Pharm Flashcards
(27 cards)
Name 4 H2 blockers
Cimetidine, Ranitidine, Famotidine, Nizatidine
“take H2 blockers before you DINE”
H2 blockers MOA?`
reversible block of histamine H2 receptors–> decr H+ secretion by parietal cells
H2 blockers: clinical use?
Peptic ulcer, gastritis, mild esophageal reflux
which two H2 blockers decr renal excretion of creatinine?
Cimetidine and ranitidine
Cimetidine ADRs?
Potent inhibitor of P-450 (many drug intxns), Antiandrogrnic effects (Gynecomastia!!!, decr libido in males!!!, impotence, prolactin release), Can cross BBB (confusion, dizzy, HA) and placenta
Omeprazole, Lansoprazole, esomeprazole, pantoprazole, dexlansoprazole are what class of drugs? MOA?
PPIs: irreversibly inhibit H+/K+ ATPase in stomach parietal cells
PPIs clinical use?
Peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison Sx
PPIs ADRs?
incr risk of C. diff infection!!, osteoporosis!!, and pneumonia,
decr serum Mg++ w long-term use
These drugs can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying, and all can cause hypokalemia
Antacids
ADRs of Overuse of Aluminum hydroxide antacids
constipation, hypophosphatemia, proximal m. weakness, osteodystrophy, seizures
(“aluMINIMUM amt. of feces”)
ADRs of Overuse of Calcium carbonate antacids
hypercalcemia (milk-alkali Sx), rebound acid incr,
can chelate and decr effectiveness of other drugs (ie Tetracyclines)
ADRs of Overuse of Mg++ hydroxide antacids
Diarrhea, hyporeflexia, hypoTN, cardiac arrest
“Mg2+ = Must Go 2 the bathroom
Bind to ulcer base providing physical protection and allowing bicarb secretion to re-est. pH gradient in mucous layer which promotes ulcer healing, also used for traveler’s diarrhea
Bismuth, Sucralfate
PGE1 analog, increases production/secretion of gastric mucous barrier, decreases acid production ?
Uses?
Misoprostol
Px of NSAID induced peptic ulcers, maintain PDA. off-label to induce labor
Long-acting somatostatin analog, inhibits secretion of various splanchnic vasodilatory hormones; used for acute variceal bleeding, acromegaly, VIPoma, carcinoid tumors?
ADRs?
Octreotide
Nausea, cramps, steatorrhea, incr risk of cholelithiasis due to CCK inhibition
Magnesium hydroxide, magnesium citrate, polyethylene glycol, and lactulose are all?
MOA?
Osmotic laxatives;
Provide osmotic load to draw water into GI lumen
Magnesium hydroxide, magnesium citrate, polyethylene glycol, and lactulose: clinical use?
Osmotic laxatives used for constipation
Lactulose also for hepatic encephalopathy since gut flora degrades it into lactic/acetic acid that promotes N excretion as NH4+
A combo of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflamm) that is activated by colonic bacteria?
clinical use?
Sulfasalazine
UC, Crohns disease
ADRs of Sulfasalazine?
Malaise, nausea, sulfonamide toxicity, reversible oligospermia
Mu-opioid receptor agonist w/ poor CNS penetration (low addictive potential), that slows gut motility, used for diarrhea?
ADRs?
Loperamide
constipation, nausea
5-HT(3) antagonist, decreases vagal stimulation, powerful central-acting anti-emetic used to control post-op vomiting and in chemo pts?
ADRs?
Ondansetron
HA, constipation, prolongs QT interval
Metoclopramide MOA***
Dopamine (D2) receptor antagonist, increases: resting tone, contractility, LES tone, and motility
does not influence colon transport time
Metoclopramide use?
Anti-emetic AND to incr gastric emptying- Diabetic and postop gastroparesis, GERD
Metoclopramide ADRs?
incr parkinsonian effects, tardive dyskinesia, restlessness, drowsiness, fatigue, depression, diarrhea.
D-D intxn: w Digoxin and diabetic agents
