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65 Cards in this Set
- Front
- Back
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List 5 general types of drugs that control gastric acid secretion and treat peptic ulcer disease.
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1. Antacids
2. Histamine H2-receptor antagonists 3. Proton pump inhibitors 4. Mucosal protective agents 5. H. pylori therapy |
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List 5 general prokinetic drugs.
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1. Cholinomimetics (Bethanechol)
2. Metaclopramide 3. Macrolides (Erythromycin) 4. Serotonin agonists (Cisapride, Tegaserod) 5. Ghrelin agonists |
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List 5 examples of stimulant laxatives.
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1. MgOH
2. Senna 3. Cascara 4. Bisacodyl 5. Phenylphthalein 6. Castor oil |
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List 4 examples of bulk forming laxatives.
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1. Psyllium
2. Bran 3. Lactulose 4. Sorbitol |
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List 3 examples of stool softeners
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1. Docusate
2. Mineral oil 3. Glycerin |
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Which drug is a chloride channel 2 activator?
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Lubiprostone
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List 4 examples of antidiarrheal drugs.
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1. Diphenoxylate
2. Loperamide 3. Koalin and pectin 4. Bismuth subsalicylate |
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List some examples of drugs used to treat IBD.
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1. Corticosteroids
2. Infliximab 3. Salicylates (Sulfasalazine, 5ASA derivatives) 4. Azathioprine, Mercaptopurine 5. Cyclosporine |
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List 4 general drugs used to treat IBS.
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1. Anticholinergics (atropine-like drugs)
2. Alosterone 3. Tegaserod 4. Lubiprostone |
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Name 2 endogenous agents that inhibit gastric secretion.
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Prostaglandins
Somatostatin |
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What is the mode of action of antacids?
What are antacids generally composed of? |
Neutralize HCl to form salt and water
Metal ion + base |
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Which type of antacid is known to cause constipation?
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Aluminum compounds.
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Which type of antacid is known to cause diarrhea?
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Magnesium compounds
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Which antacid can be used as an antidiarrheal?
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Al(OH)3
(can cause constipation) |
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List 4 antihistamines used to inhibit acid secretion.
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1. Cimetidine
2. Ranitidine 3. Famotidine 4. Nizatidine |
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What are the clinical uses of Histamine H2-receptor antagonists?
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1. GERD
2. Peptic ulcer disease 3. Non-ulcer dyspepsia |
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What is the first use of therapy for reflux esophagitis?
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Ranitidine
(Histamine H2-receptor antagonist) |
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Are the Histamine H2-receptor antagonists reversible or irreversible inhibitors?
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Reversible
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Which of the Histamine H2-receptor antagonists is the most potent?
Which is the least potent? |
Famotidine--> most potent
Cimetidine --> least potent |
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How do the histamine H2-receptor antagonists differ from each other?
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Their relative potencies differ.
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Do the histamine H2-receptor antagonists differ in efficacy?
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No.
They all have equivalent efficacies despite their different potency levels. |
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What is cimetidine?
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Histamine H2-receptor antagonist
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What is ranitidine?
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Histamine H2-receptor antagonist
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What is famotidine?
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Histamine H2-receptor antagonist
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What is nizatidine?
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Histamine H2-receptor antagonist
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What is Omeprazole?
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Proton pump inhibitor
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Can Omeprazole be used to treat Z-E syndrome?
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Yes.
(PPIs are effective for Z-E syndrome, but H2-receptor antagonists are not very effective) |
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Are PPI's reversible or irreversible inhibitors?
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Irreversible
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What are the effects of Prostaglandins?
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1. Strengthen gastric mucosal barrier
2. Increase mucus secretion 3. Increase bicarbonate secretion 4. Increase gastric mucosal blood flow |
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Name the synthetic prostaglandin used to treat peptic ulcer disease.
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Misoprostol
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Which drug is combined w/ NSAID analgesics to reduce gastrointestinal toxicity of the NSAID?
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Misoprostol
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What does Sucralfate require to be activated?
Why is this clinically important? |
An acidic pH
*Do NOT use with H2-receptor antagonist or PPI |
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How does Sucralfate work?
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It binds to ulcerated tissue, inactivates pepsin, and allows the underlying tissue to heal.
