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GI Pharmacology Flashcards

(51 cards)

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1
Q

Sodium Bicarbonate

A

Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: FAST
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: Metabolic alkalosis, excessive NaCl absorption, gas/bloating
Indication: GERD, peptic ulcers, dyspepsia

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2
Q

Calcium Carbonate

A

Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: MODERATE
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: acid rebound, gas/bloating, hypercalcemia (hi doses), hypophosphatemia (rare)
Indication: GERD, peptic ulcers, dyspepsia

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3
Q

Magnesium Hydroxide

A

Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: SLOW
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: Osmotic diarrhea, hypermagnesemia (hi dose over extended periods of time)
Indication: GERD, peptic ulcers, dyspepsia

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4
Q

Aluminum Hydroxide

A

Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: SLOW
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: constipation, Al toxicity (w/ impaired renal function), hypophosphatemia, bone resorption , hypercalcemia
Indication: GERD, peptic ulcers, dyspepsia

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5
Q

Cimetidine

A

H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)
Specific Adverse Rxns:
CNS effects = confusion, hallucinations, agitation
Endocrine effects = inhibition of androgen receptors, estradiol metabolism, increase prolactin levels
Inhibit CYP metabolism

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6
Q

Ranitidine

A

H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)

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7
Q

Nizatidine

A

H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)

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8
Q

Famotidine

A

H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)

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9
Q

Omeprazole

A

Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)

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10
Q

Lansoprazole

A

Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)

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11
Q

Rabeprazole

A

Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)

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12
Q

Esomeprazole

A

Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)

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13
Q

Pantoprazole

A

Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)

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14
Q

Misoprostol

A

Mucosal Protective Agent (not a physical barrier)
Prostaglandin derivative, stimulates epith cells of gastric mucosa to secrete mucus and HCO3-, decreases activation of H+/K+ ATPase in parietal cells
Duration of Action: 6hrs
Common Adverse Rxns: Cramping, diarrhea
Adverse Rxns: abortificient
Indications: NSAID-assoc ulcers

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15
Q

Sucralfate

A

Mucosal Protective Agent (forms a physical barrier)
Stimulates mucus and HCO3- production thru unknown mechanism
Duration of Action: 6hrs
Common Adverse Rxns: Constipation, impaired drug absorption
Adverse Rxns: caution w/ renal insufficient pts
Indications: used to prevent stress-related bleeding in critically ill hospitalized pts where suppression of acid not desired

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16
Q

Bismuth Subsalicylate (mucosal protective agent use)

A

Mucosal Protective Agent (forms a physical barrier)
PEPTO-BISMOL: Stimulates mucus and HCO3- production thru unknown mechanism
Duration of Action: 6hrs
Common Adverse Rxns: black stool & tongue
Adverse Rxns: high doses salicylate toxicity
Indications: dyspepsia, antibacterial actions that are useful w/ H Pylori or traveler’s diarrhea

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17
Q

Metoclopramide

A

D2 Antagonist - Prokinetic Agent (promote cx of GI sm)
(prevents dopamine from suppressing ACh release)
Indications: GERD, impaired gastric emptying, dyspepsia, antiemetic
Adverse rxns: CNS: restless, drowsy, insomnia, anxiety, parkinsonian sx (d/t dopamine antagonist action)

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18
Q

Bethanechol

A

M3 Agonist - Prokinetic Agent (promote cx of GI sm)
Indications: GERD, gastroparesis
Adverse rxns: cholinergic side effects

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19
Q

Neostigmine

A

AchE Inhibitor - Prokinetic Agent (promote cx of GI sm)
Indications: non-obstructive urinary retention or abdominal distension
Adverse rxns: cholinergic side effects

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20
Q

Erythromycin

A

Motilin Receptor Agonist - And Antibiotic
Prokinetic Agent (promote cx of GI sm)
Indication: gastroparesis
Adverse rxn: erythromycin mediated side effects

