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85 Cards in this Set

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What three chemicals stimulate acid secretion in parietal cells?
ACh
histimines
Gastrin
what are the drugs that are used in acid pepctic siseases
antacids
H2 receptor blockers
propton pump inhibitors
sucralfate
misoprostil
bismuth comoubds
What are some examples of antacids
aluminum hydroxids
aluminm hydroxid and magnesium hydroxid
calcium carbonate
What is the MOA for antacids
react with HCl to increase pH
What are some of the adverse reactions of antacids
Mg(OH) can cause diarhea
Al(oH) causes constipation
which is why they are combined
Milk alkali syndrome-alkolosis with dairy
aluminum and magnesium can cause rean insuffiencey
decreased abosorpption of some drugs
What are some examples of H2 receptor blockers
histamine
cimetidine
ranitidine
famotidine
nizatidiine
MOA of H2 rec. blockers
competitive inhibition of H2 receptors on parietal cells decrease HCl secretion
what are some adverse effects of H2 receptor blockers
GI effects
cimetidine-possible gynecomastia
altered mental state in ICU pts
interactions
Proton pump inhibitors examples
omeprazole
pantoprazole
lansoprazole
rabeprazole
Proton pump inhibitors MOA
inhibit H/K ATPase which decreases HCl secretion. significantly
what are some adverse rxn for proton pump inhibitors
increased gastrin
interactions
What are proton pump inhibitors used in?
GERD
peptic ulcer disease
hypersecretor conditions like zellwinger ellinger syndrome
What are some examples of proton pump inhibitors?
omeprazole(prilosec)
What is the mech of action for sucralfate?
converted to thick paste binds ulcer
acts as a physical barrier
What are some adverse reactions for sucralfate?
constipation
some aluminum absorbed can cause toxicity in renal insuffienct pts
interactions
what is the MOA of misoprostil?
decrease acid secretion
increases mucas, bicarb
increase mucosal blood flow
what are the adverse rxn of misoprostil
diarrhea, abdominal cramps
contraindicated in preg. increases uterine contractions
what are some examples of bismuth compounds?
bismuth subsaliclylate
bismuth subcitrate potassium
peptobismal
what are some adverse effects of the bismuth compounds?
darkening of the tongue and stool
what are some uses of bismuth compound?
dyspepsia, diarrhea, traverer's diarrhea in some regimens against H. Pylori
What are some drugs used to increase GI motility?
metoclopramide
erythromycin
what is the moa of metopclopramide?
dopamine antagonist

stimulation of dopamine receptors inhibits motility of GI so dopamine antagonist would increase motility
What is the use of metopclopramide?
diabetic gastropariesis
what is the moa of erythomycin
stimulates motilin receptors
what is the use of erythromcyin
diabetic gasteropariesis
what are some expamples of bulk forming laxatives?
psyllium (metamucil)
methylcellulose
polycarbophil
what is the moa of bulk forming laxiatives?
Absorb water
distend colon
increase peristalsis
What are some examples of stool softeners?
docusate(colase)
What is the mech of action of stool softeners?
decrease surface tension of stoole which leads to increased lipids in stool
What are the two types of osmotic laxatives?
nonabsorbable sugars and salts
balanced polyethylene glycol
What are some examples of nonabsorbable sugrs and salts
magnesium hydroxide
lactulose
magnesiun citrate
sodium phosphate
what are some examples of use for balanced pyolyethylene glycol(Golightly)
cleansing bowel for endoscopy
what are the two stimulant laxatives?
anthrauinones(senna, cascara)
diphenylmethanes(bisacodyl)
what are some examples of chloride channel activators
lubiprostone
what is the moa of lubiprostone
increased fluid secretion which increases motility
what are some uses of lubiprostone
chronic constipation
irritable bowel sydnrome
what are some examples of opiod receptor antagonists
methylnaltrexone
what is the moa of methylnaltrexone
opioids lead to constipation

