GI Drugs Flashcards
(21 cards)
What are the 4 defenses of peptic ulcer disease (PUD)?
Mucous secretion, bicarbonate, good blood flow, prostaglandin
How does mucous secretion defend against PUD?
Barrier to protect from acid and pepsin
How does bicarbonate protect against PUD?
Neutralize H+, trap in mucus
How does good blood flow protect from PUD?
Increase mucosal integrity, decrease blood flow =local ischemia-> cell injury->acid and pepsin attack
How does prostaglandin protect from PUD?
Increase mucous secretion, bicarbonate, good blood flow (vasodilation), (not answer just fact about it : pro inflammatory)
Where are the five aggressor of PUD?
H. pylori, nonsteroidal, anti-inflammatory, gastric acid, pepsin, smoking
Why is H. Pylori a aggressor of PUD?
It’s a bacteria that causes PUD, carcinogen (gastric cancer), resistance to stomach acid, errode gut wall
How is nonsteroidal anti-inflammatory and aggressor of PUD?
Inhibit biosynthesis of prostaglandin
How is pepsin an aggressor , of PUD??
Natural enzyme that break down proteins, pH dependent, increase with acid inactivates, when pH is greater than five
How is smoking aggressor of PUD?
Sphincter tone weaken -> esophageal, acid, reflux, delay, healing, lower efficiency of drug, lower secretion of by carbonate, increase, gastric, emptying meaning there is more acid that moves to the duodenum
How do you prevent PUD?
Avoid NSAID, corticosteroid(prednisone & dexatextmethasone), etho, diet of six small meals and avoid acid and space, decrease stress
What are the three things that you need to do for an antibiotic regimen for PUD?
Do you have to use 2 to 3 antibiotics this is to decrease resistance, decreased stomach acid with antisecretory agent, use antibiotic long enough to kill H pylori
Where are the three main antibiotics to treat H. pylori?
Amoxicillin (Amoxil)
Bismuth( Pepto-Bismol)
Metronidazole ( flagyl)
How does amoxicillin (Amoxil) kill H. pylori? Best condition? Side effects?
bind to bacterial cell wall and cause cell death, is best with neutral pH, most affective, if gastric acid is lower, side effect: rash, diarrhea
How does bismuth (Pepto-Bismol) kill H. pylori? Side effect?
Acts topically lysis cell equals death, SE: black tongue, black stool
What type of H. Pylori does metronidazole ( Flagyl) kill? Why would you avoid? side effect?
Affective against sensitive strain, avoid with pregnancy, avoid alcohol because disulfiram like rxn, side effect: nausea, headache
What does a histamine H2 receptor antagonist do? Uses? What should you avoid with use? ADR
Inhibit gastric acid secretion, uses: H. pylori, decrease pain, symptoms, and prevent complication PUD, NSAID, ulcer, prophylaxis, decreased heartburn, GERD, gastroesophageal, reflux, disease, Zollinger Ellison syndrome. Avoid anti-acid one hour before meds. ADR: pleading DYSCRASIAS abnormality
Where are the three drug of histamine H2 receptor antagonist?
Cimetidine ( Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)
Where are H1 receptor for?
Allergy symptom
What are H2 receptor for?
Increase gastric acid secretion
Cimetidine (Tagamet)
Action
Pharmacokinetics (route, food eff, BBB)
ADR
Drug interaction
Action: decrease gastric acid secretion
Pharmacokinetics: (route-oral solution or tablet,food= Decrease, absorption, equal, prolong effect, cross BBB)
ADR:
Antiandrogenic eff(gynecimastia, lower libido,impotence, reversible)
CNS eff(older adult with renal and hepatic problem, confusion, hallucination, CNS depression/excitation
Pneumonia(decrease gastric activity leads to increase bacterial colony in stomach, second to increase colony in lung)
Drug interaction
Inhibit, hepatic, drug metabolism
Anti-acid decrease absorption of cimetidine take one hour
