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DEMS details, exam 1 > Redline Drugs > Flashcards

Flashcards in Redline Drugs Deck (16)
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1

Omeprazole

Antisecretory/Cytoprotective Agent
Proton Pump Inhibitor
Available OTC
Administered as prodrug, absorbed into circulation, then diffuses into parietal cells where it irreversible inactivates the enzyme

Once daily dosing (18 hours are required for new enzyme synthesis)

2

Ranitidine

Antisecretory/Cytoprotective Agent

H2 receptor antagonist

Reversible, competitive block at parietal cell H2 receptors on basolateral membrane. Less efficacious than PPIs.

Better at blocking nocturnal acid secretion rather than meal-stimulated acid

Used in GERD, PUD and stress-related gastritis

3

Cimetidine

Antisecretory/Cytoprotective Agent

H2 receptor antagonist

Reversible, competitive block at parietal cell H2 receptors on basolateral membrane. Less efficacious than PPIs.

Better at blocking nocturnal acid secretion rather than meal-stimulated acid

Used in GERD, PUD and stress-related gastritis

**Inhibits cytochrome P450 oxidative metabolism**
**Also headache, confusion, man-boobies and decreased libido in men**

4

CaCO3 (Tums)

Antisecretory/Cytoprotective Agent

Antacid (raises pH of stomach to 4-5)

Used as pain relief due to peptic ulcers and actute gastritis

*Can see rebound secretion due to Ca2+ effect on gastrin release
*Safe, but should not be used long-term
*Constipation can occur, sometimes hypercalcemia

5

Mg (OH)2

Antisecretory/Cytoprotective Agent

Antacid (raises pH of stomach to 4-5)

Used as pain relief due to peptic ulcers and actute gastritis

*Major side effect is osmotic diarrhea, often added to antacid preparations to counteract Al or Ca-induced constipation

*Avoid use if renal disease is present

6

Al (OH)3

Antisecretory/Cytoprotective Agent

Antacid (raises pH of stomach to 4-5)
Used as pain relief due to peptic ulcers and actute gastritis

*Very widely used, binds phosphate in gut
*Main side effect is constipation
*Chronic intake may lead to CNS toxicity

7

Metoclopramide

Antiemetic Agent, Prokinetic Agent

Dopamine receptor antagonist

Pro-motility; increase agonist activity at smooth muscle M3-receptors

Antagonist at presynaptic dopamine receptors that inhibit the release of ACh

Relieves n/v by block of dopamine receptors in chemorecptor trigger zone

oral-IV-IM

May cause somnolence, dystonic reaction, and tardive dyskinesia

*Can be used in morning sickness, no significant increase in birth defects*

8

Psyllium Seed (metamucil)

Laxative
Bulk-forming/fiber
Safe to use every day

Effective in 12-24 hours to 3 days, always need to take with 8oz of fluids

9

Polyethylene glycol

Laxative
Saline (osmotically-active) cathartic

High-volume: Widely used for bowel cleansing prior to radiologic, surgical, or endoscopic procedures

Smaller-volume: Now used to treat difficult constipation.

Prolonged use can lead to electrolyte depletion

10

Bisacodyl

Laxative
Stimulant/irritant

Try if fiber/saline treatments fail

Acts via increase in peristaltic activity by inducing low-grade inflammation in bowel to promote accumulation of water and electrolytes and stimulation of intestinal motility (activation of prostaglandin-cAMP and NO-cGMP pathways)

Potentially dangerous side effects of electrolyte/fluid deficiencies or severe cramping. Most widely abused class

11

Docusate

Laxative
Wetting agents, Surfactant

Acts as stool softener. Role is primarily prevention.

Used in pts with cardiovascular disease/hernia/postpartum pts. Often used in combo with stimulant laxatives with initiating opioid therapy

12

Mineral oil

Laxative
Wetting agent

Coats fecal contents preventing colonic absorption of fecal water. used with caution in very young/elderly due to potential aspiration into lungs

13

Loperamide (Imodium)

Antidiarrheals
Opioid

Effective against travelers diarrhea, alone or in combination with antimicrobrial agents. Should be discontinued if no improvement after 48 hours.

Los addiction liability. Can cause CNS depression in overdose. May worsen Shigella infections

Anti-secretory activity against cholera toxin

14

Polycarbophil

Antidiarrheal
Opioid

Useful in diarrhea by absorbing 60x weight in H20

Useful in constipation by preventing fecal desiccation

15

Bismuth subsalicylate

Antidiarrheal
Absorbent agent

Absorbs "toxins" that cause irritation. Can also absorb drugs, nutrients, digestive enzymes.

*Avoid use in children under 12 due to risk of Reye's syndrome

16

Ondansetron (Zofran)

Antiemetic Agent

5HT3 receptor antagonist at chemorceptor trigger zone, solitary tract nucleus, and on visceral afferents

Absorbed from GI tract

Well tolerated, occasionally headache, constipation, drowsiness, associated with QT prolongation

*Can be used in morning sickness. No associations with adverse fetal effects*