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26 Cards in this Set

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• bismuth subsalicylate (Pepto-Bismol)
• tetracycline (Achromycin V)
• amoxicillin (Amoxil)
• metronidazole (Flagyl)
Antibiotics
• cimetidine (Tagamet)
• ranitidine (Zantac)
• famotidine (Pepcid)
• nizatidine (Axid)
H2-Receptor Antagonists
(Inhibitors of Gastric Acid Production)
• omeprazole (Prilosec)
• lansoprazole (Prevacid)
Inhibitors of the Proton Pump:
• misoprostol (Cytotec)
Prostaglandin Analogs:
• propantheline (Pro-Banthine)
• glycopyrrolate (Robinul)
Muscarinic Antagonists: “Antispasmodics”
• aluminum hydroxide (Amphojel)
• magnesium hydroxide (“Milk of Magnesia”)
• calcium carbonate (Tums)
• sodium bicarbonate (Alka-Selzer)
Antacids:
• sucralfate (Carafate)
Mucosal Protective Agents:
Adverse Reactions:
-↑ serum prolactin levels--> gynecomastia & galactorrhea
-impotence & ↓ libido
2) ↑ Rx interactions
3) headache, dizziness, sedation, confusion, delirium.
4) GI: Diarrhea, constipation, myalgia
Cimetidine:
drug interactions involving cimetidine
theophylline, oral anticoagulants, phenytoin
(↑ chance of toxicities)
H2 Antagonists with similar spectrum of mild adverse reactions EXCEPT antiandrogenic effects of cimetidine & no rx interactions
Ranitidine, famotidine
↓ absorption of cimetidine
Antacids:
Binds to H+/K+ - ATPase proton pump at the surface of the gastric parietal cell, inhibiting the final step in gastric acid secretion.
PPI MOA
PPIs are ____ effective than H2 antagonists
more
Adverse reactions:
GI: Diarrhea, abdominal pain, headache

Caution: Any Rx that ↓ gastric acid→ ↑ risk of enteric infections
PPIs
PPIs Metabolized by hepatic P450 cytochromes → ↓ metabolism of ______, ______, & _________ (increase toxicity)
coumadin, diazepam & phenytoin
1. MOA:
a) It inhibits gastric acid secretion, both basal and stimulus induced from food, histamine, gastrin-- ↓ cAMP
b) It stimulates the gastric mucosa to secrete bicarbonate and mucus, thus providing a mucosal protective effect.
Misoprostol (Cytotec):
Adverse reactions:
Diarrhea, NV & cramping abdominal pain
↑ uterine contraction– Rare

WARNING: Contraindicated in pregnant women ( Pregnancy Category X)
Misoprostol
CNS side effects (Sedation)
Anti -SLUD
• propantheline (Pro-Banthine)
• glycopyrrolate (Robinul)
Worst Side Effects: CONSTIPATION
Al(OH)3 (Amphojel)
MOA: Osmotic Effect
↑cholecystokinin secretion
Worst Side Effects: LAXATIVE EFFECT
Mg(OH)2 (Milk of Magnesia)
Releases CO2→ belching & gastric distention

Caution if hypertensive or CHF → Fluid Retention

Unneutralized HCO3- is readily absorbed→ Metabolic Alkalosis
NaHCO3 (Alka-Selzer):
Milk-Alkali Syndrome: hypercalcemia, alkalosis & renal failure

belching & flatulence
CaCO3 (Tums)
MOA: (-) charged SO4 binds (+) charged denatured proteins to form a complex at the base of ulcer craters.
Sucrafate (Carafate)
Sucralfate Adverse reaction:
Constipation
Sucralfate ↓ absorption of other Rxs
tetracyclines, cimetidine, warfarin, phenytoin
Do not administer Sucralfate simultaneously with _______ or ________
antacids or H2 antagonists