GI drugs Flashcards

(107 cards)

1
Q

Hepatitis A Vaccine: Mechanism of Action

A

Gamma globulin

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2
Q

Immunoglobulin: Mechanism of Action

A

Passive immunity to Hep A, for travel to endemic areas

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3
Q

Hepatitis B Vaccine: Mechanism of Action

A

Recombinant Vaccine, active immunity

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4
Q

PEGylated Interferon: Sub

A

HepB AND HepC

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5
Q

Tenofovir, Entecavir, Lamivudine

A

HepB only

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6
Q

Tenofovir, Entecavir: Mechanism of Action

A

Competitively decreases DNA polymerase, replication

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7
Q

PEGylated Interferon: Indication(s)

A

For all types of hepatitis C

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8
Q

Ribavirin: Indication(s)

A

For Hepatitis C genotype 2/3

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9
Q

Ribavirin: Mechanism of Action

A

Synthetic nucleoside analog

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10
Q

Ribavirin: Adverse Effects

A

causes anemia

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11
Q

Boceprevir, teleprevir: Indication(s)

A

For Hep C genotype 1

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12
Q

Boceprevir, telaprivir: Mechanism of Action

A

Protease inhibitors

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13
Q

Diuretics: Sub AND Indication(s)

A

Ascites (Cirrhosis, PHTN)

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14
Q

Diuretics: Mechanism of Action

A

Aldosterone inhibitor (aldactone) + loop diuretic (furosemide)

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15
Q

Diuretics: Adverse Effects

A

Gynecomastia (switch to amiloride or triamterene)

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16
Q

Diuretics: If ascites is refractory

A

Large volume paracentesis (LVP) or transjugular intrahepatic portosystemic shunt (TIPS)

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17
Q

Conivaptan, Tolvaptan: Indication

A

for decreased Na+ in Cirrhosis, PHTN

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18
Q

Conivaptan: Mechanism of Action

A

Vasopressin antagonists

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19
Q

Conivaptan, Tolvaptan: Adverse Effects

A

Cerebral edema

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20
Q

Nadolol, Propanolol: Indication

A

Varices in Cirrhosis and PHTN

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21
Q

Nadolol, Propanolol: Mechanism of Action

A

Beta blockers decreases portal vein inflow

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22
Q

Lactulose: Indication(s)

A

Hepatic encephalopathy

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23
Q

Lactulose: Mechanism of Action

A

Draws out NH3

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24
Q

Rifaximin: Indication(s)

