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Flashcards in GIT Deck (23)
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1

H2 blocker
Drug names

Cimetidine, Ranitidine, Famotidine, Nizatidine

2

H2 blockers
MOA

Reversibly block H2-receptors -- dec. H+ secretion by parietal cells.

3

H2 blockers
Clinical use

Peptic ulcer
Gastritis
Mild esophageal reflux

4

H2 blockers
Toxicity

>Cimetidine: CYP450 inhibitor, antiandrogenic, crosses BBB and placenta.
>Cimetidine, ranitidine: dec. creatinine excretion.

5

Proton Pump Inhibitors
Drug names

Omeprazole, Lansoprazole, Esomeprazole, Pantoprazole, Dexlanzoprazole

6

Proton Pump Inhibitors
MOA

Irreversibly inhibit H/K ATPase in parietal cells.
Inc. gastric pH.

7

Proton Pump Inhibitors
Clinical use

Peptic ulcer, gastritis, esophageal reflux
Zollinger-Ellison syndrome

8

Proton Pump Inhibitors
Toxicity

C.difficile infection, pneumonia.
Dec. serum Mg w/ long-term use.

9

Octreotide
MOA

Somatostatin analog.
Inhibits splanchnic vasoconstriction hormones.

10

Octreotide
Clinical use

Acute variceal bleeds
Acromegaly
VIPoma, carcinoid tumors

11

Misoprostol
MOA

PGE1 analog.
Inc. production/secretion of gastric mucosa.
Dec. acid production.

12

Misoprostol
Clinical use

>Prevents NSAID-induced peptic ulcers.
Maintains PDA.
*CI in women of childbearing potential (abortifacient).

13

Bismuth, Sucralfate
MOA, clinical use

>Bind to peptic ulcer base -- protection -- allows HCO3- secretion to reestablish pH gradient in mucous layer.
>For ulcer healing, traveler's diarrhea.

14

Antacids
MOA, clinical use

Affect absorption, bioavailaibility, urinary excretion of other drugs -- alters gastric acid and urinary pH, delays gastric emptying

15

Antacids
Drug names

Aluminum hydroxide
Calcium carbonate
Magnesium hydroxide

16

Osmotic laxatives
Drug names

Magnesium hydroxide
Magnesium citrate
Polyethylene glycol
Lactulose

17

Osmotic laxatives
MOA

Provide osmotic load to draw H2O into GI lumen

18

Osmotic laxatives (Lactulose)
Clinical use

Constipation.
Treat hepatic encephalopathy.
*Lactulose degraded into lactic acid and acetic acid by gut flora -- promotes nitrogen excretion (NH4+).

19

Metoclopramide
MOA

D2 receptor antagonist.
Inc. resting tone, contractility, LES tone, motility.
>No influence on colon transport time.

20

Metoclopramide
Clinical use

Diabetic and postsurgery gastroparesis.
Antiemetic

21

Metoclopramide
Toxicity

Inc. parkinsonian effects, tardive dyskinesia.
*CI in pts w/ small bowel obstruction, Parkinson dse (due to D1-receptor blockade).

22

Ondansetron (5HT3 antagonist)
[MOA, use]

Normally, 5HT released from enterochromaffin cells in response to chemotherapy drugs -- stimulates vagal afferents to initiate vomiting reflex.
Odansetron blocks the action of 5HT3 in vagal terminals at GIT and receptors in CTZ.
>For controlling post-op vomiting, and for pts undergoing chemotherapy.

23

Sulfasalazine
[MOA, use]

>Combination of sulfapyridine (antibac) and 5-aminosalycylic acid (anti-inflam). >Activated by colonic bacteria.
>For UC, CD (colitis component).