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85 Cards in this Set
- Front
- Back
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What three chemicals stimulate acid secretion in parietal cells?
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ACh
histimines Gastrin |
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what are the drugs that are used in acid pepctic siseases
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antacids
H2 receptor blockers propton pump inhibitors sucralfate misoprostil bismuth comoubds |
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What are some examples of antacids
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aluminum hydroxids
aluminm hydroxid and magnesium hydroxid calcium carbonate |
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What is the MOA for antacids
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react with HCl to increase pH
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What are some of the adverse reactions of antacids
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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 |
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What are some examples of H2 receptor blockers
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histamine
cimetidine ranitidine famotidine nizatidiine |
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MOA of H2 rec. blockers
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competitive inhibition of H2 receptors on parietal cells decrease HCl secretion
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what are some adverse effects of H2 receptor blockers
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GI effects
cimetidine-possible gynecomastia altered mental state in ICU pts interactions |
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Proton pump inhibitors examples
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omeprazole
pantoprazole lansoprazole rabeprazole |
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Proton pump inhibitors MOA
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inhibit H/K ATPase which decreases HCl secretion. significantly
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what are some adverse rxn for proton pump inhibitors
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increased gastrin
interactions |
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What are proton pump inhibitors used in?
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GERD
peptic ulcer disease hypersecretor conditions like zellwinger ellinger syndrome |
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What are some examples of proton pump inhibitors?
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omeprazole(prilosec)
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What is the mech of action for sucralfate?
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converted to thick paste binds ulcer
acts as a physical barrier |
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What are some adverse reactions for sucralfate?
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constipation
some aluminum absorbed can cause toxicity in renal insuffienct pts interactions |
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what is the MOA of misoprostil?
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decrease acid secretion
increases mucas, bicarb increase mucosal blood flow |
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what are the adverse rxn of misoprostil
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diarrhea, abdominal cramps
contraindicated in preg. increases uterine contractions |
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what are some examples of bismuth compounds?
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bismuth subsaliclylate
bismuth subcitrate potassium peptobismal |
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what are some adverse effects of the bismuth compounds?
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darkening of the tongue and stool
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what are some uses of bismuth compound?
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dyspepsia, diarrhea, traverer's diarrhea in some regimens against H. Pylori
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What are some drugs used to increase GI motility?
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metoclopramide
erythromycin |
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what is the moa of metopclopramide?
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dopamine antagonist
stimulation of dopamine receptors inhibits motility of GI so dopamine antagonist would increase motility |
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What is the use of metopclopramide?
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diabetic gastropariesis
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what is the moa of erythomycin
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stimulates motilin receptors
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what is the use of erythromcyin
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diabetic gasteropariesis
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what are some expamples of bulk forming laxatives?
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psyllium (metamucil)
methylcellulose polycarbophil |
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what is the moa of bulk forming laxiatives?
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Absorb water
distend colon increase peristalsis |
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What are some examples of stool softeners?
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docusate(colase)
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What is the mech of action of stool softeners?
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decrease surface tension of stoole which leads to increased lipids in stool
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What are the two types of osmotic laxatives?
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nonabsorbable sugars and salts
balanced polyethylene glycol |
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What are some examples of nonabsorbable sugrs and salts
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magnesium hydroxide
lactulose magnesiun citrate sodium phosphate |
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what are some examples of use for balanced pyolyethylene glycol(Golightly)
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cleansing bowel for endoscopy
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what are the two stimulant laxatives?
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anthrauinones(senna, cascara)
diphenylmethanes(bisacodyl) |
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what are some examples of chloride channel activators
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lubiprostone
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what is the moa of lubiprostone
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increased fluid secretion which increases motility
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what are some uses of lubiprostone
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chronic constipation
irritable bowel sydnrome |
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what are some examples of opiod receptor antagonists
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methylnaltrexone
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what is the moa of methylnaltrexone
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opioids lead to constipation
methylnaltrexone blocks peripheral receptors without entering the brain. |
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what are some examples of opioid agonist antidiarrheals
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loperamide-poor entry into CNS
diphenyloxylate- higher doses produce CNS effects |
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what are the different classes of antidiarrheal drugs?
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opioid agonists
colloidal bismuth compounds kaolin and pectin bile salt-binding resins octreotide |
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what is the moa of octreotides
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synthetic peptide that mimic somatostatin and causes antidiarrheal effects.
