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Chapter 17 (gastrointestinal drugs) Flashcards

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1
Q

phosphodisesterase inhibitors

A

like caffeine; lower pressure of lower esophageal sphincter and made stomach more acidic which contributes to GERD

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2
Q

nicotine and alcohol

A

lower LES pressure to contribute to GERD

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3
Q

LES

A

lower esophageal sphincter

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4
Q

GERD

A

gastroesophageal reflux disease

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5
Q

PUD

A

peptic ulcer disease; inflammation/ulceration of stomach lining; includes acid and pepsin destroying inner lining of stomach and esophagus
Includes other related diseases like GERD

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6
Q

natural stomach protectors against PUD

A

protective mucus and bicarbonate

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7
Q

ARD

A

acid-related disorders; many gastric problems are caused by excessive acid stripping away protective mucus barrier, which results in autodigestion of stomach lining by pepsin (proteolytic enzyme)

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8
Q

dyspepsia

A

indigestion; can be caused from stress that is not being coped with, which can lead to ulcers if things progress and get worse
*prohylaxis anti-ulcer treatment is used before surgeries so stress ulcers do not develop from physical/emotional stress to pt.

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9
Q

heartburn

A

usually a combination of acid problem and gastroesophageal reflux

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10
Q

1/2 of family practice doctors appointments are related to…

A

anxiety/depression

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11
Q

contributors to PUD

A

ASA or other NSAID use, alcohol, cigarettes, caffeine, H. pylori infection, severe psychological stress, and traumatic (physical) stress

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12
Q

ARD treatment

A

most of the time we focus on decreasing or neutralizing HCl; to actually cure disease you must treat it for long period of time to allow for the epithelium to heal

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13
Q

oral antacids

A

neutralize HCl; can be in liquid or tablet form to treat ARD. Ca antacids have added benefit of supplementing extra calcium in those who need it.
*but for PUD and gastritis recurrence was common and scarring often resulted in gastric outlet obstruction, while hemorrhage and perforation were frequent life-threatening events

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14
Q

Amphojel

A

aluminum salt antacid

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15
Q

Tums

A

calcium salt antacid

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16
Q

Milk of magnesia

A

magnesium salt antacids; tend to cause loose stools/diarrhea (it is also used as a laxative)

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17
Q

combination antacids

A

cut down of tendency of single formulations to either produce loosened stool or constipation

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18
Q

magnesium

A

stool regulator; orally it is not absorbed much and just pulls water into GI tract to loosen stool

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19
Q

Maalox

A

combination antacid of magnesium salts and aluminum hydroxides; neutral for stool b/c of Mg and Al countering each other

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20
Q

Riopan

A

combination antacid of aluminum salts and simethicone

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21
Q

Rolaids

A

combination antacid of calcium and magnesium salts

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22
Q

baking soda

A

antacid; very effective for indigestion, but contains large amount of sodium that causes rebound acid a few hours later

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23
Q

simethicone

A

reduces surface tension or liquids so that bubbles don’t form; used for ‘gas’
*inert and has low side e’s

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24
Q

H2 blockers

A

antihistamines that only block H2 rc; dramatically reduced the number of ulcer surgeries needed
Now OTC will full strength as Rx
*some of them work better in certain people

