• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/39

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

39 Cards in this Set

  • Front
  • Back
Antacids
Hydroxides of : AL Mg
Sodium Bicarbonate
Calcium Carbonate
Other carbonates
Antacids

Side effects
Mg: Diarrhea
Al: Constipation
High sodium
Only a problem if renal function is impaired
Antacids

Drug interactions
1) Decrease Bioavailability of phenytoin, digitalis and propanolol
2) Increase:
Absorption of sulfonamides
Rate of L-dopa absorption
Blood levels of Valproic acid
Elimination of salycylates and phenobarbital
Antacids

Uses
Symptomatic relief of heartburn or gastritis
Adjunct to drug therapy in ulcer and GERD
H2 Histamine Receptor antagonists

Agents
First line of treatment for peptic ulcer
Cimetidine (Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)
Nizatidine (Axid)
H2 Histamine Receptor antagonists

Mechanism
Inhibit Gastric acid secretion by blocking H2 receptor on Parietal cells
H2 Histamine Receptor antagonists

Uses
1) Treatment of duodenal and gastric ulcers, gasroesophageal reflux, and Zollinger-Ellison syndrome
2) Pre operative administration to lessen damage of reflux
3) Prevent stress ulcers
H2 Histamine Receptor antagonists

Side effects
Low incidence, mostly elderly, low renal function
Headache
Dizziness
Nausea
Antiandrogen effect (cimetidine, chronic high dose)
H2 Histamine Receptor antagonists

Drug interaction
Cimetidine inhibits CYP3A
Decreases metabolism of 1) Warfarin, 2) phenytoin, 3) theophyline, 4) phenobarbital, 5) some benzodiasepines, 6) propanolol, 7) nifedipine, 8)digoxin, 9) quinidine, and 10) TCA
Proton Pump inhibitors
Omeprazole (Prilosec)
Esomeprazole (Nexium)
Lansoprazole (Prevacid)
Rabeprazole (Aciphex)
Pantoprazole (Protonix)
Proton Pump inhibitors

Mechanism
1) Irreversibly inhibit H+,K+ ATPase in parietal cells
2) DOC for GERD
3) Administered in inactive form, converted in parietal cells to active form
4) Last for 3 days
5) Take on empty stomach
6) For one to two months
Proton Pump inhibitors

Adverse Side effects
Nausea, diarrhea, and abdominal colic
Decrease absorption of Ca++
Increase Risk of osteoporosis
Proton Pump inhibitors

Drug interactions
1) Omeprazole, esomeprazole, lansoprazole inhibit CYP2C19 and CYP3A4 interact with phenytoin, diazepam, warfarin
2) Rabeprazole and pantoprazole barely effect liver metabolism
Proton Pump inhibitors

Uses
1) Healing of duodenal ulcers in 4 weeks and gastric ulcers in 8 with higher dose
2) Effective in treating ulcers that did not respond to H2 blockers
3) DOC for GERD
4) High dose for Zollinger-Ellison
Cytoprotective agents

Sucralfate (carafate)
Aluminum salt of sulfated sucrose
Polymerizes in stomach acid to form protective barrier
SE: Constipation, decreases absorption of digitalis, tetracycline, and phenytoin
Cytoprotective agents

Misoprostol (Cytotec)
1) Prostaglandin E1 analogue
2) Increases mucus secretion, decreases acid production
3) Prevents ulceration by NSAIDS
4) May cause abortion, contraindicated in pregnancy
Cytoprotective agents

Colloidal Bismuth Salicylate (Pepto Bismal)
1) Coats the Stomach
2) antibacterial against H. pylori
3) Contraindicated if allergic to aspirin
Antibacterial agents and treatment for Peptic ulcer
1) Metronidazole, amoxicillin, tetracycline, and clarithromycin
2) Helidac-bismuth subsalicylate, metronidazole, and tetracycline
3) Tritec-ranitidine and bismuth citrate, for use with Clarithromycin
Prokinetic agents

