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Pharm Unit 6 > GI drugs > Flashcards

GI drugs Flashcards

1
Q

Calcium carbonate (Rolaids, Tums)

A 
Class: Antacid
Mech: Chemical reaction
Thera: Ulcer treatment; GERD
Important SE's: Milk-alkali syndrome, nephrocalcinosis, "rebound" acidity, digitalis antagonism
Other SE's: Constipating effects
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2
Q

Sodium bicarbonate: differences from Ca carbonate

A

Important SE’s: Systemic alkalosis
Other SE’s: Enhanced effects of amphetamine, quinidine, and cinchophen
Misc: Rarely used due to causing systemic alkalosis

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3
Q

Magnesium hydroxide, magnesium carbonate (Maalox, Mylanta)

A

Important SE’s: Diarrhea (laxative effects)
Other SE’s: Hypokalemia, hypermagnesemia, iron deficiency
Misc: Magnesium toxicity mostly in presence of renal disease; liquid-based, so act fast

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4
Q

Aluminum hydroxide (Alternagel)

A

Important SE’s: Phosphate depletion and sequelae (weakness, anemia, tetany, apnea)
Other SE’s: Constipation
Misc: Safe for use in patients with renal failure (bonus: helps eliminate phosphate)

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5
Q

Atropine sulfate (Donnatol)

A

Class: Anticholinergics
Mech: Reduce acid secretion, reduce spasm; Relax all bowel smooth muscle (because most innervation of the bowel is cholinergic)
Thera: Ulcer treatment, Diarrhea
Important SEs: Anticholinergic effects
Misc: AKA, belladonna; contraindications: known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)

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6
Q

Propantheline (Pro-Banthine); Metantheline bromide: differences from atropine sulfate

A

Thera: Ulcer treatment (taken 15-30 minutes before meals, and before bed)
Misc: Contraindications: known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)

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7
Q

Cimetidine (Tagamet), Ranitidine

A

Class: Histamine (H2) receptor blocker
Mech: Inhibit 50-80% of 24 hour acid production
Thera: Ulcer treatment (first class to satisfy all 4 requirements); prophylactically for stress ulcers; GERD
Important SE’s: Rebound acidity if stopped suddenly
Other SE’s: Uncommon; headache, lethargy, confusion, depression, and hallucination
Misc: One dose as effective as multiple; binds and interferes with P450

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8
Q

Famotidine (Pepcid), Nizatidine (Axid): differences from the other -tidines?

A

Misc: One dose as effective as multiple

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9
Q

Misoprostol (Cytotec)

A

Class: ProstaglandinE analog
Mech: Decrease acid production, increase mucous and bicarbonate secretion
Thera: Ulcer treatment when prostaglandin production decreased (RA patients taking lots of NSAIDs)
Misc: Not very effective, since endogenous prostaglandin levels are already high in duodenal ulcer patients

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10
Q

Omeprazole (Prilosec), Lansoprazole (Prevacid)

A

Class: H/K/ATPase inhibitor
Mech: Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don’t take with antacids)
Thera: Ulcer treatment, treatment for H. pylori; GERD
Other SE’s: Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
Misc: For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin; large P450 interference; lowest bioavailability (some P450 interference in Lanso with great bioavailability)

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11
Q

Rabeprazole (AcipHex), Pantoprazole (Protonix), Esomeprazole (Nexium): differences from the other prazoles

A

Thera: Ulcer treatment; GERD
Misc: Rabe with Moderate P450 interference, panto with No P450 interference; great bioavailability, esome with Some (?) P450 interference

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12
Q

Sucralfate (Carafate)

A

Class: Mechanical protectors
Mech: Coat the ulcer crater, increase mucosal resistance (requires acid environment)
Thera: Ulcer treatment, treatment for H. pylori
Important SE’s: Aluminum toxicity possible in renal failure
Misc: For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin; big pill, need to take 4 times per day

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13
Q

Bismuth salts (Pepto-Bismol)

A

Class: Mechanical protectors
Mech: Coat the ulcer crater, increase mucosal resistance
Thera: Ulcer treatment, treatment for H. pylori
Important SE’s: Aluminum toxicity possible in renal failure; turns bowel movements (and sometimes tongues) black
Misc: For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin

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14
Q

Metochlopramide (Reglan)

A

Class; Promotility agent (dopamine antagonist
Mech: Increase motor tone in lower esophageal sphincter (prevent reflux) and stomch (esp. antrum: improves gastric emptying); peripheral (stomach) and CNS (vomiting, via CRTZ) dopamine antagonist
Thera: GERD, anti-emetic, gastroparesis
Important SE’s: Hand tremor if used 4X/day (optimum use); possible extra-pyramidal symptoms, but not so severe
Misc: Can be used once/day for good effects

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15
Q

Cisapride (Propulsid)

A

Class: Promotility agent (dopamine antagonist
Mech: Increase motor tone in lower esophageal sphincter and stomch
Thera: GERD, gastroparesis
Important SE’s: Sudden cardiac death
Other SE’s: Not really used much anymore

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16
Q

Domperidone (Motilium)

A

Class: Promotility agent
Mech: Improves gastric tone
Thera: Gastroparesis

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17
Q

Sulfasalazine (Azulfidine)

A

Class: Anti-inflammatory
Mech: Work from lumen to reduce inflammation
Thera: Acute IBD (UC)
Important SE’s: Toxicity coming from systemic absorption of sulfapyridine
Misc: Sulfapyridine conjugated to 5-ASA to prevent its degradation, improve its absorption; bond broken in large bowel by bacteria

18
Q

Olsalazine (Dipentum)

A

Class: Anti-inflammatory
Mech: Work from lumen to reduce inflammation; 5-ASA dimer
Thera: Acute IBD (UC)
Important SE’s: Less toxicity than sulfasalzine
Misc: Broken down into bowel by bacteria into 2 moleules of 5-ASA

