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44 Cards in this Set
- Front
- Back
H2 Blockers named
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for acid secretion
Tidines......cimetidine rani, famo, niza |
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H2 Blockers Moa uses
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the "tidines"
decr acid (NOT BASAL) blocks Gs----cAMP----H/K atpases cascade Partial antag of vagal acid(?) uses---PU,G-itis,eso reflux(mild) part of H.pyl. triple therapy----a DoA, and SEs only big diff between |
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Cimetidine SEs
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**inhibits CYP450 3A4/2D6 ****
CNS pen.----Confuse (esp with renal Prob) STEROID PROBS----antiandrogenic)= Gynecomastia (pain) milk women other tidines milder Se profile |
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Antacids SE
Alum Mg Ca Na |
Alum---need good renal
constipation,(Ca also) can get Al encephalopathy in dialysis patients all cause hypokalemia Ca-can get wierd hypercalcemia and met alkalosis Al acidifies urine (decr aspirin secretion) Na citrate is DOC (esp to avoid reflux in preg) |
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drugs that help with the mucus
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Bismuth Subsalicylate
Misoprostol |
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Misoprostol MoA
USES |
PGE1 analog---increases cytoprotection----increased mucus secretion
increased bicarn secretion decreased acid prod(?) (good for PU, prevent NSAID induced ulcers, MAINTAIN PDA) induce labor |
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PPI named
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PRAZOLES (ome, lanso,esomer,rabe)
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Omeprazole Moa
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irreversible block of H/K PUMP in parietal cells inhibits BASAL BASAL and gastric acid secretion
this is the GUY for PUD, GERD, ZE Syn, G-itis |
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Misoprostol SEs
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PREG X-------stim uterine contraction,,,,abort..
and diarr,abd pain,flatu, endo bleed |
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Omeprazole SEs
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headache nausea, diarr,
inhibits CYP450---- (increased warf,benzodiaz,Phenytoin) decreased abs acid requi drugs |
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Sucralfate Moa,indications,SEs
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in acid becomes crazy gel
GOOD for smokers****** Preg Aluminum......not in renal probs meeses with absorp of tons oral drugs increased constipation |
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Gastric emptying drugs
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Metoclopramide(+chol,-dop) also antiemetic (SE =steroid probs)
Cisapride(myenteric Ach--removed from market) |
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diarrhea drugs mechanisms
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opioids,adsorbants,bind and coat,inhibit PGs, bind bile acids, somatostatin analogue,anti-5HT-3, pro-5HT-4(tegaserod)(IBS)
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diphenoxylate w/ atropine
uses, mOA, SE |
nonspecific antidiarrhea
Opioid and antichol (atrop min abuse) SEs- constpation--can get TOXIC megacolon, interact with CNS depress (alcohol) (avoid in Infectious of bowel wall, poison induced diarrhea, not recomended in kids (resp depression) |
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Loperamide
mOA, uses, SE |
=immodium)
OPioids, slow motility, uses-chr/acute infectious Diarrhea W/O BLOOD FEVER, + other chronic diarrhea ibs etc. the most prompt and effective nonspecific SE-big first pass(avoid w/ hepatic dys), lower cns than diphenoxylate, constipation main problem |
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Opioids for diarrhea
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was DIPHENOXYLATE W/ATROPine and my LOPERAMIde
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adsorbants for diarrhea
named moa use |
kaolin,pectin ,methylcellulose, activated charcoal
adsorbs toxins bugs...plus coat and protect .......also stops absorbe drugs |
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Bismuth subsalicylate
use mOA SE |
pepto bismol
symptoms of diarrhea, prophylaxis of travelers mOA- COAT protect, inh PGs =antiinflam,antisecrete, increased e-lyte absorb)) antimicrobial, part of H.P> triple therapy SE- Const(impaction in old young) radiopaque, salicysm, dec abs. some drugs |
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nsaids antidiarrhea properties
SE |
inhibit PGs-= -inflam,-motile,+ reabsorb fluid
Gi bleed, Salicylism (tinnitus,vomit, |
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cholestyramine resins
moa uses in diarrhea |
diarrhea due to increased BILE ACIDS in colon mild c.diff. (binds toxins)(metro and vanco preffered)
SE- with sucrose (dm caut,) constipations, gritty poop, careful with crohns with strictures, may decrease folate |
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Octreotide
mOA uses |
HORMONAL diarrhea (good in carcinoid tomur)BUY time till figure out problem, good in HIV diarrhea
Somatostatin analog-inhibits release of many GI hormones SE- inject pain flatu steatorrhea |
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IBD drugs
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5-asa drugs Ol/Me/BAL sulfaSALAzine(this one also with antimicrobial), inh. AA cascade =anti INflam.
