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Flashcards in GI drugs Deck (11):
1

Cimetidine, Ranitidine, famotidine, nizatidine

-Tidines
H2 blockers - reversible -> decreased H+ secretion from parietal cells

Use: Peptic ulcer, gastritis, mild GERD
Toxicity: Cimetidine - potent inhibitor of P450 , antiandrogenic effects (prolactin release, gyenecomastia, impotence, decreased libido males), cross BBB, placenta.

Both cimetidine and ranitidine decrease renal excretion of Cr.

2

Omeprazole, prazoles

Proton pump inhibitors

IRREVERSIBLE block of H/K ATPase in parietal cells
Use: Peptic ulcer, GERD, ZE syndrome, gastritis

Toxicity: increased risk of C. Difficile infection, pneumonia; long term: decreased serum Mg

3

Misoprostol

PGE1 analog, increase gastric mucosal barrer, decrease acid production

Use: prevent NSAID induced peptic ulcer (NSAIDs block PGE1 production), maintain PDA
induction of labor (off label)

CI in childbearing women ( abortificant)

4

Octreotide

Somatostatin analog; inhibit splanchnic vasodilatory hormone (D1?)

Use: acute variceal bleed, acromegaly, VIPoma, carcinoid tumor

Tox: N/V, steatorrhea

5

Antacid

Can cause hypokalemia
affect absoprtion, bioavailability or urinary excretion of other drugs by altering gastric pH or by delaying gastric emptying

6

Al Hydroxide, Ca Carbonate, Mg Hydroxide

Antacids
Al OH: constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures

Ca Carbonate: Hypercalcemia, rebound acid increase

Mg OH: Diarrhea, hyporeflexia, hypotension, cardiac arrest

7

Mg Hydroxide, Mg citrate, polyethylene glycol, lactulose

Osmotic diuretics
Use: osmotic load to draw water into GI lumen

Use: constipation
Lactulose - treats hepatic encephalopathy (gut flora converts to lactic acid and acetic acid that promote nitrogen excretion as NH4+)

8

Sulfasalazine

Sulfapyridine (antibacterial) and 5-aminosalicyclic acid (anti-inflammatory). Activated by colonic bacteria

Use: UC, Crohn disease (colitis component)

Tox: sulfonamide toxicity, reversible oligospermia

9

Ondansetron

5-HT3 antagonist, decrease VAGAL stimulation. CENTRAL acting anti-emetic
Use: control post operative vomiting, chemo patients

Tox: QT interval prolongation, HA, constipation

10

Metoclopromide

D2 receptor antagonist. increases resting tone, contractility, LES tone, motility. Does not alter colon transit time

Use: Diabetic and posoperative gastroparesis; antiemetic

Tox: increase parkinsonian efffects, tardive dyskinesia. Diarrhea
Drug interaction: Digoxin and diabetic agents

CI: small bowel obstruction or Parkinson (due to D1 receptor blocker)

11

Orlistat

Inhibit gastric and pancreatic lipase -> decrease dietary fat absorption and breakdown

Use: weight loss
Toxicity: steatorrhea, decreased absorption of fat soluble vitamins