19
Q

Mesalamine (Pentasa)

A

Class: Anti-inflammatory
Mech: Work from lumen to reduce inflammation
Thera: Acute IBD (UC)
Misc: Delayed release 5-ASA, for terminal ileum, colon

20
Q

Prednisone (Decadron)

A

Class: Corticosteroid
Thera: Acute IBD, chronic IBD
Misc: Can be given systemically or as enemas

21
Q

Azathioprine (Imuran)

A

Class: Immunosupressive
Mech: Purine antimetabolite; interferes with DNA synthesis
Thera: Chronic IBD

22
Q

Cyclosporine (Sandimmune)

A

Class: Immunosupressive
Mech: Suppresses T helper and T suppressor lymphocytes
Thera: Chronic IBD

23
Q

Infliximab (Remicade)

A

Class: MAb Immunosupressive
Mech: Binds and neutralizes TNFa
Thera: Chronic IBD

24
Q

Prochlorperazine (Compazine)

A

Class: Phenothiazines (neuroleptic class)
Mech: Probable CNS interaction with dopaminergic receptor-antagonist (leading to reduction of stimulation in the CRTZ in the medulla)
Thera: Anti-emetic
Important SE’s: Largely extra-pyramidal (torticollis!)

25
Q

Promethazine (Phenergan)

A

Class: Phenothiazines (neuroleptic class)
Mech: Antihistaminic (H1 receptor), anticholinergic
Thera: Anti-emetic
Important SE’s: Somnolence (especially in the elderly)

26
Q

Trimethobenzamide (Tigan)

A 
Class: Benzamide derivitive
Mech: Unknown effect on CRTZ
Thera: Anti-emetic
Other SE's: Low-side effect profile; possible extra-pyramidal symptoms, but not so severe
Misc: Not used much
27
Q

Tetrahydrocannabinol (Nabilone)

A

Mech: Suppresses CRTZ, probably by anticholinergic mechanism
Thera: Anti-emetic
Important SE’s: Munchies
Misc: Now often administered in pill form

28
Q

Odansetron (Zofran), Granesitron (Kytril), Dolasetron (Anzemet)

A

Class; Serotonin (5HT3) receptor antagonists
Mech: Blocks serotonin at 5HT3 receptor (in central CRTZ)
Thera: Anti-emetic
Other SE’s: Headache, dizziness, somnolence
Misc: Very safe for vomiting of any type (including drug-induced); can even be given to 6 month-old (odansetron)

29
Q

Loperamide (Immodium)

A

Class: Opiod agonist
Mech: Less penetration to CNS; stimulates μ receptors in GI tract; increased rectal tone leading to segmentation of colon and disruption of peristalsis, leading to increased absorption time
Thera: Diarrhea; irritable bowel syndrome (diarrhea)

30
Q

Diphenoxylate (Lomotil), Codeine sulfate

A

Class: Opiod agonist
Mech: Less penetration to CNS; stimulates μ receptors in GI tract: increased rectal tone leading to segmentation of colon and disruption of peristalsis, leading to increased absorption time; combined with atropine (anti-cholinergic narcotic), which relaxes bowel smooth muslce
Thera: Diarrhea
Misc: Contraindication: children (narcotic will cause respiratory suppression); Lomotil = diphenoxylate + atropine (for diphenoxylate)

31
Q

Metamucil (Colace)

A

Class: colloid
Mech: Absorb water
Thera: Diarrhea
Misc: Doesn’t prevent potential dehydration

32
Q

Bismuth subsalicylate (Kaopectate): difference from metamucil

A

Class: pectin

33
Q

Castor oil; Cascara sagrada; senna extract; Bisacodyl; phenolphthalein

A

Class: Irritant/Stimulant
Mech: Irritate lumen of the colon, causes peristaltic contractions
Thera: Constipation
Misc: Castor oil, cascara sagrada, senna extract, bisacodyl, phenolphthalein

34
Q

Magnesium citrate; Magnesium sulfate (Epsom salt); sodium sulfate (Glauber salt); Milk of Magnesia

A

Class: Osmotic cathartics
Mech: Draw water into the colon
Thera: Constipation; clean bowel prior to colonoscopy
Misc: Also includes sodium phosphate & lactulose (digested by bacteria in colon)

35
Q

Psyllium seed (Metamucil); methylcellulose (Hydrolose); sodium carboxymethylcellulose

A

Class: Bulk-forming hydrophillic colloid
Mech: Bulk-forming
Thera: Constipation (especially small, hard stools)

36
Q

Mineral oil; Dioctyl sodium sulfo-succinate (Colace); poloxalkol

A

Class: Lubricant and fecal softeners
Mech: Stool softening, lubricating
Thera: Constipation

37
Q

Dicyclomine HCl (Bentyl)

A

Class: Anticholinergic (antispasmodic)
Mech: Blocks cholinergic action
Thera: Reduce spasm in irritable bowel syndrome

38
Q

Hyoscyamine sulfate (Levsin)

A

Class: Anticholinergic (antispasmodic)
Mech: Blocks cholinergic action
Thera: Reduce spasm in irritable bowel syndrome

39
Q

Alosetron (Lotronex)

A 
Class: Serotonergic antagonist
Mech: Blocks 5HT3
Thera: Diarrhea in irritable bowel syndrome
Important SE's: Ischemic bowel
Other SE's: Constipation
Misc: FDA approval recently withdrawn
40
Q

Tegaserod maleate (Zelnorm)

A

Class: Serotonergic agonist
Mech: Hits 5HT4
Thera: Constipation in irritable bowel syndrome
Misc: FDA approval recently withdrawn

Pharm Unit 6 (8 decks)

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