PUD and GERD pharm Flashcards
aluminum hydroxides adverse effects
constipation
magnesium hydroxides adverse effects
diarrhea
H2 antagonists
cimetidine, ranitidine, famotidine, nizatidine
H2RA MOA
competitive inhibition of H2 receptors, resulting in the inhibition of gastric acid secretion
most potent H2RA
famotidine
H2RA adverse effects
infrequent and mild adverse effects
cimetidine inhibits CYPs
proton pump inhibitors
omeprazole, esomeprazole, lansoprazole, pantoprazole, rabeprazole,
PPI moa
PPIs diffuse into the secretory canaliculi, where they are protonated and trapped near the proton pump; this activates the drug and permits irreversible binding to the H/K ATPase preventing the movement of H+ cells from the parietal cell into the stomach
PPI with least amount of CYP metabolism
rabeprazole
bismuth subsalicylate moa
enhances secretion of mucus and HCO3, inhibits pepsin activity, chelates with proteins at the base of the ulcer crater and forms a protective barrier against acid and pepsin; inhibits H. pylori
sucralfate moa
forms sticky, viscous gel that adheres to gastric epithelial cells protecting them from acid and pepsin; requires acid pH for maximal activity
misoprostol moa
slowly metabolized analog of PGE1 that stimulates mucus and HCO3 production
misoprostol adverse effects
diarrhea in 40%
metochloparmide and domperidone moa
D2 receptor blockers, increasing the local release of Ach; resulting in the stimulation of GI smooth muscle, increased amplitude of esophageal contractions, accelerated gastric emptying, and increased LES pressure
metochloparmide and domperidone adverse effects
high incidence of tardive dyskinesia (only prescribe for 1-2 weeks)
