Unit 6-GI Drugs Flashcards
1
Q
Calcium carbonate
Drug class
A
Antacid
2
Q
Calcium carbonate
Uses
A
Ulcer treatment; GERD
3
Q
Calcium carbonate
Side effects
A
Milk-alkali syndrome, nephrocalcinosis, “rebound” acidity, digitalis antagonism
Constipating effects
4
Q
Sodium bicarbonate
Drug class
A
Antacid
5
Q
Sodium bicarbonate
Uses
A
Ulcer treatment; GERD
6
Q
Sodium bicarbonate
Side effects
A
Systemic alkalosis
Enhanced effects of amphetamine, quinidine, and cinchophen
Rarely used due to causing systemic alkalosis
7
Q
Magnesium hydroxide, magnesium carbonate
Drug class
A
Antacid
8
Q
Magnesium hydroxide, magnesium carbonate
Uses
A
Ulcer treatment; GERD
9
Q
Magnesium hydroxide, magnesium carbonate
Side effects
A
Diarrhea (laxative effects)
Hypokalemia, hypermagnesemia, iron deficiency
Magnesium toxicity mostly in presence of renal disease; liquid-based, so act fast
10
Q
Aluminum hydroxide
Drug class
A
Antacid
11
Q
Aluminum hydroxide
Uses
A
Ulcer treatment; GERD
12
Q
Aluminum hydroxide
Side effects
A
Phosphate depletion and sequelae (weakness, anemia, tetany, apnea)
Constipation
Safe for use in patients with renal failure (bonus: helps eliminate phosphate)
13
Q
Atropine sulfate
Drug class
A
Anticholinergics
14
Q
Atropine sulfate
Mechanism
A
Reduce acid secretion, reduce spasm
15
Q
Atropine sulfate
Uses
A
Ulcer treatment
16
Q
Atropine sulfate
Side effects
A
Anticholinergic effects
AKA, belladonna;
contraindications: known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)
17
Q
Propantheline; Metantheline bromide
Drug class
A
Anticholinergics
18
Q
Propantheline; Metantheline bromide
Mechanism
A
Reduce acid secretion, reduce spasm
19
Q
Propantheline; Metantheline bromide
Uses
A
Ulcer treatment (taken 15-30 minutes before meals, and before bed)
20
Q
Propantheline; Metantheline bromide
Side effects
A
Anticholinergic effects
Contraindications: known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)
21
Q
Cimetidine
Drug class
A
Histamine (H2) receptor blocker
22
Q
Cimetidine
Mechanism
A
Inhibit 50-80% of 24 hour acid production
23
Q
Cimetidine
Uses
A
Ulcer treatment (first class to satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple;
24
Q
Cimetidine
Side effects
A
Rebound acidity if stopped suddenly
Uncommon; headache, lethargy, confusion, depression, and hallucination
binds and interferes with P450
25
Ranitidine
| Drug class
Histamine (H2) receptor blocker
26
Ranitidine
| Mechanism
Inhibit 50-80% of 24 hour acid production
27
Ranitidine
| Uses
```
Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple;
```
28
Ranitidine
| Side effects
Rebound acidity if stopped suddenly
Uncommon; headache, lethargy, confusion, depression, and hallucination
Binds and interferes with P450
29
Famotidine
| Drug class
Histamine (H2) receptor blocker
30
Famotidine
| Mechanism
Inhibit 50-80% of 24 hour acid production
31
Famotidine
| Uses
```
Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple
```
32
Famotidine
| Side effects
Rebound acidity if stopped suddenly
| Uncommon; headache, lethargy, confusion, depression, and hallucination
33
Nizatidine
| Drug class
Histamine (H2) receptor blocker
34
Nizatidine
| Mechanism
Inhibit 50-80% of 24 hour acid production
35
Nizatidine
| Uses
```
Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple
```
36
Nizatidine
| Side effects
Rebound acidity if stopped suddenly
| Uncommon; headache, lethargy, confusion, depression, and hallucination
37
Misoprostol
| Drug class
Prostaglandin E analog
38
Misoprostol
| Mechanism
Decrease acid production, increase mucous and bicarbonate secretion
39
Misoprostol
| Uses
Ulcer treatment when prostaglandin production decreased (RA patients taking lots of NSAIDs)