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25
Tagamet
cimetidine; first H2 blocker, used for ARD
26
Zantac
ranitidine; H2 blocker, used for ARD
27
Pepcid
famotidine, calcium, and magnesium salts used as combination ARC treatment; H2 blocker and antacids
28
PPIs
proton pump inhibitors; decrease H pumped into stomach from parietal cells Now OTC same strength as Rx *all named -prazole
29
Prilosec
omeprazole; PPI
30
Prevacid
lansoprazole; PPI
31
Nexium
esomeprazole, 'Purple Pill'; PPI
32
combining antacids with H2 blockers
works great
33
combining PPIs with H2 blockers
very bad; causes atrophic gastritis where the smooth lining of stomach can become precancerous
34
Pepcid Complete
famotidine, Ca carbonate, and Mg hydroxide
35
H. pylori
bacterium which is highly associated with development of peptic ulcers People with this infection often associated with much worse acid-related symptoms
36
Pepto-Bismol
bismuth subsalicylate; indicated for treating heartburn, but is actually a very weak antacid, but does have antisecretory activity in gut to decrease water in stool and absorbs toxins caused by E. coli for diarrhea (acts locally) Very good for augmenting therapy with travelers diarrhea
37
H. pylori infection treatment
amoxicillin or clarithromycin (Biaxin, a macrolide) and a PPI
38
PrevPac
H. pylori treatment has been vastly simplified by this combination of amoxicillin, carithromycin, and lansoprazole
39
opioid drugs for diarrhea
have anticholinergic properties used to treat diarrhea; typically the ones used do not induce euphoria and have lower addictive potential
40
codeine
opioid drug used to treat diarrhea b/c of parasympatholytic effects
41
Paregoric
tincture of morphine used for diarrhea; NO LONGER AVAILABLE
42
Lomotil
diphenoxylate and atropine; opioid mixture used to treat diarrhea. Rx
43
Imodium
loperamide; synthetically produced opioid congener used just for diarrhea. OTC
44
bulk agents
binding agents; inert, non-digestable fiber that binds free water in gut to treat constipation or diarrhea Contain cellulose fibers similar to Kaolin-Pectin used for diarrhea; they hold on to water to increase bulk
45
Kaopectate
kaolin and pectin; bulk (binding) agents for diarrhea
46
infectious diarrhea treatment (traveler's diarrhea)
Septra (TMP-SMX ), Cipro (ciproflaxacin), Vibramycin (doxycycline)
47
Konsyl
bulk agent laxative; pure psyllium fiber inside is key ingredient (can also treat diarrhea). Psyllium is fiber: retains water in colon so stool doesn't dry out to treat constipation, but can also 'soak up' excess water to treat diarrhea
48
oatmeal
acts like a binding agent for diarrhea treatment (or constipation)
49
Metamucil
bulk agent laxative
50
stool softeners and lubricants
slowly work (over hours to days) to create a film around stool which allows retention of moisture
51
Colace
contains docusate; stool softener
52
mineral oil
lubricant for constipation; should only be used for short periods to avoid significant absorption
53
irritant/stimulant drugs
purgatives that stimulate vigorous bowel peristalsis
54
exercise
helps increase peristalsis of bowels; why so many elderly have constipation is because they do not move around much
55
castor oil
irritant/stimulant for constipation
56
sennosides
similar to irritant/stimulant for constipation; active ingredients in Ex-Lax
57
salt solutions
used as laxatives
58
Fleets enema
saline; salt solution used for laxative
59
hypertonic magnesium citrate solutions
used as bowel preps before colonoscopy or surgery
60
magnesium salts
attract water by osmosis into bowel lumen as a laxative
61
Epsom salts
hypertonic magnesium salt used as laxative
62
Mag Citrate
hypertonic magnesium salt used as laxative
63
fleet enemas
pre-prepared enemas for laxative
64
enema prep kits
meant to hang in bathtub; laxative
65
Phenergan
promethazine; 1st gen antihistamine used for anticholingergic properties as an anti-emetic
66
Dramamine
dimenhydrinate; antihistamine used for antiemetic properties from anticholinergic effects
67
Transderm-Scop
scopolamine; anticholingergic antiemetic
68
antiemetics
used for nausea/vomiting, vertigo, and motion sickness
69
antipsychotics and dopamine antagonists
have antiemetic effect
70
Compazine
prochlorperazine; dopamine antagonist used as antipsychotic drug, but also for n/v. Can be given p.o., parenterally, or rectally
71
n/v
nausea/vomiting
72
corticosteroids
mainly dexamethasone used for n/v after chemotherapy
73
benzodiazepines
used to treat n/v secondary to anxiety
74
cannabinoids
used as antiemetics and useful for glaucoma patients to reduce eye pressure
75
Marinol
dronabinol; cannabinoid with THC as active ingredient
76
5-HT type 3 rc antagonists
serotonin type 3 rc antagonists; most recent and most effective antinausea drugs When 5-HT type 3 rc are stimulated they send out vagus nerve signals that stimulate vomiting Used for chemo patients, anesthesia patients, and even pregnancy induced n/v
77
Zofran
ondansetron; 5-HT type 3 rc. antagonist for n/v
78
Anzemet
dolasetron; 5-HT type 3 rc. antagonist for n/v
79
emetics
given to conscious patients as soon as possible for poisoning treatment to prevent absorption
80
ipecac syrup
given as emetic for poisoning; not used much anymore b/c can be dangerously emetogenic
81
activated coal (charcoal)
used for poisoning (more popular now than ipecac syrup); binds to other drugs so they cannot be absorbed into blood stream
82
hemodialysis
used for poisoning by filtering out toxin that has been absorbed already
83
amphetamine-like 'uppers'
Rx weight loss drugs that suppress appetites and increase metabolism; but not used much anymore after Fen-Phen fiasco in 97 when it caused heart attacks *but phentermine is still used sometimes
84
Meridia
SNRI antidepressant; suppresses appetite | *was very dangerous and was PULLED FROM MARKET
85
lipase inhibitors
first and only non-stimulant weight loss drugs; causes greasy poop b/c fat is not broken and absorbed so it remains in feces
86
Xenical
orlistat; Rx lipase inhibitor to reduce caloric fat intake for weight loss
87
Alli
lower dose version of Xenical (orlistat); a lipase inhibitor for weight loss
88
glycerin suppositories
draws water into bowel for constipation
89
Benadryl
diphenhydramine; first gen antihistamine used as antiemetic from anticholinergic effect
90
medical marijuana
legal in some states to treat n/v and weight loss associated with cancer and AIDS
91
Cortenema
hydrocortisone; corticosteroid given by enema as potent anti-inflammatory in cases of severe Crohn's disease or Ulcerative colitis
92
congener
"___"-like drug

Pre-pharmacology (27 decks)

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