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30 Cards in this Set
- Front
- Back
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Antacids can treat....but not...
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Duodenal ulcers and GERD but not Gastric ulcers
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Which antacids use aluminum and magnesium hydroxides to bind gastric acid?
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Maalox, Mylanta, Gaviscon
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Which antacid uses calcium carbonate to neutralize acid.
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Tums
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At what pH should the stomach be at for adequate therapy
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> 4
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Neutralizing capability of Al(OH)3, Mg(OH)2, and NaHCO3 vs. CaCO3
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High/Low
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What effect does Al(OH)3 have on gastric motility?
How about Mg(OH)2 |
Decreases
Increases |
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Sucraflate MA
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forms protein crosslinks at ulcer site--Mucosal protectant
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Bismuth Subsalicylate(Pepto) MA
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Binds to ulcer site and binds bile acid- Mucosal protection
*also (-) PGs and alkali secretion |
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H2 receptor antagonists
(there are 4) |
Cimetidine (Tagamet)
Ranitidine (Zantac) Famotidine (Pepcid) Nizatidine (Axid) |
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Use of H2RA
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Treatment of GERD, gastric ulcers, ZES, and H. pylori(used in combo w/antibiotics)
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MA of H2RA
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Analog of histamine, (-) bindnig of histamine to H2 receptors of parietal cells
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Metabolism and excretion of H2RA
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Excreted in urine mostly unmetabolized
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Toxicities of Cimetidine
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Gynecomastia (increased Prl)
Confusion |
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Toxicities of Famotidine and Ranitidine
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Headache
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Drug interxn with cimetidine
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Inhibits P450--prolongs 1/2 life of phenobarbital (anti-epileptic), theophylline (asthma), diazepam (anti-anxiety)
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Proton Pump Inhibitors (PPIs)
(there are 5) |
Omeprazole (Prilosec)
Esomeprazole(S enatiomer of Ome.) Lansoprazole Pantoprazole Rabeprazole |
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Which PPI is available OTC
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Omeprazole
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PPI use
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Treatment of duodenal and gastric ulcers, ZES, and severe GERD
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MA of PPIs
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Covalently bind and irreversibly inhibit proton pumb on parietal cells
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Activity of PPIs
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Inactive at neutral pH, activated by low pH
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When should you take PPIs for maximal effect
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30-60 min before eating
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Why so long for PPI action?
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Absorbed in duodenum FIRST then circulate to stomach
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How long do PPIs work
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Several days--due to irreversible binding
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Why does Esomeprazole have a longer half life than Omeprazole
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Hepatic metabolism is slower
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PPI toxicities
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Nausea, diarrhea, abdominal pain/constipation
*Increased risk of resp. infection w/prolonged use |
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PPI drug interxns
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Reduce absorption of drugs that need acidic environment: iron, ketconazole, ampicillan
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How is PPI metabolism affected by those with CYP2C19 deficiency
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Slow metabolizers of all PPIs except Rabeprazole
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Misoprostol (Cytotec)
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Prostaglandin E1 analog (-) acid secretion from parietals and (+)mucin secretion
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Use of Misoprostol and side effects
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Exclusively to prevent NSAIDs induced ulcers
Diarrhea |
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Contraindications of Misoprostol
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Pregnancy
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