START LOW GO SLOW |
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Sulfasalzine SEs
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for IBD
mostly common headache nausea some allergic Rxs oligasperm hepatitis rare sever blooddyscriasis |
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drugs for Crohn's
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Infliximab
Budesonide |
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Infliximab
use SE |
mouse Ab to TNF-alpha
mod to sever crohn's, and RA SE-Ab so think HYPERSENSITIVITY can get reaction reactivate TB********MUST PRETEST screne |
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Budesonide
use SE |
Crohn's
Systemic corticosteroid (more Gluco than Mineralo) low bioavailable (GOOD stays in lumen) |
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Tx IBS
Diarrhea constipation |
dia-ALosetron (anti5ht-3) (in women)
COnst-tegaserod(pro5ht-4) (IN WOMEN) |
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alosetron
uses mOA SEs |
Tx-diar pred IBS in WOMEN without anat/metab abnorm
5HT-3 antag-=inhibit secret/motil/affernet pain signals SE-RESTRICTED ACCES DRUG NEED TO BY IBS CERTIFIED....OBSTRUCTS THE BOWEL,PERF,TOX.MEGACOLON,ISCHEMIA DEATH |
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tegaserod--sE
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OFF MARKET FOR CV PROBS
INCREASED ABD SURGERY AND PAIN....ACTUALLY STILL USED OFF LABEL WHEN NO OTHER OPTION AVAILABLE |
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BULK FORMING LAXATIVES
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CARBOXYMETHYLCELLULOSE,METHYLCELLULOSE,KARAYA GUM, PSYLLIUM HYDROPHILIC COLLOID(metamucil) CA POLYCARBOPHIL
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PSYLLIUM
MOA SE USES |
A GOOD BULK FORMING LAX (FIBER) DILUTE FOR FULL BENIFIT
CONTIPATION AND DIARRHEA(MILD) MGMT SE-POSSIBLE ALLERGIC,BLOAT FLATULENCE WITH BULK (LESS WITH PSYLLIUM) CAN DECR ABS OTHER DRUGS |
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LAXATIVES WITH PAF ACTIVITY
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PLATELET ACTIVATING FACTOR
TISSUE DISTRUCTIVE BISACODYL AND CASTOR OIL (THEY HAVE NITRIC OXIDE ALSO) |
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LAXATIVES WITH NITRIC OXIDE ACTIVITY
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BISACODYL AND CASTOR OIL
(THEY HAVE PAF ALSO) CASCARA (MILD)SENNA |
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BISACODYL
USE MOA SE |
FOR CONSTIPATION----RECTAL (1 HR) ORAL 6 HRS SOFT STOOL
SE-PAIN IF RECTAL, TISSUE DAMAGE (paf) SE- TISSUE DAMAGE |
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CASCARA
USE MOA |
NO
MILD SOFT 6 HRS |
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CASTOR OIL
mOA USE SE |
OUCH
CONSTIPATIO....WATERY EVAC VERY FAST THOUROUGH NO & PAF CATHARTIC---CONV TO RICINDEIC ACID BY GUT FLORA SE- TOO POWERFUL,ENeMA GOOD |
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DOCUSATE
USE MOA |
MARGINALLY EFFECTIVE
SOFT STOOL 1-2 DAYS DETERGENT EMULSIFIES FAT, RETAIN FLUID IN CA,K,NA FORMS |
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SENNA
MOA USE |
MORE POTENT THAN CASCARA..DISCONT W/ NORMAL
NO MECH SENNA POD PHYSIOLOGIC IS BEST NOT FOR EXTREME.....SOME HEPATOTOX |
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SALINE CATHARTICS
Mg, K, Ca |
Mg most common
osmotic attract h2o fast DEhydration must give with tons water mg, k not in renal dis na not in HF edema (not used much) |
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Mineral Oil
uses SE |
good rectal for compaction
no TOLLERANCE good SE---lipid pneumonia...stand for two hours LYMPH nodes Inflamation( granulomas) don't take with docusate(LN scene worse from bigtima absorption) |
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Polyethylene glycol
use mech se |
Bowel cleansing agent
pretreat with metaclopramide for nausea................. salt water osmotic scene se---gross....gi distress safe and hated |
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Lactulose
uses SE |
COnstipation
HEPATIC ENCEPHALOPATHY (OR CHRONIC PORTAL HTN) HELPS GET AMMONIA OUT OF BLOOD SYNTHETIC DISSACHARIDE NON DIGESTED = OSMOTIC SCENE SE- BACTERIAL OVERGROWTH, FLATULENCE, AVOID IN DM |
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GALL STONE TX
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CHENODIOL URSODIOL
THESE ARE NATURAL BILE ACIDS-----DECREASE THE SATURATION INDEX SHOCK WITH LITHOTRIPSY CHENODIOL INCREASES AST |
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PANCREATIC ENZYME REPLACEMENT
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NOT SUPPLEMENT--YES REPLACE
CAN HAVE ALLERGIC REACTION TX STEATORHEA SCENE |