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49 Cards in this Set
- Front
- Back
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what cells in the stomach secrete acid?
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parietal cells
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what is the bodies natural defense against acid?
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mucous and bicarb
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what 3 things cause an increase in secretion of acid from parietal cells?
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ACH, histamine, and gastrin
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what 3 receptors on the basolateral side cause activation of PP
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M3, H2, and CCKb
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what are 3 ways to block the release of acid from parietal cells?
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M3 blocker, H2 blocker, PPI
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which is a better choice for GERD, PPI or M blocker?
why |
PPI, M blockers have more AE
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what 2 functions do prostoglands have in protection against acid?
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bind to EP receptor in epithelial cells and cause the secretion fo mucous and bicarb as well as binding EP3 on parietal cells to block the activation of AC and this stops the activation of PP
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does the activation of EP3 activate Gi or Gs?
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Gi
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what are the 3 main causes of peptic ulcers
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h pylori
NSAIDs zollinger ellison disease |
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what is GERD
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acid reflux into the esophogus
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what is the common ending of the PPI?
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prazole
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why are PPI administered in sustained release capsules?
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the acid of the stomach would degrade them and keep them from being absorbed
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where are PPI absorbed?
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the duodenum
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PPI get into the blood and are uncharged. when they get to parietal cells they cross the membrane into the stomach and become charged and IRREVERSIBLY bind to PP.
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blank
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why is the half life of a PPI shorter than the duration of its action?
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they irreversibly bind to PP
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what PPI is immediate acting?
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zegerid
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why are PPI taken before a meal?
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because by the time they get to the basolateral side of the parietal cell, you want food in the stomach so there is acid present and this will cause the drug to become charged and thus activated.
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what are PPI metabolized by?
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cyp-450s
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what are the clinical uses of PPI?
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gastric and duodenal ulcers (of all causes) and GERD
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what are some AE of PPI?
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hyperplasia of gastric cells, increased risk of pneumonia, fractures in menopausal women due to decrease calcium absorbtion.
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old hag presents with GERD and has an increase in the number of fractures you think...
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PPI
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what drug should not be used with clopidogrel
why |
PPI inhibit cyp2c19 that is used to activate clopidogrel
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what is the common ending of H2 blockers
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-tidine
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do H2 blockers bind reversibly or irreversibly?
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reversibly
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what is the MOA for H2 blocker?
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they bind to the H2 receptor on the basolateral side of the cell to stop the activation of PP
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what are the clinical uses for H2 blockers?
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GERD
ulcers (gastric and duodenal) at high doses, NSAID ulcers |
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which is more effective, PPI or H2 blockers
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PPI
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what are 2 sig AE for H2 blockers for men and women?
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men- gynoclemastia
women- galactorrhea |
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man presents with boobs you think (rx)
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H2 blockers
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woman lactates to much you think (rx)
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H2 blocker
cimetidine |
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what H2 blocker is known to induce gynoclemastia and galactorrhea?
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clematidine
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what H2 blockers is known to inhibit CYP-450s?
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clematidine
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name the prostoglandin analog
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misoprostol
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what is the MOA for misoprostol?
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bind to epithelial cell EP receptor and cause the release of mucous and bicarb
bind to parietal cell EP3 receptor-->Gi-->block the activation of PP |
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what is the clinical use of misoprostol?
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prevent mucosal injury from NSAID use.
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what is the AE of misoprostol?
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diarrhea
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When is misoprostol contraindicated?
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IBD and pregnancy
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why is misoprostol contraindicated in prego
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increase in uterine contraction causes abortion
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what is the name of the cytoprotective agent?
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sucralfate
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what is the MOA of sulcralfate?
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it is negatively charged and the ulcer and lining near it are positively charged from the acid. it will then coat the ulcer
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should you take an antiacid or PPI prior to ingestion of sucralfate?
why |
no, you want acid to be in the stomach so the sulcrafate will stick
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what are the clinical uses for sulcrafate?
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gastric and duodenal ulcers
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what is the MOA of bismuth-subsalicylate?
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bind to mucousal glycoproteins, coats the ulcer, has antimicrobial properties, binds pepsin
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what are the clinical uses of bismuth-subsalicylates?
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gastric and duodenal ulcer
in combination with ABX for H.pylori |
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what are 2 AE of bismuth-subsalicylate?
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dark tongue and stool
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person presents with dark stool, you think.....
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bismuth-subsalicylate
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person presents with dark tongue, you think...
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bismuth subsalicylate
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why do you not give bismuth-subsalicylate to kids?
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reyes syndrome
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what is the tx for h. pylori?
why |
2 abx and a PPI
resistance. |
