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Pharmacology II > GI Pharmacology > Flashcards

GI Pharmacology Flashcards

(46 cards)

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1
Q

Omeparazol (class, indication, MOA)

A

PPI
Indication: Peptic Ulcer
MOA: react with H/K ATPase to irreversibly inactivate the enzyme (limit gastric acid in the stomach)

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2
Q

Omeprazol ADE

A

Short term use: GI symptoms

Long term use: reduced plasma B12, non-heme iron, Ca2+, and Mg2+ (hypomagnesia may lead to prolonged QT) increased risk of enteric and respiratory infection

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3
Q

Omeprazole Drug-Drug interactions

A

Drugs who’s bioavailability is affecte by intragastric activity (digoxin and ketochonazole- an antifungal)

Digoxin 
Ketochonazole 
Phenytoin 
Diazepam 
Theophylline 
Clopidrogrel
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4
Q

Cimetidine (class, MOA, Indication)

A

H2 receptor antagonist

MOA: competitively and selectively bonds H2 receptors on parietal cells to reduce histamine induction of Acid secretion(irreversible)

Indication: PUD

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5
Q

Ranitidine (class, MOA, Indication)

A

H2 receptor antagonist

MOA: competitively and selectively bonds H2 receptors on parietal cells to reduce histamine induction of Acid secretion(irreversible)

Indication: PUD

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6
Q

Cimetidine ADE

A

extremely safe

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7
Q

Ranitidine ADE

A

extremely safe

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8
Q

Cimetidine Drug- Drug interaction

A

Inhibit first pass metabolism of alcohol - ask pt to limit use (common to all H2 antagonists)

Inhibits CYP1A2, 2D6 and weak 3A4 (Lidocaine, diazapam, and antifungal agents)

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9
Q

Ranitidine Drug-Drug interaction

A

Inhibit first pass metabolism of alcohol - ask pt to limit use (common to all H2 antagonists)

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10
Q

Cimetidine contraindication

A

alcohol use

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11
Q

Ranitidine contraindication

A

alcohol use

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12
Q

sodium bicarbonate, calcium carbonate, aluminum hydroxide, magnesium hydroxide (class, MOA, indication )

A

antacid

MOA: neutralize gastric acid

indication: short term relief of PUD symptoms

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13
Q

sodium bicarbonate, calcium carbonate, aluminum hydroxide, magnesium hydroxide AE

A

altered electrolytes
constipation
diarrhea

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14
Q

sodium bicarbonate, calcium carbonate, aluminum hydroxide, magnesium hydroxide Drug-Drug interactions

A

Affects absorption of antibiotics - require separate administration times (4-6 hours)

Remember: tetracyclines and fluorquinolones are affected by di and trivalent cations

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15
Q

Bismuth subsailacylate (class, MOA, indication)

A

Mucosal defense

MOA: coats ulcer and errosions, stimulate prostaglandin, mucus and bicarb secretion, some antimicrobial effects, reduces stool frequency and liquidity

Indication: Treat dyspepsia, prevent travelers diarrhea, treat H.pylori induced peptic ulcer

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16
Q

Bismuth Subsailacylate ADE

A

Black tongue and stools

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17
Q

Bismuth Subsailacylate contraindication

A

Renal insufficiency ( can bind to metal binding protein in the kidney and stay there for a long time )

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18
Q

Triple therapy for H.pylori caused peptic ulcer

A

PPI-CA: PPI + clarythromycin + amoxicillin

PPI-CM: PPI+ calrythromycin+ Metronidazole

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19
Q

Quad therapy for H.pylori caused peptic ulcer

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A

triple therapy (PPI-CA or PPI-CM) + mucosal defense (Bismuth Subsailacylate)

20
Q

Sulflasalazine (class, MOA, indication

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A

Class: 5-ASA

MOA: Inhibit IL-1 and TNFa expression, inhibit the lipoxgygenase pathway (needed for synthesis of leukotrienes), inhibit NFkB and ROS

Indication: induce and maintain remission of mild or moderate UC

21
Q

Mesalamine

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A

Class: 5-ASA (inflammatory supressor)

MOA: Inhibit IL-1 and TNFa expression, inhibit the lipoxgygenase pathway (needed for synthesis of leukotrienes), inhibit NFkB and ROS

