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Flashcards in GI drugs Deck (21)
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1
Q

H2 blockers: Ranitidine, Cimetidine, Famotidine, Nizatidinen

A

Sketchy: Tie-dye kids = “-tidine” MOA: Reversible block of H2 receptors, which usually upregulate the H+/K+ ATPase of the apical membrane EFFECTS: Decrease of H+ secretion by parietal cells USES: Peptic ulcers Gastritis GERD (but PPIs are first line) ADVERSE EFFECTS: Increased prolactin Gynecomastia Impotence Inhibitor of CYP450

2
Q

PPIs: Omeprazole, Lansoprazole, Rabeprazole

A

Sketchy: “-azoles” = prizes MOA: Irreversible inhibits H+/K+ ATPase EFFECTS: Blocks acid production in response to all 3 stimuli: histamine, gastrin, and vagal stimulation USES: Peptic ulcers Gastritis GERD Zollinger-Ellison syndrome H. Pylori ADVERSE EFFECTS: C. Diff Pneumonia Decreases Mg2+ (require acidic environment for absorption)

3
Q

Aluminum hydroxide

A

Sketchy: None MOA: Antacid ADVERSE EFFECTS: Hypokalemia Constipation (alu-minimum amount of feces) hypophosphatemia Muscle weakness Osteodystrophy Seizure

4
Q

Calcium carbonate

A

Sketchy: None MOA: Antacid ADVERSE EFFECTS: Hypokalemia Hypercalcemia (milk-alkali syndrome) Increased rebound acid

5
Q

Magnesium hydroxide

A

Sketchy: None MOA: Antacid ADVERSE EFFECTS: Hypokalemia Diarrhea (Mg2+ must go to the bathroom) Hyporeflexia Hypotension Cardiac arrest

6
Q

Bismuth

A

Sketchy: None MOA: Binds to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucus layer USES: Increased ulcer healing Traveler’s diarrhea

7
Q

Misoprostol

A

Sketchy: None MOA: PGE analog EFFECTS: Increases production and secretion of gastric mucus barrier Decreases gastric acid production USES: - Prevention of NSAID-induced ulcers (NSAIDs block PGE production) - Maintenance of a patent ductus arteriosus - Induction of labor (ripens the cervix) ADVERSE EFFECTS: Diarrhea Contraindicated in women of child-bearing potential (abortifacient)

8
Q

Octreotide

A

Sketchy: stop sign MOA: Somatostatin analog EFFECTS: Inhibits the secretion of various hormones (e.g. inhibits histamine production from ECLs and gastrin production from G-cells) USES: Acute variceal bleeds Acromegaly VIPoma Carcinoid tumor Gastrinomas ADVERSE EFFECTS: Nausea, cramps, steatorrhea, increased risk of cholelithiasis due to CCK inhibition

9
Q

Magnesium hydroxide

A

Sketchy: magnesium bubble bath MOA: Osmotic laxative EFFECTS: Non-absorbable substance that draws water into the lumen USES: Constipation ADVERSE EFFECTS: Diarrhea Dehydration

10
Q

Polyethylene glycol (PEG)

A

Sketchy: PEG plug in floor drain MOA: Osmotic laxative EFFECTS: Non-absorbable substance that draws water into the lumen USES: Constipation ADVERSE EFFECTS: Diarrhea Dehydration

11
Q

Lactulose

A

Sketchy: Relaxulose soap being poured into the bath MOA: Osmotic laxative EFFECTS: Non-absorbable substance that draws water into the lumen USES: Constipation *Hepatic encephalopathy (gut flora degrade lactulose into acidic metabolites, which can convert toxic NH3 into NH4+ to be trapped in the lumen and excreted - prevent ammonia toxicity in the brain) ADVERSE EFFECTS: Diarrhea Dehydration

12
Q

Psyllium

A

Sketchy: bulky seaweed MOA: Bulk-forming laxative EFFECTS: Is an indigestible hydrophilic colloid; will absorb water, leading to distension and and peristalsis (pushing out everything in the bowel) USES: Constipation ADVERSE EFFECTS: Increased bloating and flatulence

13
Q

Docusate

A

Sketchy: docked boat MOA: Stool softener EFFECTS: Surfactant agent that facilitates the penetration of stool by water and lipids USES: Constipation

14
Q

Senna

A

Sketchy: Stimulating senna suntan lotion MOA: Stimulant laxative EFFECTS: Directly stimulates the enteric nervous system USES: Constipation

15
Q

Sulfasalazine

A

Sketchy: None MOA: Combination of sulfapyridine (antibacterial) and 5-ASA (anti-inflammatory); activated by colonic bacteria USES: Ulcerative colitis; Crohn disease ADVERSE EFFECTS: Malaise Nausea Sulfonamide toxicity Reversible oligospermia

16
Q

Loperamide

A

Sketchy: lop-earred rabbit MOA: Mu-opioid agonist with minimal CNS effects EFFECTS: Increases colonic phasic segmenting activity (increases colonic transmit time, thus increasing water reabsorption) USES: Diarrhea ADVERSE EFFECTS: Constipation Nausea

17
Q

Diphenoxylate

A

Sketchy: 2 dolphins fountain MOA: Mu-opioid agonist with some CNS effects EFFECTS: Increases colonic phasic segmenting activity (increases colonic transmit time, thus increasing water reabsorption) USES: Diarrhea ADVERSE EFFECTS: Constipation Nausea Treat with atropine to prevent abuse

18
Q

Ondansetron

A

Sketchy: dancer MOA: 5-HT3 antagonist EFFECTS: Decreases vagal stimulation to the medullary vomiting center produced by serotonin USES: Nausea and vomiting (postoperatively and chemo) ADVERSE EFFECTS: HA Constipation Prolonged QT interval (torsades)

19
Q

Metoclopramide

A

Sketchy: Tickler blocking the D2 rings MOA: D2 receptor antagonist EFFECTS: Upper GI prokinetic effect: Increases resting tone, contractility, LES tone, motility USES: Antiemetic Delayed gastric emptying ADVERSE EFFECTS: Diarrhea Drowsiness Depression Extra-pyramidal effects (dystonia, akathisia, parkinson’s features) Tardive dyskinesia Contraindicated in small bowel obstruction and Parkinons

20
Q

Orlistat

A

Sketchy: None MOA: Inhibits gastric and pancreatic lipase EFFECTS: Decreased breakdown and absorption of dietary fats USES: Weight loss ADVERSE EFFECTS: Steatorrhea Decreased absorption of fat soluble vitamins

21
Q

Ursodiol (ursodeoxycholic acid)

A

Sketchy: None MOA: Nontoxic bile acid EFFECTS: Increased bile secretion; decreased cholesterol secretion and reabsorption USES: Primary biliary cirrhosis Gallstone prevention or dissolution