Metoclopramide (Reglan)
1) D2 receptor antagonist
2) Enhances motility and tone of smooth muscle
3) Antiemetic (CTZ in CNS)
4) Use: gastroparesis, Esophageal reflux
5) SE: GI cramping and diarrhea, extrapyramidal symptoms
6) Contraindicated in pregnancy
Prokinetic agents

Bethanechol (Urecholine)
Muscarinic agonist increase tone and motility of GI
Uses: postoperative ileus
Increase lower esophageal tone
Does not get into CNS
Common SE of antimuscarinics: SLUDGE
Antispasmodics/Anticholinergics
1) Glycopyrrolate and Dicyclomine
2) Decrease over activity
3) Reduce cramping and spasms
4) Anticholinergic side effects
Anti-emetics and anti-nausea agents

5HT3 receptors antagonists
1) Ondansetron(Zofran), other Setrons
2) Useful in treatment of vomiting due to vagal stimulation and chemotherapy.
3) Not useful against motion sickness
4) SE: headache, dizziness, constipation
Anti-emetics and anti-nausea agents

Phenothiazines and Butyrophenones
1) Prochlorpermazine and promethazine (phenergan) block Dopamine, muscarinic and histamine receptors
2) Use: postoperative nausea and vomiting as well as other causes
3) Cause sedation
4) Droperidol blocks central DA receptors, can be injected
Anti-emetics and anti-nausea agents

Cannabinoids
Dronabinol (THC)
Nabilone THC analogue
1) Anti-emetic and appetite stimulant
2) Used for Chemo induced N/V
3) Combination with prochlorperazine or promethazine increases effectiveness of both
Bulk forming laxatives
Methylcellulose (Citrucel)
Psyllium (metamucil)
Acts like fiber, prevents constipation and diverticulitis
SE: Bloating and flatulence, impaction or obstruction if not enough water is consumed
Osmotic Laxatives
1) Poorly absorbed salts and sugars
2) Have intense effects to prepare bowel for surgery or colonoscopy
3) Only lactulose can be used chronically
Osmotic Laxatives

Magnesium salts
Magnesium hydroxide (Milk of Magnesia)
Magnesium sulfate (Epsom salts)
Magnesium citrate ( EvacQ Kwick)
Osmotic Laxatives

Sodium Salts
Orally or as enema
Administer with large amounts of water
Contra indicated in CHF
Osmotic Laxatives

Lactulose
Disaccharide
Metabolized to Lactic acid by colonic bacteria
SE: gas abdominal distention and flatulence
Use: reduce hyperammonemia with cirrhosis or other hepatic failure
Osmotic Laxatives

Sorbitol or mannitol
Used as sweetener
Over consumption will cause laxative effect
Osmotic Laxatives

Polyethylene glycol (Golytely)
OTC Miralax for occasional constipation

GoLytely for surgical prep NG tube or orally
Agents that affect mucosa
laxatives
Irritants stimulates peristalsis, enhances secretion, and inhibits water absorption
produces semi formed stool in2-8 hr
Mucosa

Bisacodyl (dulcolax)
inhibit absorption of water
stimulate peristalsis
Mucosa

Senna and Cascara Sagrada
Very mild
effective in 8-10 hr
Mucosa

Castor oil
Requires presence of bile
Not used in pregnancy
Cause cramps and pain
Dehydration
Used for prep for diagnostic procedures
Lubricating agents and fecal softners
Not absorbed
Increase bulk
Softening the stool
Lubricating and softener

Mineral oil
Takes 2-3 days
Oil lubricates stool
Decreases absorption of lipid soluble vitamins
Absorped slightly
Lubricating and softener

Ducosate sodium
Emusifying agent allow water to pentrate colonic contents and soften them.
Increase water absorption (oral)
Lubricating and softeners

Glycerin
Supositories lubricate distal end of bowel.
Stimulate peristalsis
Possible osmotic effect