methylnaltrexone blocks peripheral receptors without entering the brain.
what are some examples of opioid agonist antidiarrheals
loperamide-poor entry into CNS
diphenyloxylate- higher doses produce CNS effects
what are the different classes of antidiarrheal drugs?
opioid agonists
colloidal bismuth compounds
kaolin and pectin
bile salt-binding resins
octreotide
what is the moa of octreotides
synthetic peptide that mimic somatostatin and causes antidiarrheal effects.
what are some drugs used in IBS(irritable bowel syndrome)?
antispasmodics(anticholinergics
serotonin 5 HT3 receptor antagonist
chloride receptor activators
what are some examples of serotonin 5 HT3 receptor blockers
alosetron
what are some adverse effects of alosetron?
infrequent but serious GI tox
ischemic colitis, constipation with serisou complications
participation in prescribing program required for use
what is an example of use for alosetron
indicated only in woman with severe diarrhea predominant IBS
what is an example of chloride receptro activator
lubriprostone
what are some examples of serotonin 5 HT3 receptor antagonists used for antimimetics
ondansetron
what are some adverse effects of ondansetron
headache, constipation
increased QT interval
what is the moa of ondansetron
block peripheral and central 5 HT3 receptors
what is the ending on all 5 HT3 receptor blockers
setron
how are the 5 HT3 receptor blockers metabolised?
hepatic metabolism
What are the examples of neurokinin 1 substance P receptor antagonists used for antimemetics
aprepitant
fosaprepitant
what is the antimemetic MOA of substnace P receptor blockers
blocks central receptors to inhibit bothe the acute and delayed phases of cislatin induced emesis
what are some adverse effects of the neurokinin (sub P) rec. blockers
fatigue
dizziness
diarrhea
what are the examples of the phenothiazines antiemeic drugs
prochlorperazine
promethazine(phenergin)
what is the moa of the phenothiazines
inhibit DA and muscarine receptors
inhibit the histamine recprtos
what is the moa of metoclopramide
blocks dopamine rec.
what are the adverse effects of metoclopramide?
extrapyramidal effects
what are some examples of H1 antihistamines and antichlolingergic drugs?
diphenyhydramine
meclizine
scopolmine
what is an example of use for the H1 / anticholinergic drugs
motion sickness
what are some examples of cannabinoids?
dronabinal (THC)
nabilone
what is the adverse effects of cannabinoids
CNS effects
what are some drugs used to treat IBS
aminosalicylates
glucocorticoids
purine analogs
methotrexte
anti TNF antibodies
anti integrins
Why are aminosalicylates made as azo compounds
bc aminosalicylates provide topical relief to IBS in the colon, but are absorbed in the proximal bowel. azo compounds are not absorbed until they are broken down into aminosalicylsates in the colon.
what are some examples of the aminosalicylates?
azo compounds
-sulfasalzine, olsalazine, baslsalazid
5-ASA
-mesalamine- non azo formulation usually given in casuple that allows it to only be released in the colon.
what are some adverse effects found in the aminosalicylates?
sulfasalazine- leads to GI upset headache hypersensistiviy, reversable oligospermia, decreased folate absorption
other forumations of the aminosalicylates cause less adverse effects
what are some uses of aminosalicylates
ulcderative ccolites
crohns disease
Whater are some examples of purine analogs?
azathioprine
6 mercaptopurine
what is the mechanism of action in 6-mercaptorpurine
active nucleotides interfere with multiple reactions also incorporated into DNA and RNA.
what are some adverse effects found in 6 mercaptopurines?
BM
Liver
imunosuppporesionn
what is the moa of methotrexates?
inhibit DHRF which is needed for a step in DNA synthesis
what are some examples of the anti TNF antibodies used in inflammatory bowel disease
infiximab
adalimumab
certolizumbad.
what is the moa of infliximab?
chimeric that binds TNF
what are some adverse effects of infliximab
increased risk of infection
infusino reaction
serum sickness
devlopment of antiobdies to drug
reports of lymphomas
what are some uses of infliximab
chrons
ulcerative colits
what are some examples of anti integrin therapy used in inflamatory bowel?
natalizumam(tysarbi)
what is the moa of natalizumab
binds to alpha4 integrin which decreases extravasation of some cells to inflammatorory area
what are some adverse effects of natalizumab?
increases risk of progressive multifocal leukoencephalopathy, an opportunistic viral infection of the brain that usualy leads to death ro severe disability.
examples of use fore natalizumab
indicated for severe crohns with evidence of inflammation who have inadequeate respone to other conventional therapies and the inhibitors of TNF alpha,

never use in combonation with immunosupppresants
what is an example of pancreatic enzyme supplements used to treat inflamatory bowel syndrome
pancrelipase
what are some adverse effects of pancrelipase
fibrosing colonopathy
increased uric acid
allergic reactions
what is an example of use for pancrelipase
exocrine pancreatic insufficiency
cystic fibrosis
What is bile acid therapy used for ?
gallstones
what are some examples of bile acid therapy
ursodilol
what are some drugs used to treat variceal bleeding?
octreotide

beta blockers