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7 Cards in this Set
- Front
- Back
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Laxatives
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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 |
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Antacids
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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 |
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H2 antihistamines
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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 |
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Proton Pump Inhibitors
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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 |
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Mucosal Protectants
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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 |
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Antibiotics for gastric ulcers and GERD
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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 |
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Antidiarrheal agents
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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 |