Not very effective, since endogenous prostaglandin levels are already high in duodenal ulcer patients
40
Omeprazole
| Drug class
H/K/ATPase inhibitor
41
Omeprazole
| Mechanism
Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don't take with antacids)
42
Omeprazole
| Uses
Ulcer treatment, treatment for H. pylori; GERD
For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin; large P450 interference; lowest bioavailability
43
Omeprazole
| Side effects
Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
44
Lanzoprazole; Dexlansoprazole
| Drug class
H/K/ATPase inhibitor
45
Lanzoprazole; Dexlansoprazole
| Mechanism
Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don't take with antacids)
46
Lanzoprazole; Dexlansoprazole
| Uses
Ulcer treatment, treatment for H. pylori (in combination with tetracycline, metronidazole & clarithromycin); GERD
47
Lanzoprazole; Dexlansoprazole
| Side effects
Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
Some P450 interference; great bioavailability; dexlansoprazole is an extended release version
48
Rabeproprazole
| Drug class
H/K/ATPase inhibitor
49
Rabeproprazole
| Mechanism
Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don't take with antacids)
50
Rabeproprazole
| Uses
Ulcer treatment; GERD
51
Rabeproprazole
| Side effects
Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
Moderate P450 interference
52
Pantoprazole
| Drug class
H/K/ATPase inhibitor
53
Pantoprazole
| Mechanism
Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don't take with antacids)
54
Pantoprazole
| Uses
Ulcer treatment; GERD
55
Pantoprazole
| Side effects
Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
No P450 interference; great bioavailability
56
Esomeprazole
| Drug class
H/K/ATPase inhibitor
57
Esomeprazole
| Mechanism
Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don't take with antacids)
58
Esomeprazole
| Uses
Ulcer treatment; GERD
59
Esomeprazole
| Side effects
Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
Some (?) P450 interference
60
Sucralfate
| Drug class
Mechanical protectors
61
Sucralfate
| Mechanism
Coat the ulcer crater, increase mucosal resistance (requires acid environment)
62
Sucralfate
| Uses
Ulcer treatment, treatment for H. pylori
For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin; big pill, need to take 4 times per day
63
Sucralfate
| Side effects
Aluminum toxicity possible in renal failure
64
Bismuth salts
| Drug class
Mechanical protectors
65
Bismuth salts
| Mechanism
Coat the ulcer crater, increase mucosal resistance
66
Bismuth salts
| Uses
Ulcer treatment, treatment for H. pylori
For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin
67
Bismuth salts
| Side effects
Aluminum toxicity possible in renal failure; turns bowel movements (and sometimes tongues) black
68
Metochlopramide
| Drug class
Promotility agent (dopamine antagonist
69
Metochlopramide
| Mechanism
Increase motor tone in lower esophageal sphincter (prevent reflux) and stomach (esp. antrum: improves gastric emptying); peripheral (stomach) and CNS (vomiting, via CRTZ) dopamine antagonist
70
Metochlopramide
| Uses
GERD, anti-emetic, gastroparesis
Can be used once/day for good effects
71
Metochlopramide
| Side effects
Hand tremor if used 4X/day (optimum use); possible extra-pyramidal symptoms, but not so severe
72
Cisapride
| Drug class
Promotility agent (dopamine antagonist
73
Cisapride
| Mechanism
Increase motor tone in lower esophageal sphincter and stomach
74
Cisapride
| Uses
GERD, gastroparesis
75
Cisapride
Sudden cardiac death
| Not really used much anymore
76
Domperidone
| Drug class
Promotility agent
77
Domperidone
| Mechanism
Improves gastric tone
78
Domperidone
| Uses
Gastroparesis
79
Sulfasalazine
| Drug class
Anti-inflammatory
80
Sulfasalazine
| Mechanism
