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38 Cards in this Set
- Front
- Back
What are the protective effects of the stomach? What hormone produces it?
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increase blood supply, increase mucus and bicarbonate-----Prostaglandins
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Gastric acid increase is caused by
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endogenously - histamine, gastrin, acetylcholine --------------- others - infection, NSAIDs, smoking
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What antibiotics are used to treat ulcer disease
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amoxicillin, clarithromycin, tetracycline, metronidiazole
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What are the types of antiulcer drugs?
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H2 receptor (histamine) inhibitor ------------- Proton pump inhibitor ------------- Mucosal protectants ------------- Prostaglandin replacement therapy
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What is the mechanism of Cimetidine?
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(H2 inhibitor) - H2 receptor stimulates acid production. Cimetidine blocks this receptor. Ranitidine also.
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What is the action of Omeprazole?
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(proton pump inhibitor) - irreversible inhibition of enzyme that secretes gastric acid. Also Esomeprazole, Lansomeprazole.
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What is mechanism of Sucralfate?
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(Mucosal protectant) - creates protective barrier around ulcer
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What is Mechanism of Misoprostal?
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(prostaglindin replacement) - analog for endogenous Prostaglandin E - stomach protective effects
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Mechansims of antacids?
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alkaline substances that neutralize stomach acid
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Compare Cimetidine and Ranitidine adverse effects.
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Ranitidine produces similar, but less adverse effects. ------- Cimetidine has anti-androgenic effects ( gynocomastia, reduced libido, impotence) ------ hallucinations in the elderly --------- hypotension and dysrhythmias from IV Bolus
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What effect does concurrent food have with Cimetidine?
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prolongs the effect of Cimetidine
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What reduces absorption of Cimetidine?
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antacids
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How long does Omeprazole have an effect?
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irreverible binding to proton pump enzymes. replaced after 2 hours.
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Omeprazole reduces the absorption of what?
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Ataznavir (HIV) and ketoconazole (antifungal)
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What medications are contraindicated with sucralfate?
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antacids, proton pump inhibitor, H2 receptor antagonist b/c sucralfates require and acid pH for proper activation
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What is the most common adverse effect of sucralfate? What can be done to avoidit?
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constipation. drink at least 1500 ml/day and high fiber diet
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What antiulcer drugs are contraindicated for pregnancy?
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misoprostal (prostaglandin replacement) and cemitidine (H2 antagonist)
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What are adverse effects for Misoprostal?
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abdominal pain, diarrhea, cramping and vaginal bleeding in women
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What antacid may cause acid rebound?
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Calcium carbonate
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What antacid can cause hypertenntion and HF
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sodium bicarb - not used often
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What are different kinds of antacids?
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Mg(OH)2, Al(OH)2 -------- Calc Carb, Sodium Bicarb
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How does methylcellulose and psyllium work?
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bulk formaing lax - retains water as it moves down tract
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How does docusate sodium work?
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surfactant lax - decrease surface tension on stool allowing water to be absorbed
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How does Bisacodyl work?
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Stimulant lax - stimulate intestinal motility
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How does lactulose work?
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osmotic lax - disaccharide not absorbed, water pulled into intestines
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What does Mg(OH)2 do?
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both antacid and laxative. as laxative, salts are not absorbed through GI wall. Water pulled in through osmotic effect.
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What does sodium phosphate do?
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osmotic laxative - as laxative, salts are not absorbed through GI wall. Water pulled in through osmotic effect.
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How does a glycerin suppository work?
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lubricant - like mineral oil, it softens stool
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What is a precaution for osmotic laxatives?
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since evacuates large amt of watery stool, keep hydrated
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What laxative causes a burning sensation??
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bisacodyl (due to intestinal motility?)
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While on laxatives it is important to
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take fluids
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What are the kinds of antidiarrheal meds?
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opiates (paregoric) and opiodios (lomotil, loperamide = immodium, bismuth subsalicylate = pepto bismol)
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What is the action of odensatrion
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serotonin receptor antagonist (seratonin associated with emesis)
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Action of Metclopramide?
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1. block dopamine and serotonin receptors 2. inc upper GI motility and tone
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Action of scopolamide?
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for motion sickness - muscarinic antagonist, suppressing neuarl activity in pathway to middle ear
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Action of chlorpromazine?
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block dopamine
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Action of Dramamine?
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blocks acetylcholine and histamine, blocking neuronal receptors in path from inner ear to vomit center
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Action of antivert?
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blocks acetylcholine and histamine, blocking neuronal receptors in path from inner ear to vomit center
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