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drugs gi Flashcards

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1
Q

buspirone

A

5HT1A receptor agonist - inhibits 5HT release and increases NO release
improves fundic and pyloric accomodation

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2
Q

metroclopramide (reglan)

A

5 HT4 agonist & dopamine antagonist
improves gastric emptying and is antiemetic

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3
Q

dicyclomine & hyoscyamine

A

anticholinergics that slow gastric empyting

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4
Q

octretoide

A

somatostatin analog that inhibits 5HT & motilin release

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5
Q

lubriprostone

A

laxactive (for constipation) that activates Cl- channelf or increased Cl- secretion & water follows

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6
Q

tagaserod

A

relieves constipation as 5HT4 partial agonist

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7
Q

ondanstron (zofran)

A

antiemetic - 5HT3 antagonist

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8
Q

dronabinol

A

antiemetic that has effects of pot

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9
Q

5PDE antagonist

A

reduce strength of esophageal contractions

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10
Q

cimetidine

A

competitive antagonist of H2 receptor
rapidly absorbed and quick onset of action
hepatic metab by p450
renal excretion
continuous dosing - keeps gastic pH > 4 –> inactivates pepsin

used for PUD
*most important one to know - GERD!!

potently binds p450 sytem –> can cause significant drug interactions (warfarin, phenytoin, thephylline and diazepam –> levels are increased)

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11
Q

ranitidine

A

competitive antagonist of H2 receptor
rapidly absorbed and quick onset of action
hepatic metab by p450
renal excretion
continuous dosing - keeps gastic pH > 4 –> inactivates pepsin
**Most important for GERD
used for PUD

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12
Q

nizatidine

A

competitive antagonist of H2 receptor
rapidly absorbed and quick onset of action
hepatic metab by p450
renal excretion
continuous dosing - keeps gastic pH > 4 –> inactivates pepsin

used for PUD

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13
Q

famotidine

A

competitive antagonist of H2 receptor
rapidly absorbed and quick onset of action
hepatic metab by p450
renal excretion
continuous dosing - keeps gastic pH > 4 –> inactivates pepsin

used for PUD

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14
Q

omeprazole, lansoprazole, rebprazole, pantoprazole, esomeprazole

A

PPIs –> irrrevesibly block the H+/K+/ ATPase final common pathway –> reduces secretion by parietal cells into the lumen
intentionally delivered as prodrugs
when delivered to parietal cell –> protonated, concentrated and sulphonated

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15
Q

tums & oscal

A

calcium carbonate that neutralize stomach acid
may cause rebound acid secretion, nephrocalcinosis or milk alkali syndrome

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16
Q

regimes used to get rid of H. pylori

A

clarithromycin, amoxicillin & PPI
clarithromycin, metronidazole, PPI
levofloxin, metronidazole and PPI

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17
Q

misoprostol

A

PGE2 anaology – prevention of GUI in pt taking NSAIDs
use limited by bloating.diarrhea
abortifacient

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18
Q

sucralfate

A

complex salt of sucrose sulfate and ALOH3–> binds to mucosa and acts within lumen
stimulates mucus and bicarb and PGE2 production
binds to areas of health mucosa and ulceration
has no effect on acid production and is NOT absorbed

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19
Q

metoclopramide & domperidone (w/drawn b/c SE)

A

dopamine antagonist used as prokinetics for gastroparesis
D2 antagonist
also antiemetic

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20
Q

erythromycin

A

motilin agoinst used for gastroparesis
interacts with CYP-3A inhibitors

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21
Q

5-aminoasalicylates

A

tx of UC
inhibit T cell proliferation, Ag presentation & adhesion & descrease TNF production
SE: diarrhead, interstitial nephritis

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22
Q

busedonide

A

non systemic glucocorticoid - ileal release - used for CD
inhibit pro-inflammatory cytokines, adhesion molecules, leuktrienes
inhibit protease
regulated NF-kapa beta
decreased phagocytosis for neutrophiles
apoptosis of lympoctes

high degree of first pass metab in liver –> lessened systemic efects
induces remission in CD

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23
Q

thiopurines - AZA & 6-MP (AZA must be converted to 6MP)

A

inhibits DNA synthesis, induction of apoptosis & inhibition of purine synthesis - immunomodulator used for CD–> Induction & maintenance of remission
must monitor if someone has TPMT mutation –> bone marrow suppresion
take months to begin to work

