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Phar 141 > GI drugs incomplete > Flashcards

GI drugs incomplete Flashcards

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1
Q

Antacids

A

NaHCO3
CaCO3
Al(OH)3
Mg(OH)2

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2
Q

MOA of antacids

A

• reduce the concentration & total load of
acid in the gastric contents
• inhibit pepsin activity
• strengthen the mucosal barrier

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3
Q

AE of Al(OH)3

A

constipation

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4
Q

AE of Mg(OH)2

A

diarrhea

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5
Q

with an AE of milk-alkali syndrome and rebound acid secretion

A

CaCO3

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6
Q

with AE of gastric distention & belching

A

NaHCO3

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7
Q

proper dosing of antacids

A

1 hr before & 3 hrs after

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8
Q

H2-RECEPTOR ANTAGONISTS

A
  • Famotidine (Pepsid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)
  • Cimetidine (Tagamet)
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9
Q

competitively inhibits the action of histamine at parietal cell receptors sites, reducing the volume & H+ concentration of gastric acid secretions

A

H2-RECEPTOR ANTAGONISTS

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10
Q

AEs of Cimetidine

A

mental status changes
gynecomastia or impotence in men
galactorrhea in women

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11
Q

salt of sucrose

complexed to sulfated Al(OH)3

A

Sucralfate

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12
Q

MOA of sucralfate

A

negatively charged sucrose sulfate binds to positively charged proteins in the base of ulcers or erosion, forming a physical barrier that restricts further caustic damage & stimulates mucosal PG (PGE1) & HCO3-secretion

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13
Q

drugs for prevention of stress-related bleeding

A

H2-RECEPTOR ANTAGONISTS

MUCOSAL PROTECTIVE AGENT

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14
Q

AE of MUCOSAL PROTECTIVE AGENT

A

constipation

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15
Q
  • decrease basal & stimulated gastric acid & pepsin secretion
  • delay gastric emptying (with antacids)
A

GI ANTICHOLINERGICS

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16
Q

adjunctive agents for relief of refractory duodenal ulcer pain

A

GI ANTICHOLINERGICS

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17
Q

CIs on the use of GI ANTICHOLINERGICS

A
  • gastric ulcer
  • narrow-angle glaucoma
  • urinary retention
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18
Q

AEs of GI ANTICHOLINERGICS

A

dry mouth, blurred vision, tachycardia, urinary retention, constipation (ALICE IN WONDERLAND)

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19
Q

binds to a PG receptor on parietal cells, reducing histamine-stimulated cAMP production & causing modest acid inhibition

A

PROSTAGLANDIN ANALOG

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20
Q

prevention of NSAID-induced ulcers in high-risk patients

A

Misoprostol (PGE1 analog)

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21
Q

AEs of PROSTAGLANDIN ANALOG

A
  • diarrhea

* cramping abdominal pain

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22
Q

CIs on use of Misoprostol

A

pregnancy or in women of childbearing potential

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23
Q

PROTON PUMP INHIBITORS

A
  • Omeprazole (Prilosec)
  • Lansoprazole (Prevacid)
  • Rabeprazole (Aciphex)
  • Pantoprazole (Protonace)
  • Esomeprazole (Nexium)
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24
Q

MOA of PPIs

A

bind to the H+/K+-ATPase enzyme system (proton pump) suppressing secretion of gastric acid

