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37 Cards in this Set

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How does Bismuth Subsalicylate (Pepto Bismol) act as an antibiotic?
Disrupts cell wall of H. Pylori=lysis & cell death.
Decreases urease secretion by H. Pylori.
Prevents H. Pylori from adhering to gastric surface.
How does Bismuth Subsalicylate (Pepto Bismol) act as an anti-diarrheal?
Adsorbent.
Coats wall of GI tract, binds toxin or bacteria, eliminates it thru stool.
Uses for Bismuth Subsalicylate (Pepto Bismol)
PUD, anti-diarrhea
Side effects of Bismuth Subsalicylate (Pepto Bismol)
Hemotologic effects (due to aspirin), constipation, CNS effect (confusion, etc)
MOA of Omeprazole (Prilosec)
Proton Pump Inhibitor
Activated in parietal cells, inhibits HKATPase, decreases basal & stimulated acid release.
Uses for Omeprazole (Prilosec)
PUD, GERD
Side effects of Omeprazole (Prilosec)
Headache, constipation, nausea. (cancer in lab rats with extended use).
Decreased effect of drugs that need an acidic environment.
MOA of Cimetidine (Tagamet)
Decreases gastric juice amount, H+ concentration, and basal acid secretion
Uses for Cimetidine (Tagamet)
GERD, gastric & duodenal ulcers, hypersecretion states, erosive esophagitis, upper GI bleed.
Side effects of Cimetidine (Tagamet)
Binds to androgen receptors (gynecomastia, impotence, decreased libido in men), CNS (headache, confusion), nausea. Caution with hepatic impairment.
Other characteristics of Cimetidine (Tagamet)
Food & antacids decrease absorption (take on empty stomach). Increases drug levels of Warfarin, Phenytoin, Lidocaine.
MOA of Sucralfate (Carafate)
Mucosal Protectant
Forms protective barrier against acid & pepsin when ph<4 (thick gel that attaches to ulcer).
Uses for Sucralfate (Carafate)
Acute stage & maintenance of ulcer (not for GERD)
Other notes on Sucralfate (Carafate)
Antibiotics, Warfarin, Digoxin, Theophylline increase ph -> gel does not form. Give these 3 hrs apart.
MOA of Polyethylene Glycol (Miralax)
Osmosis draws water into intestines, feces soften, swell, stretches intestinal wall, causes peristalsis = watery stool in 2-6 hrs.
MOA of opiate antidiarrheals
Activate opiate receptors in GI tract, inhibit GI motility & excessive propulsion with some analgesic activity.
Classes of anti-emetics
Anticholinergics
Antihistamines
Neuroleptics
Prokinetics
Serotonin blockers
Anti-emetic that block ACh receptor in ear; used for motion sickness, to decrease secretions befor surgery & for nausea & vomiting.
Anticholinergic
Anti-emetic that blocks dopamine receptors in CTZ; used for nausea, vomiting, & intractable hiccups.
Neuroleptics
Side effects of Antichoinergic anti-emetics.
CNS (headache, dizzy, fatigue)
EENT (dry mouth, blurred vision)
GU (urine retention, dysuria)
Side effects of Neuroleptic anti-emetics
CNS (headache, dizzy, fatigue)
GU (urine retention, dysuria)
Extra pyramidal symptoms
MOA of Meclizine (Antivert)
Antihistimine anti-emetic
H1 receptor blocker->inhibits ACh binding to H1 receptors, prevents cholinergic stimulation in ear.
Uses of Meclizine (Antivert)
Motion sickness, nonproductive cough, sedation, nausea, vomiting
Side effects of Meclizine (Antivert)
CNS (headache, dizzy, fatigue)
EENT (blurred vision, dry mouth)
GU (urine retention, dysuria)
MOA of Metoclopramide (Reglan)
Prokinetic anti-emetic
Blocks dopamine receptors in CTZ, desensitizes impulses received from GI tract.
Uses of Metoclopramide (Reglan)
Delayed gastric emptying, nausea, vomiting.
Side effects of Metoclopramide (Reglan)
CNS (headache, dizzy, fatigue)
MOA of Ondansetron (Zofran)
Serotonin blocker anti-emetic
Blocks serotonin receptors in GI, VC, CTZ
Uses for Ondansetron (Zofran)
Nausea & vomiting due to chemotherapy or post op.
Side effects of Ondansetron (Zofran)
CNS (headache, dizzy, fatigue)
Elevated liver enzymes (ALT, AST)
Diarrhea
MOA of Tegaserod (Zelnorm)
5HT4 seratonin antagonist. Used for Irritable Bowel Syndrome. Normalizes impaired motility, aids in constipation, stimulates peristalsis.
Side effects of Tegaserod (Zelnorm)
GI (nausea, vomiting)
CNS (headache, dizzy)
Other notes about Tegaserod (Zelnorm)
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.
MOA of Sulfasalazine (Azulfidine)
Aminosalicylate
Suppresses prostaglandin synthesis -> decreases inflammation, stops migration of inflammatory cells to affected area of colon
Uses of Sulfasalazine (Azulfidine)
Acute episodes of mild to moderate ulcerative colitis and to maintain remission.
Same family as sulfonamides (contains aspirin & sulfa)
MOA of glucocorticoids for IBD.
antiinflammatory to relieve symptoms, esp. acute.
Decreases prostaglandins
Side effects of glucocorticoids for IBD
ADRENAL SUPPRESSION, osteoporosis, decreased immune defense.