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Pharma 2nd semester > A.38. Drugs used in peptic ulcer diseases. pharmacotherapy of peptic ulcer diseases. > Flashcards

A.38. Drugs used in peptic ulcer diseases. pharmacotherapy of peptic ulcer diseases. Flashcards

1
Q

what are Aluminum hydroxide and Magnesium oxide?

A

antacids

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2
Q

what is the function of antacids

A

weak bases that neutralize the stomach acid by reacting with protons in the lumen of the gut

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3
Q

where is Aluminum hydroxide and Magnesium hydroxide absorbed from?

A

poorly absorbed from the bowel

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4
Q

how is aluminum hydroxide and Magnesium hydroxide given?

A

orally

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5
Q

what are the side effects of aluminum hydroxide (Al[OH]₃)?

A

constipation

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6
Q

what are the indications for giving Aluminum hydroxide and Magnesium hydroxide?

A

symptomatic relief of dyspepsia and heartburn

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7
Q

what is Famotidine?

A

H₂-receptor antagonist

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8
Q

how is famotidine and cimetidine given?

A

oral, parenteral

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9
Q

what is the duration of action of famotidine?

A

12-24 hours

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10
Q

are H₂-receptor antagonists (famotidine) inhibitors of cytochrome P450 enzymes?

A

yes

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11
Q

what is the function of H₂-receptor antagonists?

A

competitive inhibitors of H₂-receptors–> indirect effect on proton pump activity –> ↓ gastric acid secretion (mainly nocturnal)

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12
Q

which agents have a greater acid-suppressing effect- H₂-receptor antagonists or PPI’s?

A

PPI’s

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13
Q

what are the indications for giving famotidine and PPI’s??

A 
GERD
Peptic ulcer disease (PUD)
H.pylori associated ulcers 
NSAID'S induced ulcers 
Zollinger Ellison syndrome
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14
Q

side effects of H₂-receptor antagonists

A

**famotidine has milder SE than cimetidine

GI distress
confusion, agitation (in elderly)
weak antiandrogenic effects (cimetidine)

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15
Q

What is omeprazole or Pantoprazole?

A

proton pump inhibitors (PPI’s)

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16
Q

what is the function of PPI’s?

A

irreversible, direct inhibitors of a proton pump (K⁺/H⁺ antiport) in gastric parietal cells

17
Q

what are the 1st line agents for reducing stomach acidity?

A

PPI’s

18
Q

how is omeprazole given?

A

orally

should be administered on an empty stomach

19
Q

how is pantoprazole given?

A

IV

20
Q

what is the T1/2 of PPI’s?

A

1-2 hours
the acid-suppressing effect lasts up to 24 hours
full acid-suppressing is reached within 3-4 days

21
Q

what effect does omeprazole have on Clopidogrel?

A

omeprazole is an inhibitor of cytochrome P450 enzymes

↓ the antiplatelet effect of clopidogrel

22
Q

what are the SE of PPI’s?

A

diarrhea, abdominal pain
headaches
↓ oral bioavailability of vitamin B12, iron, digoxin, and ketoconazole
↑ risk of respiratory and enteric infections
hypergastrinemia (ECL and parietal cells hyperplasia)

23
Q

how do PPI’s cause hypergastrinemia?

A

there’s a loss of negative feedback of H⁺ on D-cells

24
Q

what are Sucralfate and Misoprostol?

A

mucosal protective agents

25
Q

what is Sucralfate and what’s it’s function?

A

Aluminium sucrose sulphate

  1. polymerizes on the GI luminal surfaces to form a protective gel-like coating of ulcer beds
  2. enhances PGE synthesis
  3. stimulates mucus and bicarbonate secretion
  4. enhances mucosal defense and repair
26
Q

how are Sucralfate and Misoprostol given and how many times are they administered daily?

A

orally

4 times daily

27
Q

what does sucralfate require for activation?

A

acidic pH

It’s a prodrug

28
Q

what does sucralfate do?

A

improve healing after mucosal damage

prevent reoccurrence

29
Q

side effect of sucralfate

A

constipation

30
Q

what is Misoprostol

A

Prostaglandin (PGE₁) analogue

31
Q

what is the function of Misoprostol?

A

mucus and bicarbonate secretion ↑
HCl secretion ↓
mucosal vascularity and blood flow ↑

32
Q

when do we give Misoprostol?

A

NSAID’S induced ulcers (also prophylaxis)

33
Q

when is Misoprostol CI?

A

in pregnancy (abortifacient)

34
Q

a side effect of misoprostol

A

diarrhea

35
Q

misoprostol and Diclofenac are combined to treat..

A

arthritis pain, in patients with high-risk GI bleeding/ulceration

36
Q

what is the #1 triple therapy for H.pylori

A

‘BMT regimen’
Bismuth subsalicylate
Metronidazole
Tetracycline

37
Q

what is the #2 triple therapy for H.pylori

A

Ranitidine bismuth citrate
Tetracycline
clarithromycin or Metronidazole

38
Q

what is the #3 triple therapy for H.pylori

A

Omeprazole
clarithromycin
amoxicillin or metronidazole

39
Q

what is the Quadruple therapy for H.pylori

A 
"BOMT"
Bismuth subsalicylate 
Omeprazole
Metronidazole 
Tetracycline

Pharma 2nd semester (49 decks)

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