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7 Cards in this Set

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Laxatives
over 700 different laxative preparations- most overused

1. Emollients (mineral oil) – softens the stool- reduce your vitamin absorption
2. Bulk (Dietary fiber)- bran, methylcellulose, psyllium - take time to work- retain water in the bowel
3. Saline cathartics (Epsom salts, etc)-Mg(OH)2, MgSO4, Mg citrate - hypertonic compounds- cause abdominal pain and alter acid-base balance
4. Contact stimulants - Phenolphthalein, bisacodyl, danthron, castor oil, senna, Carter’s Little Pills, Ex-Lax- poorly understood mechanisms- cause pain, abdominal cramping, etc
Antacids
GERD/PUD- OTC
calcium carbonate (eg, TUMS) or magnesium hydroxide (eg, Milk of Magnesium)
weakly basic salts that neutralize stomach acid that is already secreted
Side Effects: can impair drug absorption (think elderly)
Hypercalcemia (kidney stones) with TUMS
H2 antihistamines
GERD/PUD- OTC
block histamine 2 receptors blocking histamine induced acid secretion from parietal cells

Cimetidine (Tagamet)- competitive antagonist
Side Effects: Inhibits cytochrome P450, Antiandrogenic- gynecomastia, Reduces hepatic blood flow

new generations of H2 blockers- Ranitidine, Famotidine, Nizatidine
Decreased side effects
Proton Pump Inhibitors
GERD/PUD
Omeprazole (Prilosec)- or Lansoprazole, rabeprazole, esomeprazole (Nexium)
inhibit final common pathway of acid secretion- Covalent binding (Irreversibly) to H+, K+ ATPase
its a Prodrug, activated only at low pH of 2- site selective*
more effective than H2 blockers- less side effects and longer acting
Mucosal Protectants
GERD/PUD
protect mucosa of stomach and allows it time to heal from acidic environment

1. Sucralfate (a polysaccharide)– Binds proteins on cell surface- Selective to damaged tissue
2. Colloidal Bismuth Compounds
– Peptobismol-
3. Prostaglandins– Misoprostol, Cytotec- inhibit acid release- *extensive side effects
Antibiotics for gastric ulcers and GERD
b/c H. pylori is the causative agent of ulcers and relapse. Treat with triple Abx can dramatically reduce relapse (single abx won’t work)
1. Metronidazole
2. Clarithromycin
3. Amoxicillin
4. Tetracyclines
Antidiarrheal agents
1. Opioids – Loperamide (Immodium), diphenoxylate (+ atropine-Lomotil)- *do not cross BBB (no abuse potential)

2. Gel forming absorbants– aluminum silicates, pectin, kaolin— chalky substances to increase viscosity of bowel contents- *not as effective as opioids but have less side effects