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GI Flashcards

1
Q

Cimetidine
Ranitidine
Famotidine
Nizatidine

A

H2 blocker “tidine”
MOA: reversible block of Histamine H2 receptors
- decrease parietal cell stimulation –> decrease H+ secretion
- does not block ACh or gastrin stimulation of parietal cells
Use
- peptic ulcer
- gastritis
- esophageal reflux
Toxicity
- Cimetidine: Inhibits CYP450*
– anti-androgenic effects (prolactin release, gynecomastia, impotence, decrease libido)
– cross BBB (confusion, dizziness, headache)
– cross placenta
- Cimetidine + Ranitidine: decrease renal excretion of creatinine

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2
Q 
Omeprazole
Lansoprazole
Esomeprazole
Pantoprazole
Dexlansoprazole
A 
PPI "prazole"
MOA: irreversibly inhibit H+/K+ ATPase in stomach parietal cells 
- inhibit primary active transport
- blocks acid production from all stimuli of parietal cells
Use
- peptic ulcer
- gastritis
- esophageal reflux
- zollinger ellison syndrome
Toxicity
- increased risk C. diff
- pneumonia
- hip fracture
- deceased Mg2+
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3
Q

Bismuth

A

MOA: bind ulcer providing physical protection
- allow HCO3- secretion to reestablish pH gradient in mucous layer
Use:
- increase ulcer healing
- traveler’s diarrhea

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4
Q

Sucralfate

A

MOA: bind ulcer providing physical protection
- allow HCO3- secretion to reestablish pH gradient in mucous layer
Use:
- increase ulcer healing
- traveler’s diarrhea

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5
Q

Misoprostol

A 
MOA: PGE1 analog
- increase production and secretion of gastric mucous barrier
- decrease acid production 
Use
- PREVENT NSAID induced peptic ulcers 
- maintain patent ductus arteriosus 
- induce labor (ripens cervix)
Toxicity
- diarrhea
- contraindicated in women of childbearing potential (abortifacient)
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6
Q

Octreotide

A 
MOA: somatostatin analog
Use:
- acute variceal bleeds
- acromegaly
- VIPoma
- Carcinoid tumor
Toxicity:
- nausea
- cramps
 - steatorrhea
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7
Q

Aluminum hydroxide

A

Antacid

  • affect absorption, bioavailability or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying
  • hypokalemia
  • Overuse: constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures

aluMINIMUM amount of feces

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8
Q

Magnesium hydroxide

A

Antacid

  • affect absorption, bioavailability or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying
  • hypokalemia
  • Overuse: diarrhea, hyporeflexia, hypotension, cardiac arrest

Osmotic laxative

  • MOA: osmotic load to draw water out
  • Use: constipation
  • Toxicity: diarrhea, dehydration, bulimics use

Mg = must go to the bathroom

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9
Q

Calcium carbonate

A

Antacid

  • affect absorption, bioavailability or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying
  • hypokalemia
  • Overuse: hypercalcemia, rebound acid increase, can chelate and decrease effectiveness of other drugs
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10
Q

Polyethylene glycol

A

Osmotic laxative

  • MOA: osmotic load to draw water out
  • Use: constipation
  • Toxicity: diarrhea, dehydration, bulimics use
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11
Q

Lactulose

A

Osmotic laxative

  • MOA: osmotic load to draw water out
  • Use: constipation
    • hepatic encephalopathy (gut flora degrade it into metabolites of lactic acid and acetic acid which promote nitrogen excretion as NH4+)
  • Toxicity: diarrhea, dehydration, bulimics use
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12
Q

Infiliximab

A 
MOA: Monoclonal TNF-alpha antibody
Use: 
 - Crohn's disease
- ulcerative colitis
- rheumatoid arthritis
Toxicity
- infection (reactivation of Tb)
- fever
- hypotension
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13
Q

Sulfasalazine

A 
MOA: combo of sulfapyridine (antibacterial) and 5-aminosalicylic acid (Anti inflammatory)
- activated by colonic bacteria
Use
- ulcerative colitis
- crohn's disease
Toxicity
- malaise
- nausea
- sulfonamide toxicity
- reversible oligospermia
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14
Q

Ondansetron

A 
MOA: 5-HT3 antagonist
- central acting anti-emetic
Use:
- control vomiting post-op and in patients undergoing cancer chemo
Toxicity
- headache
constipation
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15
Q

Metoclopramide

A 
MOA: D2 receptor antagonist
- increased resting tone, contractility, LES tone, motility 
- no effect on colon transport time
Use: 
- diabetic and post surgery gastroparesis
- antiemetic
Toxicity
- increased parkinsonism effects
- restlessness
- drowsiness
- fatigue
- depression
- nausea
- diarrhea
- interacts with digoxin and diabetic agents
Contraindications
- patients with small bowel obstruction
- parkinson
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16
Q

Magnesium citrate

A

Osmotic laxative

  • MOA: osmotic load to draw water out
  • Use: constipation
  • Toxicity: diarrhea, dehydration, bulimics use
17
Q

Diphenoxylate

A

Anti-diarrhea

  • binds mu receptor slowing motility
  • combined with small doses of atropine to prevent morphine like euphoria
  • Toxicity: bloating, mild sedation

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