PUD drugs Flashcards
(44 cards)
PUD drugs that are lipophilic weak bases enabling diffusion across lipid membranes
PPI
Active form of PPIs
omeprazole sulfonamide
lansoprazole sulfone & hydroxylansoprazole
CYP450 member enzymes affecting PPI
CYP2C19
CYP3A4
Indications for PPIs
GERD PUD non-ulcer dyspepsia stress-related mucosal bleeding gastrinoma (Zollinger-Ellison syndrome)
Common preparation of PPIs
enteric coated
Vitamin deficiency seen in chronic PPI use
vit b12
PPI that inhibits metabolism of warfarin, diazepam, and phenytoin
omeprazole
esomeprazole only decreases diazepam metab
Competitive inhibition of parietal cell H2 receptor
cimitidine
ranitidine
nizatidine
famotidine
H2 receptor blockers are particularly effective at
nocturnal acid secretion
Effect of food on PPI bioavailability
decreased by 50%
H2 blockers are rapidly absorbed where?
intestines
H2 blocker that does NOT inhibit first-pass metabolism of ethanol
famotidine
Creatinine and procainamide compete with H2 blockers for ____
renal tubular secretion
Contraindications for H2 blocker
pregnancy (crosses placenta)
lactating mothers (secreted in breastmilk)
Most potent H2 blocker
famotidine
H2 blocker that causes gynecomastia, male impotence and glactorrhea
cimetidine (prototype H2 blocker)
Systemic antacids
Na bicarbonate
Ca carbonate
1) Local antacid that causes diarrhea:
2) Local antacid that causes constipation:
1) Mg(OH)2
2) Al(OH)3
Drugs that require acid for dissolution and absorption (should not be used with acid reducers)
digoxin, phenytoin, isoniazid, ketoconazole
Drugs affected by gastric acidity
tetracycline
fluoroquinolone
itraconazole
iron
When hypercalcemia and metabolic alkalosis caused by antacids
milk alkali syndrome
Mucosal protective: binds to HCl and coats mucosal ulcer or erosions; absorbs bile salts
sucralfate
Disadvantage of sucralfate
cannot be taken with acid reducers because it requires acid for activation
Indication for sucralfate
duodenal ulcers
