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14 Cards in this Set
- Front
- Back
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What are the five different Proton Pump Inhibitors?
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Omeprazole = prilosec
Lansoprazole Rabeprozole = aciphex Pantoprazole Esomeprazole = Nexium |
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How do PPI's act?
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proton pump inhibitors bind irreversibly to K+/H+ ATPase (proton pumps) to block acid secretion into the stomach
This enzyme takes 18hours for the cell to recycle new ones Prevents basal and meal-time acid |
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Where are PPI's absorbed?
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In the small intestine.
They require a high pH for the drug capsule to dissolve. Gastric acid would destroy the drug. |
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When would you use an IV form of a PPI?
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If the patient has a stomach ulcer or GI bleeding.
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What are the adverse side effects of PPI's?
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Headache, diarrhea,
May be due to low gastric acid secretion (higher pH) Be careful of drug interactions (drugs that require an acidic environment for absorption) More prone to bacterial infections, and or pneumonias |
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What is the mechanism of action for H2 Receptor antagonist?
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Competitive inhibition of the H2 Receptor.
ECL (enterochromaffin-like) cells are stimulated by gastrin and ACh to release histamine. Histamine acts on parietal cells through H2 Receptors to release acid |
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How often are H2 Receptor antags dosed vs. PPI's?
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PPI = once daily
H2 R.A. = twice a day |
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Do H2 Receptor antagonists have any drug interactions? Adverse effects?
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Cimetidine goes through CYP 3A4 (which is a major P450)
Must also worry about renal function b/c these drugs require kidney clearance Mental status changes can occur |
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What forms are H2 Receptor Antagonists available in?
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oral and IV
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What are the different types of H2 Receptor antagonists?
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Cimetidine (tagamet)
Rantidine (xantac) Famotidine (pepsid) Nizatidine (axid) |
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What's faster PPI's or H2 Receptor antags?
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H2 Receptor A. are not given as pro-drugs so they are technically faster
PPI's usually take a couple days to reach their full effect |
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What are prostaglandins used for?
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Misoprostal
anti-acid secretions, often from NSAID-induced stomach ulcers DO NOT use on pregnant women (may induce abortion) |
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What are Metoclopramide and Domperidone?
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Pro-kinetic drugs (stimulate GI motility) used to treat constipation
D2 Receptor antagonists, inhibits smooth muscle stimulation Domperidone (not available in US) |
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What is an antibiotic that can stimulate GI motility?
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Macrolides!
e.g. erythromycin (which may cause diarrhea) |
