Antacids Neutralize? Taken when and lasts for? Can affect the absorption of?
Neutralize gastric acid, taken 1 hr after meal effective for up to 2 hrs. Can affect absorption of drugs by direct binding or via increasing gastric pH.
Sodium bicarbonate What does it do? Brand names?
Reacts with HCl to produce NaCl and CO2 which causes belching and gastric distention. Baking soda, Alka Seltzer
Magnesium hydroxide & Aluminum hydroxide What does it do what are the brand names?
Maalox, Mytanta, Gelusil Reacts with HCl to form water and aluminum chloride or magnesium chloride. Magnesium salts not absorbed can cause osmotic diarrhea and aluminum salts can cause constipation so often used together.
H2 receptor antagonists
Pharmaco kinetics of H2 receptor antagonists all but which one undergoes?
All but nizatidine under-go first pass metabolism resulting in 50% bioavailability. Cleared by both metabolism and excretion so need for dose reduction with severe renal dysfunction.
Pharmacodynamics of H2receptor antagonists
Highly selective H2 competitive antagonists which inhibit meal-stimulated but especially basal nocturnal gastric acid secretion and pepsin. Inhibit 60-70% of acid secretion per day.
H2 receptor antagonists AEs
Extremely safe, < 3% diarrhea, constipation, headache fatigue, myalgias In elderly in intensive care or renal or hepatic dysfunction- mental status perturbation Cimetidine inhibits binding of dihydrotestosterone to androgen receptors and estradiol metabolism so increases serum prolactin resulting in possible male gynecomastia or impotence and female galactorrhea. Cross placenta and excreted in breast milk
DIs of H2 antagonists
Competes with creatinine and with some drugs for renal tubule secretion Cimetidine inhibits P450 drug metabolism
Definitions of the 3 diseases of acid-peptic diseases
Factors that Protect (6) and Damage (9)
Parietal cell acid secretion
H. Pylori in Duodenal Peptic Ulcer Disease
What environment does it live in?
What does it do?
What does it produce?
What does this product cause?
What on the surface of this causes inflammation?
NSAIDS in Peptic Ulcer Disease
What type of inhibitor?
What type of inhibition is the biggest issue?
How does local injury happen?
Drugs used for Acid-peptic diseases
Drugs that reduce gastic acidity 3
and Mucosal protecting agents 3
- Sodium Bicarb
- Calcium Carbonate
- Mg Hydroxide
- Aluminum hydroxide
H2 receptor antagonists 4 only need to know one
all are ___ except for?
What types of drugs are these?
Mucosal Protecting Agents
Abx for the tx of helicobacter pylori-associated ulcers
only need to know 2
Overview of drug site of action
Laxative bulk forming
Bulk forming laxative 3
Chloride Channel Activator
Opioid receptor antagonists
Guanylate cyclase agonists
- Plecanatide, Linaclotide
- Bismuth subsalicylate
- Nismuth subcitrate potassium
Kaolin and pectin?
Chalk and Apples?
Bile-salt binding resins
Antiemetics regulations of?
Neurokinin 1 receptor antagonists
D2 dopmaine antagonists
H1 antihistamine and anticholinergics
Chronic ___ disorder
____ discomfort and? Both or neither?
Disorder that doesnt lead to?
Types of IBS 4
Treatment of IBS with Diarrhea
IBS with constipation
Lifestyle and Alternative medicine for IBS
Avoid or reduce?
4 other things
Low FODMAPs Diet
What does it stand for?
What are they?
What does this lead to?
Chronic disease that causes?
How does it begin?
What is the goal of therapy?
IBD 2 types
- Inflammation usually extends from the mucosa through the entire thickness of the bowel wall
- Inflammation limited to the mucosa of the colon
- Inflammation limited to the colon
- Can affect any area of the GI tract from the mouth to the anus
- Thuse fistulas, abscesses or strictures of the bowel much less common
- Thus may lead to fistulas, abscesses or strictures of the bowel much less common
Symptoms of IBD
Most common symptoms are?
Other symptoms are?
Inflammation outside the GI can cause?
Children with the disease may have?
IBD OTC tx 3 things
Rx med for IBD
Anti-Tumor necrosis factor
Abx for IBS
___ - mediated intestinal disorder
Dietart proteins in?
Diagnosis of Celiac Disease
How does it present
What type of testing?
Tx for celiac disease