Indication: induce and maintain remission of mild or moderate UC

22
Q

Sulfasalazine AE

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A

common: dyspnea, skin rash, headache, abdominal pain

Rare but serious: NEPHROTOXICITY

23
Q

Mesalamine

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A

common: dyspnea, skin rash, headache, abdominal pain

Rare but serious: NEPHROTOXICITY

24
Q

Sulfasalazine Drug-Drug interactions

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A

antacids (formulations with pH sensitive coat will not reach the intestine- will get stuck on the stomach)

25
Mesalamine Drug-Drug Interactions
antacids (formulations with pH sensitive coat will not reach the intestine- will get stuck on the stomach)
26
Prednisone (class, MOA, indication)
Cortocosteroids (inflammatory suppressor) MOA: inhibit the expression of inflammatory mediators and increase the expression of anti-inflammatory mediators Indication: induce remission and control acute moderate to severe active IBD (more potent than 5-ASA) SHORT TERM USE ONLY
27
Budesonide (class, MOA, indication)
Cortocosteroids (inflammatory suppressor) MOA: inhibit the expression of inflammatory mediators and increase the expression of anti-inflammatory mediators Indication: induce remission in mild and moderate IBD (SHORT TERM USE ONLY)
28
Budesonide Drug-Drug interactions
interacts with CYP34a inhibitors and inducers
29
Prednisone AE
MANY!! Drug must be tappered gradually in order to avoid systemic effects mood changes, fluid retention, increased appetite and glucose levels, increased change of infection, adrenal axis suppression, slow growth rate in children
30
6-mecaptopurine (class, MOA, indication)
Class: Thipurine (immunomodulators) MOA: inhibit purine synthesis - anti-proliferation and induce apoptosis in T-cells Indication: maintain remission of UC and CD NOTE: can be added in tappering of corticosteroids
31
6- mecaptopurine AE
Major dose: bone marrow suppression Most serious: pancreatitis
32
6-mecaptopurine Drug-Drug interactions
XO inhibitors (gout medications)
33
Infliximab (class, MOA, indication)
Class: anti-TNFa (Biologic) MOA: prevent TNFa from producing inflammation by blocking activation of NFkB Indication: moderate to severe CD and or UC that do not respond to immunosupression
34
Infliximab AE
serious infection injection site reaction lymphoma (when taken with immunomodilators)
35
Inflixamab Contraindications
uncontrolled infection | simultaneous administration of other biologics
36
Natalizumab (class, MOA, indication)
Class: anti-a4 integrin (Biologic) MOA: bind to a4 integrin and prevent extravagation to prevent inflammation Indication: moderate to severe CD for INPATIENTS WHO DO NOT RESPOND TO OR CANNOT RESPOND TO ANTI-TNF THERAPY
37
Natalizumab AE
Progressive multifocal leukoencephalopathy (PML) | severe hepatic toxicity
38
Natalizumab Drug-Drug interaction
other immunosupressants
39
Metoclopramide (class, MOA, indication)
Class: D2 dopamine receptor antagonist (Prokinetic) MOA: Peripheral - bind to receptors to decrease motility and decrease LES pressure Central- antiemetic action (CTZ) Indication: impaired gastric emptying (Gastroparesis, post surgical disorders), prevent emesis
40
Metoclopraminde AE
Neurpsychiatric and extrapyramidal symptoms, Taradive dyskinesia, Parkinsonism
41
Metoclopramide CI
Seizures, GI obstruction, hemorrhage, Parkinson Disease
42
Psyllium (class, MOA, indication)
class: Bulk forming laxative MOA: absorb water into the intestines to increase fecal bulk and stimulate peristalsis (through stretch receptors) Indications: Prevent constipation NOTE: pt needs to drink a lot of fluids and have the strength for bowel movement (not for weak patients or young children)
43
Methylcellulose (class, MOA, indication)
class: Bulk forming laxative MOA: absorb water into the intestines to increase fecal bulk and stimulate peristalsis (through stretch receptors) Indications: Prevent constipation NOTE: pt needs to drink a lot of fluids and have the strength for bowel movement (not for weak patients or young children)
44
Docusate (class, MOA, indication)
class: Stool surfactant/softener MOA: permit water and lipids to penetrate the stool - softens it indication: prevent constipation in patients who should avoid strain (MI and surgery)
45
Mineral oil (class, MOA, indication)
class: stool softener MOA: lubricate stool and inhibit water absorption indication: treat and prevent constipation in young children and dibilitated adults
46
Mineral oil AE
``` lipid pneumonitis (oral dose should be avoided in young children) long term: malabsorption of lipid soluble vitamins ```

Pharmacology II (3 decks)

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