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Flashcards in GI drugs Deck (39)
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1
Q
A
2
Q

H2 blockers (4)

A

Cimetidine, Ranitidine, Famotidine, Nizatidine

3
Q

H2 blockers mechanism

A

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

4
Q

H2 blockers clinical use

A

peptic ulcer gastritis mild reflux

5
Q

Cimetidine toxicity

A

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

6
Q

Both Cimetidine and Ranitidine can...

A

decrease renal excretion of creatinine.

7
Q

Proton pump inhibitors (5)

A

Omeprazole Lansoprazole Esomeprazole Pantoprazole Dexlansoprazole

8
Q

PPI MOA

A

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

9
Q

Clinical Use of PPIs

A

-peptic ulcer -gastritis -reflux -ZE syndrome

10
Q

Toxicity of PPIs

A

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

11
Q

Bismuth and Sucralfate MOA

A

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

12
Q

Bismuth and Sucralfate Use

A

increases ulcer healing traveler's diarrhea

13
Q

Misoprostol mechanism

A

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

14
Q

Misoprostol use

A

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

15
Q

Toxciity of Misoprostol

A

diarrhea

16
Q

Misoprostol is contraindicated in...

A

women of childbearing potential because it is an abortifacient.

17
Q

Octreotide MOA

A

long-acting somatostatin analog

18
Q

Octreotide Use

A

-acute variceal bleeds -acromegaly -VIPoma -carcinoid tumors

19
Q

Toxicity of Octreotide

A

nausea cramps steatorrhea

20
Q

Antacid use can affect the...

A

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

21
Q

All antacids can cause...

A

hypokalemia.

22
Q

Antacids (3)

A

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

23
Q

Aluminum hydroxide overuse can cause...

A

constipation and hypophosphatemia, proximal muscle weakness, osteodystrophy and seizures

24
Q

Overuse of calcium carbonate can cause...

A

hypercalcemia and cause a rebound acid increase.

25
Q

Overuse of magnesium hydroxide can cause...

A

diarrhea, hyporeflexia, hypotension and cardiac arrest.

26
Q

Osmotic laxatives (4)

A

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

27
Q

Osmotic laxative MOA

A

provide osmotic load to draw water out

28
Q

Lactulose also helps treat hepatic encephalopathy since...

A

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

29
Q

Infliximab MOA

A

monoclonal antibody to TNF-alpha

30
Q

Infliximab clinical use

A

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

31
Q

Toxicity of Infliximab

A

-infection (including reactivation of latent TB)

32
Q

Sulfasalazine MOA

A

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

33
Q

Uses of Sulfasalazine

A

-UC -Crohn's

34
Q

Toxicity of Sulfasalazine

A

-sulfonamide toxicity -reversible oligospermia

35
Q

Ondansetron

A

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

36
Q

Metoclopramide MOA

A

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

37
Q

Use of Metoclopramide

A

-diabetic and post-operative gastroparesis -antiemetic

38
Q

Toxicity of Metoclopramide

A

-increased parkinsonian effects -interaction with digoxin and diabetic agents

39
Q

Metoclopramide is contraindicated in pts with...

A

small bowel obstruction or Parkinson disease.