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Flashcards in GI drugs Deck (39):
1

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H2 blockers (4)

Cimetidine, Ranitidine, Famotidine, Nizatidine

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H2 blockers mechanism

reversible block of histamine H2 receptors leading to decreased H+ secretion by parietal cells

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H2 blockers clinical use

peptic ulcer gastritis mild reflux

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Cimetidine toxicity

-potent inhibitor of CYP450 -antiandrogenic effects (prolactin release, gynecomastia, impotence, decreased libido) -crosses BBB (confusion, HA) and placenta

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Both Cimetidine and Ranitidine can...

decrease renal excretion of creatinine.

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Proton pump inhibitors (5)

Omeprazole Lansoprazole Esomeprazole Pantoprazole Dexlansoprazole

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PPI MOA

irreversibly inhibit H+/K+ ATPase in stomach parietal cells

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Clinical Use of PPIs

-peptic ulcer -gastritis -reflux -ZE syndrome

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Toxicity of PPIs

-C. diff infxn -pneumonia -hip fractures -decreased magnesium

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Bismuth and Sucralfate MOA

bind to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in mucous layer

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Bismuth and Sucralfate Use

increases ulcer healing traveler's diarrhea

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Misoprostol mechanism

PGE1 analog that increases the production/secretion of gastric mucous barrier and decreases acid production

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Misoprostol use

prevention of NSAID-induced peptic ulcers maintenance of PDA induce labor

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Toxciity of Misoprostol

diarrhea

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Misoprostol is contraindicated in...

women of childbearing potential because it is an abortifacient.

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Octreotide MOA

long-acting somatostatin analog

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Octreotide Use

-acute variceal bleeds -acromegaly -VIPoma -carcinoid tumors

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Toxicity of Octreotide

nausea cramps steatorrhea

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Antacid use can affect the...

absorption, bioavailablity or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.

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All antacids can cause...

hypokalemia.

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Antacids (3)

1. Aluminum hydroxide 2. Calcium carbonate 3. Magnesium hydroxide

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Aluminum hydroxide overuse can cause...

constipation and hypophosphatemia, proximal muscle weakness, osteodystrophy and seizures

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Overuse of calcium carbonate can cause...

hypercalcemia and cause a rebound acid increase.

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Overuse of magnesium hydroxide can cause...

diarrhea, hyporeflexia, hypotension and cardiac arrest.

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Osmotic laxatives (4)

1. magnesium hydroxide 2. magnesium citrate 3. polyethylene glycol 4. lactulose

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Osmotic laxative MOA

provide osmotic load to draw water out

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Lactulose also helps treat hepatic encephalopathy since...

gut flora degrade it into metabolites (lactic acid and acetic acid) that promote nitrogen excretion as NH4+.

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Infliximab MOA

monoclonal antibody to TNF-alpha

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Infliximab clinical use

-Crohn's -UC -RA -ankylosing spondylitis -psoriasis

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Toxicity of Infliximab

-infection (including reactivation of latent TB)

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Sulfasalazine MOA

combo of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory) activated by colonic bacteria

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Uses of Sulfasalazine

-UC -Crohn's

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Toxicity of Sulfasalazine

-sulfonamide toxicity -reversible oligospermia

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Ondansetron

5-HT3 antagonist (decreases vagal stimulation) powerful central-acting antiemetic

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Metoclopramide MOA

D2 receptor antagonist (increases resting tone, contractility, LES tone and motility)

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Use of Metoclopramide

-diabetic and post-operative gastroparesis -antiemetic

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Toxicity of Metoclopramide

-increased parkinsonian effects -interaction with digoxin and diabetic agents

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Metoclopramide is contraindicated in pts with...

small bowel obstruction or Parkinson disease.