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45 Cards in this Set
- Front
- Back
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Somatostatin (Octreotide)
- Mechanism |
-ST2 receptor on ECL cell
-inhibits H2 secretion -less stimulated of gastric Parietal Cell |
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H2 Blockers
-name the drugs -Mechanism |
-Cimetidine, Ranitidine, Famotidine, Nizatidine
-REVERSIBLE block of histamine H2 receptors ->decreased secretion of H+ from parietal cells |
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H2 Blockers
-Clinical use |
Peptic Ulcer
Gastritis Mild esophageal reflux |
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H2 Blockers
-Toxicity for which drugs |
Cimetidine & Ranitidine
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Cimetidine
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-H2 receptor blockers
-Potent inhibitor of P-450 -antiandrogenic effects: prolactin release, gynecomastia, impotence, decresed libido in male -crosses BBB: confusion, dizziness, HA -crosses placenta -decreased renal excretion of Creatinine |
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Ranitidine
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H2 blocker
-decreased renal excretion of creatinine |
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Omeprazole, Lansoprazole
-mechanism |
Protein pump inhibitor
- Irreversibly inhibits H+/K+ ATPase in stomach parietal cells |
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Protein pump inhibitors
-indications |
peptic ulcer
gastritis esophageal reflux Zollinger-Ellison syndrome |
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Bismuth, Sucralfate:
-mechanism |
-Bind to ulcer base (physical protection)
-Allow HCO2 secretion to reestablish pH gradient in mucus layer |
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Bismuth, Sucralfate:
-clinical use |
-to promote ulcer healing
-traveler's diarrhea -part of triple tx for H. pylori ulcers: metronidazole, bismuth, amoxicillin (or tetracycline) |
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Misoprostol:
-Mechanism |
-a PGE1 analog
-increases production and secretion of gastric mucous barrier -decreases acid production |
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Misoprostol:
-Clinical use |
- prevention of NSAID-induced peptic ulcers
- maintenance of a patent ductus arteriosus - to induce labor |
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Misoprostol:
-Toxicity -Contraindication |
-Diarrhea
-Contraindicated in women of childbearing potential (abortifacient) |
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Muscarinic Antagonists
-name them |
-Pirenzepine
-Propantheline |
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Pirenzepine:
-mechanism |
Muscarinic antagonist- for PUD
-Block M1 receptors on ECL cells (decrease histamine secretion) -Block M3 receptors on parietal cells (decrease H+ secretion) |
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Propantheline:
-mechanism |
Muscarinic antagonist- for PUD
-Block M1 receptors on ECL cells (decrease histamine secretion) -Block M3 receptors on parietal cells (decrease H+ secretion) |
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Pirenzepine:
-toxicity |
-Tachycardia
-Dry Mouth -Difficulty focusing eyes |
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Propantheline:
-toxicity |
-Tachycardia
-Dry Mouth -Difficulty focusing eyes |
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Antacid Overuse: consequences
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-alters gastric and urinary pH or delays gastric emptying
-> affects absorption, bioavailability, or urinary excretion of other drugs |
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Antacid Overuse: additional problems
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1. ALUMINUM HYDROXIDE
2. MAGNESIUM HYDROXIDE 3. CALCIUM CARBONATE |
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Antacid overuse related
ALUMINUM HYDROXIDE sxs "AlumMINIMUM amount of feces.." |
-constipation
-HYPOPHOPHATEMIA -proximal mm weakness -osteodystrophy -seizures *HYPOKALEMIA |
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Antacid overuse related
MAGNESIUM HYDROXIDE sxs "Mg = Must Go to the bathroom |
-diarrhea
-hyporeflexia -hypotension -CARDIAC ARREST *HYPOKALEMIA |
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Antacid overuse related
CALCIUM CARBONATE sxs |
- hypercalcemia
- REBOUND ACID increase *HYPOKALEMIA |
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Infliximab
-Mechanism -Clinical Use -Toxicity |
-Monoclonal antibody to TNF-alpha (proinflammatory cytokine)
-Used for Crohn's dz, Rheumatoid arthritis -Toxicity: respiratory infection, fever, hypotension |
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Sulfasalazine
-Clinical Use -Mechanism |
- UC, Crohn's dz
- A combination of SULFAPYRIDINE (antibacterial) and MESALAMINE (anti-inflammatory). -Activated by colonic bacteria! |
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Sulfasalazine
-Toxicity |
Malaise
Nausea Sulfonamide toxicity Reversible OLIGOSPERMIA |
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Ondansetron
-Mechanism |
5-HT3 antagonist
Powerful central-acting antiemetic |
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Ondansetron
-Clinical Use -Toxicity |
-to Control vomiting postop
-for pts undergoing chemotherapy -toxicity: HA and constipation |
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Pro-kinetic Agents
-name the drugs (2) |
Cisapride
Metoclopramide |
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Cisapride:
-Mechanism |
-Acts through serotonin receptors -> increases ACh release at the myenteric plexus
-increases esophageal tone -increases gastric and duodenal contractility -improves transit time (including through the colon) |
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Antacid overuse related
ALUMINUM HYDROXIDE sxs "AlumMINIMUM amount of feces.." |
-constipation
-HYPOPHOPHATEMIA -proximal mm weakness -osteodystrophy -seizures *HYPOKALEMIA |
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Antacid overuse related
MAGNESIUM HYDROXIDE sxs "Mg = Must Go to the bathroom |
-diarrhea
-hyporeflexia -hypotension -CARDIAC ARREST *HYPOKALEMIA |
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Antacid overuse related
CALCIUM CARBONATE sxs |
- hypercalcemia
- REBOUND ACID increase *HYPOKALEMIA |
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Infliximab
-Mechanism -Clinical Use -Toxicity |
-Monoclonal antibody to TNF-alpha (proinflammatory cytokine)
-Used for Crohn's dz, Rheumatoid arthritis -Toxicity: respiratory infection, fever, hypotension |
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Sulfasalazine
-Clinical Use -Mechanism |
- UC, Crohn's dz
- A combination of SULFAPYRIDINE (antibacterial) and MESALAMINE (anti-inflammatory). -Activated by colonic bacteria! |
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Sulfasalazine
-Toxicity |
Malaise
Nausea Sulfonamide toxicity Reversible OLIGOSPERMIA |
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Ondansetron
-Mechanism |
5-HT3 antagonist
Powerful central-acting antiemetic |
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Ondansetron
-Clinical Use -Toxicity |
-to Control vomiting postop
-for pts undergoing chemotherapy -toxicity: HA and constipation |
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Pro-kinetic Agents
-name the drugs (2) |
Cisapride
Metoclopramide |
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Cisapride:
-Mechanism |
-Acts through serotonin receptors -> increases ACh release at the myenteric plexus
-increases esophageal tone -increases gastric and duodenal contractility -improves transit time (including through the colon) |
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Cisapride:
Toxicity Drug Interactions (4) |
NO LONGER USED
Serious interactions with: -erythromycin -ketoconazole -nefazodone -fluconazole *TORSADES DE POINTES |
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Metoclopramide:
Mechanism |
Pro-kinetic agent
-D2 receptor antagonist -increases resting tone, contractility, LES tone, motility -does NOT increase transit time through colon |
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Metoclopromide:
Clinical use |
- Diabetic gastroparesis
- Post-surgery gastroparesis |
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Metoclopramide:
Toxicity |
-increased parkinsonian effects
-restlessness -drowsiness -fatigue -depression -nausea -constipation -drug interactions (digoxin and diabetic agents) -contraindicated in pts with SBO |
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Metoclopramide:
Drug interactions |
-Digoxin
-Diabetic agents |