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25
Clinical uses of PPIs
``` • GERD • PUD - H. pylori-associated ulcers - NSAID-associated ulcers - prevention of rebleeding from peptic ulcers • nonulcer dyspepsia • gastrinoma & other hypersecretory conditions ```
26
AEs OF PPIs
* subnormal vitamin B12 levels (prolonged therapy) * respiratory & enteric infections * hypergastrinemia
27
COLLOIDAL BISMUTH | COMPOUNDS
* Bismuth subsalicylate * Bismuth subcitrate * Bismuth dinitrate
28
clinical uses of COLLOIDAL BISMUTH COMPOUNDS
* nonspecific treatment of dyspepsia & acute diarrhea * prevention of traveler's diarrhea * eradication of H. pylori infection
29
AEs of COLLOIDAL BISMUTH COMPOUNDS
* blackening of the stool * darkening of the tongue * salicylate toxicity (high doses of bismuth subsalicylate)
30
drugs for GERD
``` antacids alginic acid h2 receptor antagonists prokinetic agents PPIs ```
31
reacts with NaHCO3 & saliva to form a viscous solution of sodium alginate
ALGINIC ACID
32
MOA of PROKINETIC AGENTS
* dopamine D2 receptor antagonists * increase esophageal peristaltic amplitude * increase LES pressure * enhance gastric emptying
33
AEs of PROKINETIC AGENTS
* extrapyramidal effects * tardive dyskinesia * galactorrhea, gynecomastia, impotence, menstrual disorders
34
indigestible, hydrophilic colloids that absorb water, forming a bulky, emollient gel that distends the colon & promotes peristalsis
BULK-FORMING LAXATIVES
35
BULK-FORMING LAXATIVES
Natural: Psyllium Malt soup extract Synthetic: Methylcellulose Polycarbophil
36
onset of action of BULK-FORMING LAXATIVES
slow onset of action (12-24 hrs & up to 72 hrs) must be given with at least 8 oz of H2O
37
AEs of BULK-FORMING LAXATIVES
* bloating | * flatulence
38
CIs of BULK-FORMING LAXATIVES
* obstructing bowel lesion * intestinal structures * Crohn’s disease
39
OSMOTICALLY ACTIVE AGENTS
Saline laxatives Nondigestible Sugars & Alcohols Polyethylene Glycol-Electrolyte Solutions Glycerin
40
onset of action of saline laxatives
5-30 mins (rectal) | 3-6 hrs (PO)
41
CIs of saline laxatives
* HTN * CHF * renal impairment
42
hydrolyzed in the colon to short-chain FAs, which stimulate colonic propulsive motility by osmotically drawing water into the lumen
Nondigestible Sugars & Alcohols
43
onset of lactulose
1-2 days
44
indication of lactulose
hepatic encephalopathy
45
AEs of Nondigestible Sugars & Alcohols
* abdominal cramping | * flatulence
46
contain an inert, nonabsorbable, osmotically active sugar with sodium sulfate, sodium chloride, sodium bicarbonate, & potassium chloride
Polyethylene Glycol-Electrolyte Solutions
47
onset of action of Polyethylene Glycol-Electrolyte Solutions
1-3 days
48
used in pediatric constipation
Glycerin
49
onset of action of glycerin
fast | within 1 hour
50
STIMULANT (IRRITANT) LAXATIVES
``` Anthraquinone Derivatives • Aloe • Senna • Cascara Diphenylmethane Derivatives • Phenolphthalein • Oxyphenisatin • Sodium picosulfate • Bisacodyl Castor oil ```
51
probably induce a limited low-grade inflammation in the small & large bowel to promote accumulation of water & electrolytes & stimulate intestinal motility
STIMULANT (IRRITANT) LAXATIVES
52
onset of action of STIMULANT (IRRITANT) LAXATIVES
6-10 hrs (PO) | 30-60 mins (rectal)
53
AEs of anthraquinone derivatives
* melanosis coli | * cathartic colon
54
T/F Castor oil can be used in pregnant px
F
55
* act as surfactants by allowing absorption of water into the stool * patients who recently had a MI or rectal surgery
EMOLLIENT LAXATIVE
56
EMOLLIENT LAXATIVES
Docusate sodium, Docusate calcium, Docusate | potassium
57
onset of action of EMOLLIENT LAXATIVES
24-72 hrs
58
works at the colon to increase H2O retention in | the stool to soften the stool
LUBRICANT LAXATIVE
59
onset of action of LUBRICANT LAXATIVE
6-8 hrs
60
LUBRICANT LAXATIVE inc/dec absorption of vit ADEK
decrease
61
LUBRICANT LAXATIVEs may cause _____
``` anal seepage (itching & perianal discomfort) ```

Phar 141 (2 decks)

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