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21
Q

Methylcellulose

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A 
Laxative - Bulk-Forming
MOA: fiber, adds bulk and retains H2O
Poor absorption
Indications: constipation, to minimize straining, prior to surgical/endoscopic procedures
Adverse Rxn: gas/bloating
22
Q

Glycerin

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A 
Laxative - Surfactant
MOA: coats/penetrates fecal material 
Poor absorption
Indications: constipation, to minimize straining, prior to surgical/endoscopic procedures
Adverse Rxn: nutrient malabsorption
23
Q

Lactulose

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A 
Laxative - osmotic 
MOA: changes osmotic pressure
Poor absorption
Indications: constipation, to minimize straining, prior to surgical/endoscopic procedures
Adverse Rxn: gas / electrolyte flux
24
Q

Senna

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A 
Laxative - ENS Stimulant
MOA: leaky mucosa, Na+ uptake inhibited
Poor absorption
Indications: constipation, to minimize straining, prior to surgical/endoscopic procedures
Adverse Rxn: GI irritation
25
Tegaserod
Laxative - Serotonin (5HT4) Agonist MOA: Partial 5HT agonist (inhibits GI sensory neurons that relay pain sensation to CNS) (5HT stimulates ACh secretion and GI sm cx) 10% Absorption Indications: chronic, idiopathic constipation: IBS constipation NOT AVAILABLE FOR GENERAL USE Adverse Rxn: GI and CV effects
26
Lubiprostone
``` Laxative - Chloride Channel Activator MOA: Prostaglandin Derivative Poor absorption Indications: chronic constipation Adverse Rxn: nausea, vomiting, diarrhea ```
27
Methylnaltrexone
Laxative - Mu-opioid Receptor Antagonist MOA: blocks peripheral mu-opioid receptors Poor CNS Penetration Indications: opioid-induced constipation in palliative care Adverse Rxn: abd pain, flatulence, nausea, diarrhea
28
Alvimopan
Laxative - Mu-opioid Receptor Antagonist MOA: blocks peripheral mu-opioid receptors Poor CNS Penetration Indications: post-op ileus in hospitalized pts w/ bowel resection Adverse Rxn: abd pain, flatulence, nausea, diarrhea Risk of MI (so only use for 7 days)
29
Loperamide
Antidirrheal Agent MOA: opioid agonist Indications: diarrhea (IBS) Adverse Rxns: constipation (very safe)
30
Diphenoxylate
Antidirrheal Agent MOA: opioid agonist Indications: diarrhea Adverse Rxns: constipation (very safe)
31
Bismuth Subsalicylate (antidiarrheal use)
Antidirrheal Agent MOA: inhibits PG synthesis (intestinal), absorbs toxins Indications: non-specific diarrhea, travelers diarrhea Adverse Rxns: salicylate toxicity
32
Cholestryamine
Antidirrheal Agent MOA: binds bile acids and salts, this reduces the osmotic pressure caused by unabsorbed bile-salts Indications: diarrhea d/t impaired bile-salt absorption in the ileum d/t chron's disease or ileum resection Adverse Rxns: bloating, flatus, constipation, fecal impaction, impaired fat absorption
33
Octreotide
Antidirrheal Agent MOA: somatostatin receptor agonist: increase fluid absorption and decrease motility Indications: secretory diarrhea Adverse Rxns: impaired pancreatic secretion, decreased GI motility (nausea, pain), decreased gall bladder cx, glucose homeostasis
34
Ondansetron (Zofran)
Antiemetic Agent MOA: Serotonin (5HT) antagonist Indication: chemotherapy, post-op, post-radiation Adverse effects: headache, dizziness, constipation, prolonged QT interval
35
Scopolamine
Antiemetic Agent MOA: M1 antagonist Indication: motion sickness Adverse effects: antimuscarinic effects
36
Metoclopramide
Antiemetic Agent MOA: D2 antagonist Indication: chemo and radiation therapy induced nausea and vomiting Adverse effects: extrapyramidal (PARKINSONIAN Sx)
37
Dimenhydrinate
Antiemetic Agent MOA: H1 Antagonist Indication: motion sickness Adverse effects: drowsiness
