only for compassionate use) and essentially off the market by FDA |
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What is the GI MOA of Erythromycin (and drug class), the s/e and when is it used for this purpose?
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Prokinetic agent
MOA: Motilin agonist, Increases tone of lower esophageal sphinchter Used in specific setting such as coma pts in ICU Side effects - dyspepsia |
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What is the generic name and drug class of ILopan choline?
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Dexpanthenol with/without choline; prokinetic agent
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What is the MOA of Ilopan choline?
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A precursor of Coenzyme A which is needed for attaching an acetyl group onto choline to make acetylcholine
Increases gastric motility |
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What are the s/e from Ilopan choline?
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Pruritis
Tingling Difficulty in breathing Diarrhea Urticaria |