A

Hepatic encephalopathy AND IBS-D

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25
Rifaximin: Mechanism of Action
Antibiotic AND Antibiotic, decreases bloating
26
N-acetylcysteine: Indication(s)
Acetaminophen toxicity (ALF)
27
N-acetylcysteine: Mechanism of Action
Bind NAPQI (toxic metabolite of Tylenol)
28
N-acetylcysteine: Dosing / Timing
PO/IV
29
Prednisone: Indication(s)
1st line Autoimmune Hepatitis
30
Prednisone: Mechanism of Action
Immunosuppressants
31
Prednisone & Azathioprine: Adverse Effects
Cushing's, DM, cancer, etc. (70% have adverse effects)
32
Prednisone & Azathioprine: Notes
90% 10-yr survival; switch to monotherapy if severe adverse effects or for maintenance
33
Azathioprine: Sub
AIH first line AND 2nd line Remission Maintenance in Crohns
34
Azathioprine: Mechanism of Action
Immunosuppressants AND Prodrug of 6-MP
35
Cyclosporine: Class
Autoimmune Hepatitis AND UC/Crohn's
36
Cyclosporine: Sub
AIH AND Acute Flares in Crohns
37
Cyclosporine: Indication(s)
2nd line (AIH) AND 4th line acute (Crohns)
38
Cyclosporine, Tacrolimus, mycophenylate: Mechanism of Action
Immunosuppressants
39
Cyclosporine, Tacrolimus, Mycophenylate: Adverse Effects
Presumably even worse adverse effects than Aza, prednisone
40
Tacrolimus, Mycophenolate: Indication
AIH (2nd line)
41
Ursodeoxycholic Acid: Indication
PBC
42
Ursodeoxycholic Acid: Mechanism of Action
Chemically synthesized bile acid replacement, also increases production of endogenous bile acid
43
Ursodeoxycholic Acid: Notes
Cytoprotective for hepatocytes (inhibits apoptosis, stabilizes membrane)
44
Sodium Bicarbonate (Baking Soda) & Calcium Carbonate (Tums, Rolaids) & Aluminum Hydroxide + Magnesium Hydroxide (Mylanta, Maalox): Indication(s)
OTC for mild GERD and PUD
45
Sodium Bicarbonate (Baking Soda) & Calcium Carbonate (Tums, Rolaids) & Aluminum Hydroxide + Magnesium Hydroxide (Mylanta, Maalox): Mechanism of Action
Weak basic inorganic salts, neutralize H+
46
Sodium Bicarbonate (Baking Soda) & Calcium Carbonate (Tums, Rolaids) & Aluminum Hydroxide + Magnesium Hydroxide (Mylanta, Maalox): Dosing / Timing
PO PRN
47
Sodium Bicarbonate (Baking Soda) & Calcium Carbonate (Tums, Rolaids): Adverse Effects AND Notes
Combining Na and Ca can result in mild alkali syndrome
48
Aluminum Hydroxide + Magnesium Hydroxide (Mylanta, Maalox): Adverse Effects
Mg - diarrhea; Al - phosphate depletion, constipation
49
Aluminum Hydroxide + Magnesium Hydroxide (Mylanta, Maalox): Notes
Often comes with Ca+ to prevent osteoporosis
50
Cimetidine: Class
Peptic Ulcer Disease/GERD
51
Cimetidine, Rantidine, Famotide, Nizatidine: Indication(s)
OTC for mild to moderate GERD
52
Cimetidine, Rantidine, Famotide, Nizatidine: Mechanism of Action
Competitive inhibition of H2 receptors on parietal cells → decreases cAMP, HCl secretion
53
Cimetidine, Rantidine, Famotide, Nizatidine: Dosing / Timing
PO BID usually
54
Cimetidine, Rantidine, Famotide, Nizatidine: Adverse Effects
Headache, fatigue, confusion
55
Cimetidine, Rantidine, Famotide, Nizatidine: Notes
Not as strong as PPIs, more effective vs. basal / nocturnal gastric acid
56
Omeprazole (Prilosec), Lansoprazole, Pantoprazole, Rabeprazole, Esoprazole, Dexlansoprasol: Indication(s)
Moderate to severe GERD, healing PUD, acute bleeding ulcers, gastrinoma
57
Omeprazole (Prilosec), Lansoprazole, Pantoprazole, Rabeprazole, Esoprazole, Dexlansoprasol: Mechanism of Action
PPI: Prodrugs cross membrane at neutral pH, become protonated in acidic parietal cell, inactivates H/K ATPase irreversibly
58
Omeprazole (Prilosec) Lansoprazole, Pantoprazole, Rabeprazole, Esoprazole, Dexlansoprasol: Dosing / Timing
PO / IV (5% of US on one)
59
Omeprazole (Prilosec), Lansoprazole, Pantoprazole, Rabeprazole, Esoprazole, Dexlansoprasol: Adverse Effects
Diarrhea, B12/Fe absorption deficiency, atypical fractures, c. diff, rebound hyper-secretion, dependence
60
Omeprazole (Prilosec), Lansoprazole, Pantoprazole, Rabeprazole, Esoprazole, Dexlansoprasol: Notes