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what are some drugs used in IBS(irritable bowel syndrome)?
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antispasmodics(anticholinergics
serotonin 5 HT3 receptor antagonist chloride receptor activators |
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what are some examples of serotonin 5 HT3 receptor blockers
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alosetron
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what are some adverse effects of alosetron?
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infrequent but serious GI tox
ischemic colitis, constipation with serisou complications participation in prescribing program required for use |
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what is an example of use for alosetron
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indicated only in woman with severe diarrhea predominant IBS
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what is an example of chloride receptro activator
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lubriprostone
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what are some examples of serotonin 5 HT3 receptor antagonists used for antimimetics
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ondansetron
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what are some adverse effects of ondansetron
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headache, constipation
increased QT interval |
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what is the moa of ondansetron
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block peripheral and central 5 HT3 receptors
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what is the ending on all 5 HT3 receptor blockers
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setron
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how are the 5 HT3 receptor blockers metabolised?
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hepatic metabolism
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What are the examples of neurokinin 1 substance P receptor antagonists used for antimemetics
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aprepitant
fosaprepitant |
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what is the antimemetic MOA of substnace P receptor blockers
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blocks central receptors to inhibit bothe the acute and delayed phases of cislatin induced emesis
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what are some adverse effects of the neurokinin (sub P) rec. blockers
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fatigue
dizziness diarrhea |
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what are the examples of the phenothiazines antiemeic drugs
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prochlorperazine
promethazine(phenergin) |
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what is the moa of the phenothiazines
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inhibit DA and muscarine receptors
inhibit the histamine recprtos |
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what is the moa of metoclopramide
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blocks dopamine rec.
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what are the adverse effects of metoclopramide?
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extrapyramidal effects
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what are some examples of H1 antihistamines and antichlolingergic drugs?
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diphenyhydramine
meclizine scopolmine |
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what is an example of use for the H1 / anticholinergic drugs
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motion sickness
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what are some examples of cannabinoids?
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dronabinal (THC)
nabilone |
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what is the adverse effects of cannabinoids
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CNS effects
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what are some drugs used to treat IBS
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aminosalicylates
glucocorticoids purine analogs methotrexte anti TNF antibodies anti integrins |
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Why are aminosalicylates made as azo compounds
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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.
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what are some examples of the aminosalicylates?
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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. |
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what are some adverse effects found in the aminosalicylates?
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sulfasalazine- leads to GI upset headache hypersensistiviy, reversable oligospermia, decreased folate absorption
other forumations of the aminosalicylates cause less adverse effects |
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what are some uses of aminosalicylates
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ulcderative ccolites
crohns disease |
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Whater are some examples of purine analogs?
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azathioprine
6 mercaptopurine |
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what is the mechanism of action in 6-mercaptorpurine
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active nucleotides interfere with multiple reactions also incorporated into DNA and RNA.
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what are some adverse effects found in 6 mercaptopurines?
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BM
Liver imunosuppporesionn |
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what is the moa of methotrexates?
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inhibit DHRF which is needed for a step in DNA synthesis
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what are some examples of the anti TNF antibodies used in inflammatory bowel disease
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infiximab
adalimumab certolizumbad. |
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what is the moa of infliximab?
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chimeric that binds TNF
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what are some adverse effects of infliximab
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increased risk of infection
infusino reaction serum sickness devlopment of antiobdies to drug reports of lymphomas |
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what are some uses of infliximab
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chrons
ulcerative colits |
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what are some examples of anti integrin therapy used in inflamatory bowel?
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natalizumam(tysarbi)
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what is the moa of natalizumab
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binds to alpha4 integrin which decreases extravasation of some cells to inflammatorory area
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what are some adverse effects of natalizumab?
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increases risk of progressive multifocal leukoencephalopathy, an opportunistic viral infection of the brain that usualy leads to death ro severe disability.
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examples of use fore natalizumab
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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 |
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what is an example of pancreatic enzyme supplements used to treat inflamatory bowel syndrome
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pancrelipase
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what are some adverse effects of pancrelipase
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fibrosing colonopathy
increased uric acid allergic reactions |
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what is an example of use for pancrelipase
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exocrine pancreatic insufficiency
cystic fibrosis |
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What is bile acid therapy used for ?
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gallstones
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what are some examples of bile acid therapy
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ursodilol
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what are some drugs used to treat variceal bleeding?
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octreotide
beta blockers |
