Flashcards in GI drugs Deck (62)
What is the tx of choice for acute ulcers?
what type of therapy is needed to reduce the rate of recurrence for gastric ulcers?
What do all the antibiotic therapies for the tx of ulcers have in common?
They all contain a PPI
what medications are included in the bismuth quadruple therapy?
bisuth, metro, tetra, and PPI
what is included in the concomitant quadruple therapy?
clarith, metro, amox and ppi
what is included in the triple therapy?
clarith, metro or amox and ppi
which tx for ulcers shows the greatest eradication rates?
the bismuth and concomitant quadruple therapy, triple therapy is old news baby
What two proton pump drugs do we need to know?
omeprazole and lansoprazole
You have an elderly pt with who just recently had a stent placed due to an MI so they put them on clopidogrel but now they have the GERD. What drug would you not recommend ?
omeprazole because its actions on cyp450 might inhibit the conversion of clopidogrel to its active form.
Can you have rebound gastric acidity after stopping a PPI?
yes yes you can
Is anyone PPI more efficacious than the other?
no they are all created equal
Clinical uses for PPI are?
Gerd- most effective agent
Peptic ulcer disease- more rapid symptom relief and faster healing than H2 anatagonists
NSAID induced ulcers
Prevention of stress gastritis
Zollinger-ellison syndrome- higher dose provides complete symptomatic relief
H2 receptor anatagonists?
all of these are available OTC for acute gastritis
true or false: H2 blockers are better at suppressing nocturnal acid secretion than meal stimulated acid secretion?
True or false bothe PPis and H2 blockers are rapidly absorbed?
Clinical use of H2 blockers?
Gerd- if its infrequent
Peptic ulcer disease - but PPI is better
Stress-related gastritis- reduces bleeding when given IV
H2 blocker effects on CNS?
slurred speech, confusion more common with cimetidine
You have a pt taking ketaconazole (for something already forget possibly candida) and they have intermittent Gerd. should you use a PPI or H2 blocker?
neither they need to suck it up because all anitsecretory agents decrease ketaconazole absorption by causing an increase in gastric PH
out of all the H2 blockers which one has the most drug interactions?
What are the drug to drug interactions brought on by cimetidine?
it inhibits cytochrom p450 oxidative metabolism.
This can increase the effects of many drugs. some of which are warfarin, phenytoin, carbamazepine, ketoconazole
which agent is a mucosal protective agent?
How does sucralfate work?
it binds to necrotic ulcer tissue to form a protective barrier. Single dose can last 6 hours
Should you administer sucralfate with an antacid or h2 blocker?
no becasue it is activated at a acid of less than 4.
true or false sucralfate has systemic absorption?
Whats the most common adverse effect of sucralfate?
So for antisecretory drugs we have?
true or false: Misoprostol is a prostaglandin?
what is the pharmacodynamic affect of prostaglandins?
inhibits cAMP formation which results in decreased H+ secretion (most important clinical effect)
does misoprostol stimulate acid neutralizing HCO3 formation?
yes- but most important effect is decrease secretion of H+