Agents for PUD & GERD (Segars)

Question 1

Anti-ulcer agents 5 families?

Answer 1

H2 Receptor Antagonists
Proton Pump Inhibitors
Surface Acting Agents
PGE1 Analogs
Bismuth Compounds

Question 2

H2 Receptor Antagonists drug naming convention

Answer 2

Cimetidine
Famotidine
Nizatidine

Question 3

Proton Pump Inhibitors (PPI) naming convention

Answer 3

Lansoprazole
Dexlansoprazole*
Omeprazole
Esomeprazole*
Pantoprazole
Rabeprazole

*isomer of other compound in class

Question 4

Surface Acting Agent drug naming convention

Answer 4

Sucralfate

(starts with S, like Surface acting agent…)

Question 5

PGE1 Analog drug naming convention

Answer 5

Misoprostol

(prostaglandin)

Question 6

H2 Receptor Antagonist MOA

Answer 6

reversibly inhibit H2 receptors on baso-lateral membrane of parietal cell

prompt action and relief of GERD symptoms

ulcer healing 4-8 weeks (unless HPylori is cause)

inhibits 20-50% of acid production

Question 7

H2 Receptor Antagonist drug side effects

Answer 7

mild (GI, CNS)

rare: Cimetadine has weak anti-androgen effects

Question 8

H2 Receptor Antagonist drug interaction

Answer 8

Cimetadine prototypical inhibitor of several CYP450 isoenzymes

LOTS of drug-drug interactions

Question 9

Proton Pump Inhibitors (PPI) MOA

Answer 9

inhibit gastric acid secretion by irreversibly inhibiting funcitoning “-ase” pumps

slower than h2s

inhibit 50-90% of acid

Question 10

Proton Pump Inhibitors (PPI) adverse effects

Answer 10

Mild: GI and CNS

Rare: CDAD (Clostridiodes Difficile-Associated Diarrhea)

Question 11

Proton Pump Inhibitors (PPI) drug interactions?

Answer 11

Omeprazole prototyopical PPI for CYP450 inhibition

LOTS of drug-drug interactions

Question 12

Surface Acting Agents MOA

Answer 12

interacts with stomach acid to create a viscous, sticky polymer - adheres to epithelial cells around ulcer’s crater to prevent acid access

Question 13

Surface Acting Agents indications?

adverse effects?

Answer 13

patients with DU, but also used off-label for lots of things.

adverse effects: constipation

Question 14

Surface Acting Agents contraindications?

drug interactions?

Answer 14

severe renal failure (aluminum)

drug interatctions possible - take 2 hours after other meds
(dosing is tough bc QID)

Question 15

PGE1 Analog MOA

Answer 15

protective prostaglandin to gastric mucosa, reduces gastric acid release from parietal cell

increases mucosal defenses

given prophylactically when using NSAIDS

Question 16

PGE1 Analog adverse effects?
contraindications?

Answer 16

GI, CNS

contraindication: Pregnancy, IBD

Question 17

Bismuth compounds MOA

Answer 17

anti-diarrheal and antimicrobial

Question 18

Bismuth compounds adverse effects?
drug interactions?

Answer 18

adverse effects: costipation
black/dark (regularly formed) stools

drug interactions: LOTS, take 2 hrs after other meds

Question 19

Bismuth compounds contraindications?

Answer 19

relative contraindications: antiplatelets and anticoagulants
severe renal failure

absolute contraindications: GI bleed
salicylate hpersensitivity - Allergy alert!