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OSD Drugs > GI Drugs > Flashcards

GI Drugs Flashcards

(49 cards)

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1
Q

Calcium Carbonate

A

Antacid

⁃ High ANC
⁃ Rapid Onset / Long Acting
⁃ Releases CO2

⁃ AE:
⁃ Hypercalcemia
⁃ Nephrolithiasis
⁃ Milk-Alkali Syndrome

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2
Q

Sodium Bicarbonate

A

Antacid

⁃ High ANC
⁃ Rapid Onset/ Short Acting
⁃ Releases CO2

⁃ AE:
⁃ Systemic Alkalosis
⁃ Fluid Retention

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3
Q

Aluminum Hydroxide

A

Antacid

⁃ Low ANC
⁃ Slow onset/ Long acting
⁃ Binds Pepsin

⁃ AE:
⁃ Constipation
⁃ Hypophosphatemia
⁃ Decreases Bioavailability of other drugs due to binding

Note: Mix with Milk of Magnesia to balance the constipation AE.

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4
Q

Magnesium Hydroxide

A

Antacid

⁃ High ANC

⁃ Rapid Onset/ Long Acting

⁃ AE:
⁃ Diarrhea
⁃ Hypermagnesemia in Renal patients

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5
Q

Bismuth Subsalicylate

A

Cytoprotective

⁃ Cytoprotection mechanism unknown
⁃ Antisecretory
⁃ Anti-inflammatory
⁃ Antimicrobial

⁃ AE:
⁃ Black Stool
⁃ Neurological Injury via Bismuth absorption

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6
Q

Cimetidine

A

H2 Receptor Antagonist

RX:

  • PUD
  • GERD
  • ZE
  • Erosive Esophagitis

AE:

Gynacomastia

Impotence

Inhibits:

  • CYP1A2, 2C9, 2D6, 3A4
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7
Q

Ranitidine

A

H2 Antagonist

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8
Q

Famotidine

A

H2 Antagonist

No CYP interaction; Longest Half life; high bioavailability

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9
Q

Omeprazole

A

PPI

Rx:

  • GERD
  • Erosive Esophagitis
  • PUD (Hpylori, NSAIDS induced)
  • Dyspepsia
  • Prevention of Stress Ulcers in ICU (IV use)
  • ZE

MOA:

  • Inhibits HKATPase of PArietal Cell Irreversibly
  • Prodrug

AE:

  • Hepatic Liver Induction (Clopidogrel, Warfarin, Methotrexate, Tacrolimus)
  • CDIFF infection risk
  • Osteoporosis
  • Hypomagnesemia
  • B12 Deficiency
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10
Q

Esomeprazole

A

PPI

IV and PO

Less AE than Omeprazole

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11
Q

Lansoprazole

A

PPI

PO and IV

OTC

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12
Q

Misoprostol

A

Cytoprotective

Rx:

  • Prevent NSAID induced Ulcers
  • Available in combination with NSAIDS

MOA:

  • Increase Mucus and bicarb secretion from superficial epithelial cells
  • Decrease Acid secretion
  • Maintain Submucosal Flow

AE:

  • Diarrhea
  • Colic
  • CONTRAINDICATED in Pregnancy
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13
Q

Sucralfate

A

Cytoprotective

Rx:

  • Ulcer Healing
  • (Can be given with NSAIDS)

Note: Rarely used

MOA:

  • Forms Viscous gel in Acid
  • Binds to inflamed tissue
  • Protects ulcer from acid
  • Inhibits absorption of other drugs

AE:

  • Constipation
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14
Q

Bismuth Subsalicylate

A

Cytoprotective

MOA:

  • Unknown mechanism
  • Anti-secretory
  • Anti-inflammatory
  • Anti-microbial
  • Anti-diarrheal

AE:

  • Neurological Injury due to Bismuth absorption
  • Black Stool
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15
Q

Propantheline

A

Antimuscarinic

Quaternary Amine

Rx:

⁃ PUD
⁃ Hypermotility

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16
Q

Dicyclomine

A

Antimuscarinic

Tertiary Amine

Rx:

⁃ peptic disease
⁃ Hypermotility

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17
Q

Amitriptyline

A

Antidiarrheal

Anticholinergic/ Antispasmotic

Rx:

IBD

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18
Q

Glycopyrrolate

A

Quaternary Antimuscarinic

Rx:

Treat Ulcers

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19
Q

Hyoscyamine

A

Antimuscarinic

Rx:

Gastric Spasms

Ulcers

*Not used much anymore; used to be used to increase LES.

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20
Q

Cisapride

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A

Prokinetic

⁃ 5HT4 agonist
⁃ Was widely used in GERd to contract LES.
⁃ Available for Compassionate use only
⁃ can be found on internet though

⁃ AE:
⁃ Cardiac arrhythmia
⁃ Long QT

21
Q

Metoclopramide

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A

Prokinetic

MOA:⁃

-5HT4 agonist

⁃ 5HT3 antagonist (CNS and Vagus)

⁃ D2 antagonist
⁃ Enhances actions of ACh

RX:

GERD

Increase LES

Gastroparesis

Antiemetic in cancer Rx

AE:

⁃ Extrapyramidal effects from D2 antagonism.
⁃ Parkinson like- short term, reversible.
⁃ Long term use results in irreversible Tardive dyskinesia
⁃ Galactorrhea

Contra:

GI obstruction

Bleeding/ Perforation

22
Q

Erythromycin

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A

Prokinetic

⁃ Motilin like activity
⁃ Short term use for Gastroparesis Rx
⁃ Tolerance develops