*Therefore, it's effective to use for GU and DU |
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What medications are indicated in a "monotherapy" regime to treat H.pylori infections?
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1. Bismuth
2. Metronidazole 3. PPI |
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What medications are indicated in a "tritherapy" regime to treat H.pylori infections?
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(2 antibiotics + PPI)
Antiobiotics used: 1. Amoxacillin 2. Clarithromycin 3. Metronidazole PPI: Omeprazole |
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Which 3 basic types of drugs can be used to treat the symptoms associated with GERD?
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1. Antacids
2. Histamine H2-receptor antagonists 3. H+/K+-ATPase inhibitor |
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Which basic group of drugs are used to treat the underlying motility disorder in GERD?
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Prokinetic drugs
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Which drug is used for mucosal protection in GERD?
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Sucralfate
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What is Bethanechol used for?
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GERD
(Cholinergic agonist--stimulates motility) *Also stimulates gastric acid secretion, so must be careful with dosage |
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Name a dopamine antagonist used for the treatment of GERD.
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Metoclopramide
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What is the effect of Metaclopramide?
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Used for the treatment of GERD.
Promotes gastric emptying--increases ACh release from post-ganglionic cholinergic nerve terminals |
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What is Domperidone?
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Prokinetic drug used to treat GERD.
(antidopaminergic) |
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Which prokinetic drug is a 5HT3 antagonist/ 5HT4 agonist?
What is its function? |
Cisapride
Enhances gastric emptying and coordinates gastric/duodenal motility |
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Which prokinetic drug is no longer available due to possible life-threatening cardiovascular side-effects?
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Cisapride
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What is the mechanism of action of erythromycin?
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Prokinetic drug.
1. Motilin agonist 2. Increases LES muscle tone 3. Speeds up upper GI transit |
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Which prokinetic drug is a 5HT4 partial agonist/ 5HT2B antagonist?
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Tegaserod
(Prokinetic) *Augments intestinal peristalsis |
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Tegaserod is approved under restricted use for what individuals?
Why is its use restricted? |
Women younger than 55 with constipation-predominant IBS.
Cardiovascular toxicity *Patient consent required |
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Which drug is approved for post-operative ileus following abdominal surgery?
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Alvimopan
(treats constipation) *Short-term hospital use only |
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Which drug is approved for opioid-induced bowel dysfunction?
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Methylnaltrexone
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Which antidiarrheal drug has CNS and peripheral activity?
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Diphenoxylate
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Which antidiarrheal opiod derivative is peripherally restricted?
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Loperamide
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Which drug is a sympathetic agonist that is used for diabetic gastroparesis?
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Clonidine
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List 3 indications for the use of antidiarrheal agents.
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1. Rapid gastric emptying
2. IBS 3. Infectious diarrhea |
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What basic groups of drugs are used to treat IBS?
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1. Anticholinergics (antispasmodics)
2. Serotonin compounds |
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List 2 antispasmodics used to treat IBS.
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1. Hyoscyamine
2. Dicyclomine |
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List 2 serotonin compounds used to treat IBS.
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1. Alosterone
2. Tegaserod |
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What is the restricted use for Alosterone?
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Indicated for female IBS patients w/ diarrhea-predominant IBS
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What is the restricted use for Tegaserod?
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Indicated for female IBS patients w/ constipation-predominant IBS.
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Which drug has the FDA approved for women 18 or older with irritable bowel syndrome with constipation?
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Lubiprostone
(Tegaserod also indicated for constipation-predominant IBS) |
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What is an adverse effect of alosterone?
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Ischemic colitis
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Which dopamine antagonist has peripheral and central effects?
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Metoclopramide
(Used to treat GERD) |
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Which dopamine antagonist has only peripheral effects?
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Domperamide
(Used to treat GERD) |
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Along with treating GERD, which dopamine antagonist can also be used as an antimetic during cancer chemotherapy?
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Metoclopramide
(Has central and peripheral effects) |
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Which drug is a motilin agonist?
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Erythomycin
(Useful in GERD, gastroparesis) |
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List 3 groups of drugs that are used to treat constipation.
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1. Laxatives
2. Prokinetics 3. Cl- Channel activators (Lubiprostone) |