Work from lumen to reduce inflammation
Sulfapyridine conjugated to 5-ASA to prevent its degradation, improve its absorption; bond broken in large bowel by bacteria
81
Sulfasalazine
| Uses
Acute therapy for inflammatory bowel disease
82
Sulfasalazine
| Side effects
Toxicity coming from systemic absorption of sulfapyridine
83
Olsalazine
| Drug class
Anti-inflammatory
84
Olsalazine
| Mechanism
Work from lumen to reduce inflammation; 5-ASA dimer
Broken down into bowel by bacteria into 2 moleules of 5-ASA
85
Olsalazine
| Uses
Acute therapy for inflammatory bowel disease
86
Olsalazine
| Side effects
Less toxicity than sulfasalzine
87
Mesalamine
| Drug class
Anti-inflammatory
88
Mesalamine
| Mechanism
Work from lumen to reduce inflammation
Delayed release 5-ASA, for terminal ileum, colon
89
Mesalamine
| Uses
Acute therapy for inflammatory bowel disease
90
Prednisone
| Drug class
Corticosteroid
91
Prednisone
| Uses
Acute IBD, chronic IBD
| Can be given systemically or as enemas
92
Azothioprine
| Drug class
Immunosupressive
93
Azothioprine
| Mechanism
Purine antimetabolite; interferes with DNA synthesis
94
Azothioprine
| Uses
Chronic therapy for IBD
95
Methotrexate
| Drug class
Immunosupressive
96
Methotrexate
| Mechanism
Decreases synthesis of inflammatory mediators
97
Methotrexate
| Uses
Chronic therapy for IBD
98
Infliximab (Remicade); adalimumab; certolizumab
| Drug class
MAb Immunosupressive
99
Infliximab (Remicade); adalimumab; certolizumab
| Mechanism
Binds and neutralizes TNFa
100
Infliximab (Remicade); adalimumab; certolizumab
| Uses
Chronic therapy for IBD
101
Natalizumab; vedolizumab; ustekinumab
| Drug class
MAb Immunosupressive
102
Natalizumab; vedolizumab; ustekinumab
| Mechanism
Binds to a4-integrin, prevents immune cells from invading tissue
103
Natalizumab; vedolizumab; ustekinumab
| Uses
Chronic therapy for IBD
104
Prochlorperazine
| Drug class
Phenothiazines (neuroleptic class)
105
Prochlorperazine
| Mechanism
Probable CNS interaction with dopaminergic receptor-antagonist (leading to reduction of stimulation in the CRTZ in the medulla)
106
Prochlorperazine
| Uses
Anti-emetic
107
Prochlorperazine
| Side effects
Largely extra-pyramidal (torticollis!)
108
Promethazine
| Drug class
Phenothiazines (neuroleptic class)
109
Promethazine
| Mechanism
Antihistaminic (H1 receptor), anticholinergic
110
Promethazine
| Uses
Anti-emetic
111
Promethazine
| Side effects
Somnolence (especially in the elderly)
112
Trimethobenzamide
| Drug class
Benzamide derivative
113
Trimethobenzamide
| Mechanism
Unknown effect on CRTZ
114
Trimethobenzamide
| Side effects
Low-side effect profile; possible extra-pyramidal symptoms, but not so severe
Not used much
115
Tetrahydrocannabinol
| Mechanism
Suppresses CRTZ, probably by anticholinergic mechanism
116
Tetrahydrocannabinol
| Uses
Anti-emetic
| Now often administered in pill form
117
Tetrahydrocannabinol
| Side effects
Munchies
118
Odansetron
| Drug class
Serotonin (5HT3) receptor antagonists
119
Odansetron
| Mechanism
Blocks serotonin at 5HT3 receptor (in central CRTZ)
120
Odansetron
| Uses
Anti-emetic
121
Odansetron
| Side effects
Headache, dizziness, somnolence
| Very safe for vomiting of any type (including drug-induced); can even be given to 6 month-old
122
Granesitron
| Drug class
Serotonin (5HT3) receptor antagonists
123
Granesitron
| Mechanism
Blocks serotonin at 5HT3 receptor (in central CRTZ)
124
Granesitron
| Uses
Anti-emetic
125
Granesitron
| Side effects
Headache, dizziness, somnolence
126
Dolasetreon
| Drug class
Serotonin (5HT3) receptor antagonists
127
Dolasetron
| Mechanism
Blocks serotonin at 5HT3 receptor (in central CRTZ)
128
Dolasetron
| Uses
Anti-emetic
129
Dolasetron
| Side effects
Headache, dizziness, somnolence