23
Q

Domperidone

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A

Prokinetic

D2 receptor antagonist

Fewer CNS and CV side effects

Available through Investigator IND and in Canada

24
Q

Bethanechol

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A

Prokinetic

Muscarinic Agonist

Not hydrolyzed by acetylcholinesterase and therefore long half life

⁃ formerly used for GERD Rx
⁃ Widespread cholinergic AEs

25
Neostigmine
Prokinetic AChE inhibitor Stimulates nicotinic and muscarinic receptors No CNS effects Rx: ⁃ formerly used for GERD Rx ⁃ Widespread cholinergic AEs
26
Alosetron
**Antidiarrheal** MOA: ⁃ Selective 5HT3 Antagonist ⁃ Reduces lower abdominal pain and discomfort, cramps, urgency, diarrhea ⁃ **Use**: ⁃ Severe diarrhea dominant IBS in women who have not responded to other therapy. ⁃ **AE**: ⁃ Constipation ⁃ Can be severe ⁃ Ischemic colitis (can be fatal)
27
Loperamide
Antidiarrheal **Opioid** **MOA**: Acts on mu opioid receptor Slows down the GI for more H2O absorption. **Rx**: IBD Diarrhea
28
Bismuth Subsalicylate
Cytoprotective MOA: Unknown mechanism Anti-secretory Anti-inflammatory Anti-microbial Anti-diarrheal AE: Neurological Injury due to Bismuth absorption Black Stool
29
Psyllium
Laxatives Mild Stool softener Dietary Fiber
30
Magnesium Hydroxide
Laxative (and antacid) Intense MOA: Mg++ draws fluid into the intestine via osmosis Mg++ stimulates the release of CCK which results in increased water, electrolytes, and motility in the lumen. AE: Hypermagnesemia
31
Polyethylene Glycol
Laxative Intense Osmotic laxative Use: Bowel Prep before Surgery
32
Bisacodyl
Laxative Moderate Stimulates the CNS to increase NaCl and Fluid secretion; colonic stimulation mainly
33
Lubiprostone
Rx: Chronic constipation of unknown cause and IBS MOA: Acts on GI epithelial chloride channels to release Cl- and subsequently stimulate fluid secretion to soften the stool
34
Linaclotide
Prokinetic MOA: Guanylate cyclase agonist, increases cGMP Stimulates chloride and bicarb secretion via activation of Cystic fibrosis regulator channel. Increases GI transit time and reduces abdominal pain- 1x daily before 1st meal Rx: IBS with constipation or idiopathic constipation AE: Diarrhea with pain (Can be life threatening) GERD
35
Sodium Phosphate
Laxative Fast Rx: Not really used; used to be used for colonoscopy prep. AE: Phosphate nephropathy in renal patients
36
Tegaserod
Prokinetic MOA: ⁃ 5HT4 partial agonist ⁃ Approved for emergency use for severe constipation in IBS. ⁃ Available from FDA only for emergencies ⁃ AE: ⁃ Withdrawn from market ⁃ Serious Cardiac AEs
37
Sulfasalazine
IBD Drug (First Line Rx for UC) Inflammatory Mediator modulation via LOC pathway Prodrug converted to 5ASA MOA: Inhibits Nf-kappaB and inhibits formation of inflammatory cytokines Inhibits NK cells
38
Mesalamine
5-ASA (Active form of Sulfasalazine) Thus, sulfasalazine metabolite
39
Budesonide
Glucocorticoid Rectal suppository available if there is rectal or sigmoid disease Large 1st pass effect RX: IBD
40
Hydrocortisone
Rx: IBD
41
Adalimumab
IgG antibody Anti-TNF SubQ Rx: Crohn's Disease
42
Infliximab
IgG IV Crohn's disease
43
Azathioprine
Immunomodulator Prodrug of 6 Mercaptopurine Rx: IBD MOA: Purine analogue- inhibits nucleotide synthesis ⁃ Azathioprine and 6MP **⁃ Used to induce and maintain remission in UC and Crohn's.** ⁃ PO or IV daily for 6mos ⁃ AE: ⁃ Nausea ⁃ Vomiting ⁃ Bone Marrow depression ⁃ **Hepatotoxicity**
44
Methotrexate
⁃ Inhibition of dihydrofolate reductase ⁃ Low dose, once weekly for 8-12 weeks Rx: Crohn's disease MOA: Blocks purine synthesis ⁃ AE: ⁃ Uncommon at low doses ⁃ Bone marrow suppression ⁃ Anemia ⁃ Alopecia ⁃ Mucositis ⁃ Reno-hepatic toxicity potential Note: Do not use with PPI
45
Cholestyramine
Bile salt binder Lowers Cholesterol Used to prevent diarrhea in Cronh's disease AE: gallstone formation
46
N-Acetylcysteine
Acetaminophen antidote MOA: Binds to NAPQI via the donation of a sulfhydril group
47
Ursodiol
Reduces the rate of cholesterol absorption by the GI Breaks down Micelles containing cholesterol
48
Pancrelipase
synthetic mixture of pancreatic enzymes: Lipase Amylase Chymotrypsin
49
Cimetidine
H2 Receptor Antagonist RX: * PUD * GERD * ZE * Erosive Esophagitis AE: - Hepatic Enzyme Inhibition - Antiandrogenic - Gynecomastia (inhibits estradiol metabolism) - Caution in renal pts

OSD Drugs (4 decks)

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