38
Aprepitant
Antiemetic Agent MOA: NK antagonist Indication: chemotherapy Adverse effects: fatigue, dizziness, diarrhea, CYP3A4 interactions
39
Prochlorperazine
Antiemetic Agent MOA: M1, D2, H1 antagonist Indication: severe nausea and vomiting Adverse Effects: Extrapyramidal (parkinsonian sx), drowsiness, anticholinergic
40
Lorazepam (Ativan)
Antiemetic Agent MOA: GABA agonist Indication: anxiety / chemotherapy Adverse effects: drowsiness
41
Nabilone
Antiemetic Agent MOA: Cannabinoid agonist Indication: chemotherapy Adverse effects: dysphoria, sedation, increased appetite
42
Dexamethasone
Antiemetic Agent MOA: glucocorticoid agonist - increases effectiveness of serotonin antagonists Indication: chemotherapy, post-op, post-radiation Adverse effects: weight gain, water retention, other corticosteroid effects
43
Alosetron
Antidiarrheal used to tx IBS (diarrhea predominant) MOA: 5HT3 Antagonist Indications: IBS-diarrhea predominant (WOMEN ONLY) Adverse effects: constipation, ischemic colitis
44
Sulfasalazine
Aminosalicylate - used to topically tx IBD 1st line agent for mild to moderate ulcerative colitis MOA: inhibition of COX production of PGs, interferes w/ inflammatory cytokine production (IL-1), inhibits NF-kB signaling (transcription factor) Administration: oral Target: colon Modification: Azo linked (N-N) Adverse effects: Nausea, GI upset, headache, arthralgia, myalgia, bone marrow suppression, malaise (40% of pts can't tolerate this drug)
45
Mesalamine-Pentasa
Aminosalicylate - used to topically tx IBD 1st line agent for mild to moderate ulcerative colitis MOA: inhibition of COX production of PGs, interferes w/ inflammatory cytokine production (IL-1), inhibits NF-kB signaling (transcription factor) Administration: oral Target: throughout intestine Modification: time release microgranules Adverse effects: headache, dizziness, abdominal pain
46
Mesalamine-Asacol
Aminosalicylate - used to topically tx IBD MOA: inhibition of COX production of PGs, interferes w/ inflammatory cytokine production (IL-1), inhibits NF-kB signaling (transcription factor) Administration: oral Target: ileum/proximal colon Modification: pH sensitive resin
47
Mesalamine-Rowasa/Canasa
Aminosalicylate - used to topically tx IBD MOA: inhibition of COX production of PGs, interferes w/ inflammatory cytokine production (IL-1), inhibits NF-kB signaling (transcription factor) Administration: enema / suppository Target: rectum / sigmoid colon Modification: high concentrations
48
Prednisone
Glucocorticoid (steroid) - can be used to tx IBD Indication: moderate to severe active IBD MOA: suppression of inflammatory cytokines (TNFalpha, IL-1), suppression of chemokines (IL-8), suppression of adhesion molecules, suppression of signal transduction molecules that mediate cytokine and chemokine activities (NOS, PLA2, COX2, NFkB) Administration: IV / oral / suppository
49
Methotrexate
Antimetabolite: anti-cancer drug used to tx IBD Indications: maintenance of Chron's remission MOA: inhibits DHFR resulting in impaired cellular proliferation (inhibition of immune cell proliferation) Administration: IM, subQ, orally Adverse effects: low dose side effects uncommon: bone marrow depression, megaloblastic anemia
50
Inflixamab
Monoclonal Ab - used to tx IBD Indication: moderate to severe IBD MOA: binds and sequesters TNFalpha: can't stimulate production of inflammatory cytokines: inhibits immune response. Adverse effects: infection (6%)
51
Azathioprine
Immunosuppressive, antineoplastic, antibiotic drugs function by interfering with nucleotide synthesis: azathioprine inhibits de novo purine synthesis Indications: maintenance of IBD remission Adverse effects: nausea, vomiting, bone barrow suppression

Pharmacology (8 decks)

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