Gets concentrated 1000x in parietal cell canaliculi, 70% of hospital patients on a PPI
61
Sucralfate: Indication(s)
PUD/GERD
62
Sucralfate: Mechanism of Action
PO: Coats mucosal surface with viscous paste
63
Bismuth Subsalicylate (Pepto-Bismol): Class
Peptic Ulcer Disease/GERD AND Diarrhea
64
Bismuth Subsalicylate (Pepto-Bismol): Mechanism of Action
Coats ulcers and erosions, anti-h.pylori AND Antisecretory, antimicrobial, anti-inflammatory
65
Bismuth Subsalicylate (Pepto-Bismol): Adverse Effects
Turns your tongue / stool black AND Tongue / stool turns black, neurotoxicity at high doses, Reye's in theory
66
Lansoprazole / Amoxicillin / Clarithromycin: Class
Peptic Ulcer Disease/GERD
67
Lansoprazole / Amoxicillin / Clarithromycin: Mechanism of Action
PO: Most common PPI triple regimen (PPI + 2 Abx combo)
68
Lansoprazole / Amoxicillin / Clarithromycin: Adverse Effects
Resistance to clarithromycin or metronidazole possible
69
Lansoprazole / Amoxicillin / Clarithromycin: Notes
Eradication in 75%
70
Mesalamine (Asacol, Lialda, etc.): Sub
UC/Crohns: Acute Flares AND Remission Maintenance
71
Mesalamine (Asacol, Lialda, etc.): Indication(s)
1st line acute AND 1st line maint
72
Mesalamine (Asacol, Lialda, etc.): Mechanism of Action
~Aspirin, anti-oxidant
73
Mesalamine (Asacol, Lialda, etc.): Dosing / Timing
PO or PR AND PO
74
Sulfasalazine: Sub
UC/Crohn's Acute Flares, 1st line acute
75
Sulfasalazine: Mechanism of Action
Prodrug of 5-ASA
76
Steroids (Prednisone): Sub
UC/Crohns, 2nd line, Acute Flares
77
Steroids (Prednisone): Dosing / Timing
PO or IV
78
Steroids (Prednisone): Notes
Rapid action; budesonide for local
79
Infliximab: Class
UC/Crohn's
80
Infliximab: Sub
UC/Crohns: 3rd line Acute Flares AND Remission Maintenance
81
Infliximab: Mechanism of Action
Anti-TNFalpha, rapid action
82
Infliximab: Adverse Effects
Re-activates latent TB
83
Cyclosporine: Notes
Rapid action, fourth line acute
84
J pouch anastomosis
UC/Crohn's: acute flares, last resort
85
6-Mercaptopurine: Class
UC/Crohn's
86
6-Mercaptopurine: Sub
UC/Crohns, 2nd Line Remission Maintenance
87
6-Mercaptopurine: Dosing / Timing
Takes 2-4 months
88
6-Mercaptopurine: Adverse Effects
decreases BM, pancreatitis
89
Methotrexate: Class
UC/Crohn's remission maintenance, not used in US
90
Loperamide: Indication(s)
Non-Inflammatory Diarrhea AND IBS-D
91
Loperamide: Mechanism of Action
Opioid receptor agonist selectively affects myenteric plexus, causes constipation" AND decreases Diarrhea"
92
Loperamide, Diphenyloxylate: Adverse Effects
Constipation, bloating, nausea, megacolon if you misdiagnose infectious
93
Loperamide: Notes
Doesn't cross BBB; contraindicated in c. diff or any inflammatory diarrhea (bloody, fever) AND Less effective in IBS-D
94
Diphenoxylate + Atropine : Indication(s)
Non-Inflammatory Diarrhea
95
Diphenoxylate + Atropine : Mechanism of Action
Opioid receptor agonist that does cross BBB (atropine prevents abuse)
96
Diphenoxylate + Atropine : Adverse Effects
Same as loperamide + possibility of dependence
97
Alosetron: Indication(s)
IBS-D
98
Alosetron: Mechanism of Action
5HT3R antagonist; decreases gut motility, diarrhea, hypersensitivity
99
Alosetron: Notes
Best evidence
100
Rifaximin: Indication and Mechanism
Relatively safe, IBS-D, antibiotic plus decreased bloating
101
TCAs: Mechanism of Action and Indication
decreases Pain in IBS-D, anticholinergic
102
Lubiprostone: Mechanism of Action and Indication
IBS-C: Cl- channel (ClC-2) activator
103
Linaclotide: Mechanism of Action and Indication
IBS-C: GC-2 agonist increases cGMP, CFTR, Cl- secretion
104
SSRIs: Mechanism of Action and Indication
IBS-C: decreases Pain
105
Metronidizole, Vancomycin Indication
C. diff. Discontinue other antibiotics and give for two weeks
106
Metronidizole notes
best response, lowest relapse rate
107
Vancomycin notes
IV won't work. Six weeks oral vanc could prevent relapse