Meredith's Gi Drugs

Front 1

How does Bismuth Subsalicylate (Pepto Bismol) act as an antibiotic?

Back 1

Disrupts cell wall of H. Pylori=lysis & cell death.
Decreases urease secretion by H. Pylori.
Prevents H. Pylori from adhering to gastric surface.

Front 2

How does Bismuth Subsalicylate (Pepto Bismol) act as an anti-diarrheal?

Back 2

Adsorbent.
Coats wall of GI tract, binds toxin or bacteria, eliminates it thru stool.

Front 3

Uses for Bismuth Subsalicylate (Pepto Bismol)

Back 3

PUD, anti-diarrhea

Front 4

Side effects of Bismuth Subsalicylate (Pepto Bismol)

Back 4

Hemotologic effects (due to aspirin), constipation, CNS effect (confusion, etc)

Front 5

MOA of Omeprazole (Prilosec)

Back 5

Proton Pump Inhibitor
Activated in parietal cells, inhibits HKATPase, decreases basal & stimulated acid release.

Front 6

Uses for Omeprazole (Prilosec)

Back 6

PUD, GERD

Front 7

Side effects of Omeprazole (Prilosec)

Back 7

Headache, constipation, nausea. (cancer in lab rats with extended use).
Decreased effect of drugs that need an acidic environment.

Front 8

MOA of Cimetidine (Tagamet)

Back 8

Decreases gastric juice amount, H+ concentration, and basal acid secretion

Front 9

Uses for Cimetidine (Tagamet)

Back 9

GERD, gastric & duodenal ulcers, hypersecretion states, erosive esophagitis, upper GI bleed.

Front 10

Side effects of Cimetidine (Tagamet)

Back 10

Binds to androgen receptors (gynecomastia, impotence, decreased libido in men), CNS (headache, confusion), nausea. Caution with hepatic impairment.

Front 11

Other characteristics of Cimetidine (Tagamet)

Back 11

Food & antacids decrease absorption (take on empty stomach). Increases drug levels of Warfarin, Phenytoin, Lidocaine.

Front 12

MOA of Sucralfate (Carafate)

Back 12

Mucosal Protectant
Forms protective barrier against acid & pepsin when ph<4 (thick gel that attaches to ulcer).

Front 13

Uses for Sucralfate (Carafate)

Back 13

Acute stage & maintenance of ulcer (not for GERD)

Front 14

Other notes on Sucralfate (Carafate)

Back 14

Antibiotics, Warfarin, Digoxin, Theophylline increase ph -> gel does not form. Give these 3 hrs apart.

Front 15

MOA of Polyethylene Glycol (Miralax)

Back 15

Osmosis draws water into intestines, feces soften, swell, stretches intestinal wall, causes peristalsis = watery stool in 2-6 hrs.

Front 16

MOA of opiate antidiarrheals

Back 16

Activate opiate receptors in GI tract, inhibit GI motility & excessive propulsion with some analgesic activity.

Front 17

Classes of anti-emetics

Back 17

Anticholinergics
Antihistamines
Neuroleptics
Prokinetics
Serotonin blockers

Front 18

Anti-emetic that block ACh receptor in ear; used for motion sickness, to decrease secretions befor surgery & for nausea & vomiting.

Back 18

Anticholinergic

Front 19

Anti-emetic that blocks dopamine receptors in CTZ; used for nausea, vomiting, & intractable hiccups.

Back 19

Neuroleptics

Front 20

Side effects of Antichoinergic anti-emetics.

Back 20

CNS (headache, dizzy, fatigue)
EENT (dry mouth, blurred vision)
GU (urine retention, dysuria)

Front 21

Side effects of Neuroleptic anti-emetics

Back 21

CNS (headache, dizzy, fatigue)
GU (urine retention, dysuria)
Extra pyramidal symptoms

Front 22

MOA of Meclizine (Antivert)

Back 22

Antihistimine anti-emetic
H1 receptor blocker->inhibits ACh binding to H1 receptors, prevents cholinergic stimulation in ear.

Front 23

Uses of Meclizine (Antivert)

Back 23

Motion sickness, nonproductive cough, sedation, nausea, vomiting

Front 24

Side effects of Meclizine (Antivert)

Back 24

CNS (headache, dizzy, fatigue)
EENT (blurred vision, dry mouth)
GU (urine retention, dysuria)

Front 25

MOA of Metoclopramide (Reglan)

Back 25

Prokinetic anti-emetic
Blocks dopamine receptors in CTZ, desensitizes impulses received from GI tract.

Front 26

Uses of Metoclopramide (Reglan)

Back 26

Delayed gastric emptying, nausea, vomiting.

Front 27

Side effects of Metoclopramide (Reglan)

Back 27

CNS (headache, dizzy, fatigue)

Front 28

MOA of Ondansetron (Zofran)

Back 28

Serotonin blocker anti-emetic
Blocks serotonin receptors in GI, VC, CTZ

Front 29

Uses for Ondansetron (Zofran)

Back 29

Nausea & vomiting due to chemotherapy or post op.

Front 30

Side effects of Ondansetron (Zofran)

Back 30

CNS (headache, dizzy, fatigue)
Elevated liver enzymes (ALT, AST)
Diarrhea

Front 31

MOA of Tegaserod (Zelnorm)

Back 31

5HT4 seratonin antagonist. Used for Irritable Bowel Syndrome. Normalizes impaired motility, aids in constipation, stimulates peristalsis.

Front 32

Side effects of Tegaserod (Zelnorm)

Back 32

GI (nausea, vomiting)
CNS (headache, dizzy)

Front 33

Other notes about Tegaserod (Zelnorm)

Back 33

Take before food. 98% protein bound (watch other drug levels). Approved only for women (used off lable for men). Extensive liver metabolism. Increases absorption of sodium & water.

Front 34

MOA of Sulfasalazine (Azulfidine)

Back 34

Aminosalicylate
Suppresses prostaglandin synthesis -> decreases inflammation, stops migration of inflammatory cells to affected area of colon

Front 35

Uses of Sulfasalazine (Azulfidine)

Back 35

Acute episodes of mild to moderate ulcerative colitis and to maintain remission.
Same family as sulfonamides (contains aspirin & sulfa)

Front 36

MOA of glucocorticoids for IBD.

Back 36

antiinflammatory to relieve symptoms, esp. acute.
Decreases prostaglandins

Front 37

Side effects of glucocorticoids for IBD

Back 37

ADRENAL SUPPRESSION, osteoporosis, decreased immune defense.