5 - GI, Respiratory, Chemo Flashcards
Major causes of peptic ulcer dz
#1: Helicobactor pylori #2: NSAIDs
List
- H2 blockers (3)
- proton pump inhibitors (2)
- gastic lining protector (1)
H2: cimetiDINE, ranitiDINE, famotiDINE
PPI: omeprazole (Prilosec), esomeprazole (Nexium)
*No Protons
GLP: sucralfate
Cimetidine, Ranitidine, Famotidine
- MOA
- clinical indications
- adverse effects
Prevent histamine stimulation of gastic acid (HCl) secr by blocking H2 receptors on parietal cells
Healing/preventing stomach ulcers, acid reflux
Diarrhea
Cimetidine: numerous drug inxns, gynecomastia + loss of libido (Klinefelters XXY)
Omeprazole, Esomeprazole
- MOA
- clinical indications
Inhibit H+/K+ ATPase proton pumps -> decr stomach acid
First-line tx of PUD and GERD
Sucralfate
- MOA
- clinical indications
- adverse effects
Forms paste-like substance by binding to (+)charged proteins and damaged ulcer tissue
Acute management of PUD: allow healing of mucosa
May interfere with absorption of other oral meds: take 2 hours after other meds
Salmeterol
- MOA
- clinical indications
- adverse effects
Only long-acting B2 agonist
Maintenance therapy COPD/asthma
1-3% incidence of keratitis, conj-itis
Albuterol, Levalbuterol, Terbuteraline, Metaproterenol, Isoproterenol
- MOA
- clinical indications
- adverse effects
Short-acting B2 agonists
ALT: Rescue inhaler for acute dyspnea
M: no longer used due to CV effects from B1 stimulation
I: no longer used for asthma
-non-specific beta agonist, primarily used for tx of arrhythmias, IV administration only
B2>B1 effects (in general)
-all SE due to B1 stim: tachy, palpitations, nervous, tremor, nausea
All short-acting B2 agonists have glaucoma warnings due to incr IOP
Ipratropium
- MOA
- adverse effects
Blocks muscarinic receptors in bronchial smooth muscle -> inhibits bronchoconstriction
Caution in narrow angle pts: dilate, anterior iris shift
Zafirlukast, Montelukast
- MOA
- clinical indications
- adverse effects
Leukotriene receptor antagonists
Tx of asthma and bronchoconstriction (leukotrienes cause b-const)
M: approved for tx of allergic rhinitis
Theophylline
- MOA
- clinical indications
- adverse effects
Inhibits phosphodiesterase -> incr cAMP + incr release of epinephrine
Limited use due to narrow TI
Topical ophthalmic BBs (incl Timolol) can mitigate bronchodilaroty effects
Acetylcysteine
- MOA
- clinical indications
- adverse effects
Mucolytic agent that breaks disulfide bonds in proteins of mucus to reduce viscosity
Topical ophthalmic form can be RXd QID for filamentary keratitis, dry eye syndrome, corneal burns
Methotrexate
- MOA
- clinical indications
- adverse effects
Inhibits DHF reductase (like TMP + pyromethamine) -> inhibits DNA synth
RA: immunosuppressant and anti-inflammatory
Hepatotoxicity
Myelosuppression -> incr risk of opportunistic infections and lymphomas (incl eye)
Aplastic anema
Optic neuritis
Cyclosporin
- MOA
- clinical indications
- adverse effects
Inhibits release and prod of IL2 (chemical mediator for T-cell activation)
Prevents rejection of organ transplants
Restasis = topical ophthamic 0.05% rxd BID
Opportunistic infections, malignancies, HTN, kidney dysfunction
Oral cyclosporin is the most common medication-associated cause of __, characterized by HA, altered consciousness, seizures, visual disturbances - incl aura, hallucinations, hemianopsia, and/or cortical blindness
Reversible posterior leukoencephalopathy syndrome (RPLS)
Azathioprine
- MOA
- clinical indications
Purine analog, inserts into DNA and RNA and stops replication
Tx of RA
Prevent kidney transplant rejection
Ocular myasthenia - risk of secondary lymphomas limits use
