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43 Cards in this Set
- Front
- Back
Drugs used in acid-peptic dz?
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Antacids
H2 receptor antagonists PPIs Sucralfate Misoprostol Bismuth Antibiotics |
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Antacids?
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MgOH2 - laxative
AlOH3 - constipating weak bases, neutralize stomach acid and stimulate protective fxn of gastric mucosa, reduce recurrence of peptic ulcers not absorbed in the bowel |
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MOA H2-receptor antagonists?
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inhibit stomach acid production by blocking H2 receptors which mediate gastric acid secretion by parietal cells.
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examples of H2 receptor antagonists?
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cimetidine
ranitidine famotidine nizatidine |
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toxicity of H2 antagonists?
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cimetidine inhibits hepatic drug-metabolizing enzymes and reduces hepatic blood flow, significant antiandrogenic effect in high doses
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MOA of PPIs?
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lipophilic weak bases that diffuse into parietal cell canaliculi and irreversibly inactivate parietal cell H/K ATPase that produces stomach acid
More effective than H2 antagonists for GERD and PUD |
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Examples of PPIs?
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Omeprazole
esomeprazole lansoprazole pantoprazole rabeprazole |
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Result of chronic tx w/ PPIs?
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hypergastrinemia
decrease oral bioavailability of vitB12 and drugs that need stomach acidity for absorption |
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drug whose polymer binds to injured peptic tissue and forms a protective coating over ulcer beds?
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Sucralfate
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drug that is an analog of PGE1, increases mucosal protection and inhibits acid secretion (esp in NSAID users), but not popular b/c multiple daily dosing and GI upset and diarrhea?
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Misoprostol
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Drug that forms protective coating on ulcerated tissue and stimulates mucosal protective mechanisms, direct antimicrobial effects and sequestration of enterotoxins?
Also reduces frequency and liquidity of stools in infectious diarrhea? |
Colloidal bismuth
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side effect of bismuth?
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dark stools
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Regimen of choice for H. pylori?
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PPI + bismuth, tetracycline and metronidazole
OR amoxicillin + clarithromycin |
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drugs that promote upper GI motility?
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Metoclopramide (D2 receptor blocker)
Cholinomimetics |
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Examples of cholinomimetics?
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Bethanechol (direct-acting)
Neostigmine (indirect-acting) |
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Side effect of metoclopramide?
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parkinsonism
extrapyramidal effects hyperprolactinemia |
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Drugs with antiemetic actions?
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Metoclopramide (D2 receptor blocker)
Ondansetron (5HT3 blocker) Diphenhydramine (Histamine H1 blocker) Scopolamine (anti-muscarinic) Dexamethasone (corticosteroid) Dronabinol (cannibinoid receptor agonists) Aprepitant (neurokinin1 receptor antagonist) |
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Which drugs are useful in preventing N/V after general anesthesia and after cancer chemotherapy?
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5HT3 blockers
(ondansetron) |
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side effects of aprepitant?
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fatigue, dizziness, diarrhea
many drug interactions (substrate and inhibitor of CYP3A4) |
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Drugs used for IBS w/ diarrhea?
Why? |
Alosetron (5HT3 blocker)
Causes constipation (sometimes severely so) |
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Drug used for IBS that increases gastric emptying and intestinal transit time as well as increasing stool liquidity, but was discontinued d/t increased risk of CV events?
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Tegaserod (partial 5HT4 agonist)
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Drugs used in IBD?
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glucocorticoids (prednisone)
immunosuppressive antimetabolites (azathioprine) infliximab (anti-TNFa monoclonal antibody) aminosalicylates (mesalamine) |
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MOA aminosalicylates?
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not absorbed after oral admin, in small intestine, release 5-ASA which inhibits synthesis of prostaglandins and inflammatory leukotrienes
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Drugs used in steatorrhea?
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pancreatic enzyme replacements
pancreatin, pancrealipase |
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How must pancreatic lipase be administered to be effective?
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Enteric-coated unless pH is raised w/ antacids or PPIs/H2 blockers
(lipase is inactivated below pH 4.0) |
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Bulk forming laxatives?
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psyllium
methylcellulose polycarbophil |
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stool softening laxatives?
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docusate
glycerine mineral oil |
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osmotic laxatives?
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Mg oxide
sorbitol lactulose polyethylene glycol |
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stimulant laxatives?
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aloe
senna cascara castor oil |
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5-HT4 receptor agonist laxatives?
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Tegaserod
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Antidiarrheal agents?
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Diphenoxylate, loperamide (opioid derivatives w/ little analgesic effect)
Difenoxin (active metabolite of diphenoxylate) |
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What is diphenoxylate usually combined with?
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antimuscarinic alkaloids (atropine) to reduce likelihood of abuse
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Drugs that inhibit formation of gallstones?
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Chenodiol, ursodiol
(bile acid derivatives) |
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drug that can be used as an osmotic laxative or as an antacid?
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Magnesium hydroxide
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Laxative MOA of MgOH2?
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holds water in the intestine which adds bulk and stimulates increased contractions
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Metoclopramide?
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D2 blocker
prokinetic and antiemetic |
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diphenhydramine?
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H1 histamine blocker
antiemetic |
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scopolamine?
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anti-muscarinic
antiemetic |
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Tegaserod?
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partial agonist of 5HT4 receptors
prokinetic, used for IBS |
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Loperamide?
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opioid derivative w/ weak analgesia
used as antidiarrheal |
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Mesalamine?
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aminosalicylate
used for IBD |
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Drug class to use in Zollinger Ellison?
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PPI's
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Infliximab?
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anti-TNF alpha monoclonal antibody
used in IBD |