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24
Q

methotrexate

A

folate antagonist, inhibits interleukins
induction and maintenance of remission in CD (being evaluated for UC)

increases risk for pneumonitis - if SOB/cough –> STOP DRUG

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25
anti-TNF therapy
inflizimab, adalimumab, certolizumab bind solube and cell bound TNF-alpha --> induce T cell/lymphocyte apoptosis an ddecrease IL-1,6,18 and INF gamma all three for CD, certolizumab not for UC
26
natalizumab
anti-alpha 4 integrin inhibitor --> used in CD blocks integrins and thus adhesion of leukocytes increases risk for PML via reactivation of JC virus
27
tenofovir
tx hep B - polymerase inhibitor
28
entecavir
tx hep B - polymerase inhibitor
29
interferon
hep C tx immune activation: enhances MHC I, amplification of Tc lymphocytes and NK cells, enhances macrophage activity direct antiviral: inhibition of HCV attachment and uncoating, activation of cellular RNAses SE: influenza-like, depression, suicide, pancytopenia, worsening of liver fx in cirrhosis (b.c systemic inflammation)
30
ribavirin
hep C tx & hep E tx guanosine analogue inhibits ciral RNA-dep RNA polymerase, induction of lethal mutations in HCV RNA, GTP depletion, modulatino ot T cell response favoring tH1 increases rate of SVR when combined with interferon SE: non=immune hemolytic anemia, teratogenic
31
telaprevir
hep C tx - direct antiviral agent protease inhibitor SE: anemia, rash, dysgeusia, anorectal discomfort drug-drug interactions with ARVs in HIV pts and calcineurin inhibitors in transplant pts dose 3x daily
32
boceprevir
hep C tx - direct antiviral agent protease inhibitor SE: anemia, rash, dysgeusia, anorectal discomfort drug-drug interactions with ARVs in HIV pts and calcineurin inhibitors in transplant pts dose 3x daily
33
ursodiol
treatment of primary biliary cirrhosis
34
N-acetylcysteine
tx of acetaminophen toxicity - acute liver failure replenishes glutathione stores increases metab of NAPQI
35
carbamazepine
augments autophagy for alpha antitrypsin deficiency --> gets rid of misfolded proteins in liver that cause cholestasis in clinical trials now in adults
36
trientene
oral chelating agents of cu for wilson's dz
37
zinc
used in wilson dz --> induces metallothionein and blocks cu absorption
38
stack of coin sign
scleroderma - small bowel
39
cholestyramine
resin that bidns bile salts in intenstine to help with pruritis
40
ursodeoxycholic acid
used for therapy in cholestasis prolongs life in PBC may protect against hydrophobic bile salts also used in PSC
41
rosiglatizone
insulin sensitizing agent that can be used for NAFLD
42
spironolactone
use to tx ascites- mineralocoritcoid - potassium sparing
43
furosemide
used to tx ascites due to portal htn
44
norfloxacin or ciprofloxacin
used prophylactically after first episode of spontaneous bacterial peritonitis to prevent recurrence
45
propanolol
non selective beta blockers to prevent variceal bleeding gives 50% reduction in risk for first variceal bleed works to constrict splanchnics
46
nadolol
non selective beta blockers to prevent variceal bleeding gives 50% reduction in risk for first variceal bleed works to constrict splanchnics
47
octreotide
given IV as splanchnic vasoconstrictor for variceal bleeding
48
tx for variceal bleeding
octreotid, antibx, band ligation, TIPS (refractory)
49
neomycin, metronidazole, rifaximin
tx of hepaic encephalopathy eliminates colonic bacteria leading to decreased ammonia generation
50
lactulose
non absorbed disaccharide --> acts as cathartic, decreasing bacterial load hepatic encephalopathy
51
sorafenib
mutlikinase inhibitor (Raf, VEGFR2, PDFGR) - targets VEGF so used against HCC used for pts not candidates for other tx increases life by 2.8 montsh (to 10.7 months)
52
steroids & pentoxifylline
tx of severe alcohol hepatitis
53
sofosbuvir
to be approved RNA dep RnA polymerase inhibitor for Hep C
54
simeprevir
to be approved protease inhibitor for Hept c
55
lamivudine
polymerase inhibitors for hep B no longer used --> induces YMDD mutation
56
telvibudine
polymerase inhibitors for hep B
57
adefovir
polymerase inhibitors for hep B
58
anthraquinones
mucosal afferent nerve fiber irritants - for constipation
59
diphenylmethanes
mucosal afferent nerve fiber irritants - for constipation
60
lubiprostone
increases intestinal fludi secretion and transit by activating chlorid channel for constipation
61
tegaserod
5HT4 partial agonist for constipation - restricted b/c cardiac issues
62
metronidazole
used to tx c dif
63
gangiclovir, foscarnet
tx CMV colitis diagnoses with rapid antigen, PCR or blood culture multinucleated giant cells & viral inclusions
64
meclizine
motion sickness (h1)
65
diphenhydramine
motion sickness (h1)
66
odansetron
chemotherapy (5ht3)
67
metoclopramide
moderate (d3)
68
prochlorperazine
severe nausea (d2)
69
promethazine
severe nausea (d2)
70
scopolamine
motion sickness (m1)
71
dorabinol
refractory nausea (cr)
72
lamivudine, telcibudine, entecavir, adefovir, tenofovir
viral polymerase inhibitor for hep B

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