antacids and anti-ulcer tx Flashcards
low systemic antacids
aluminum salts
calcium salts
magnesium salts
high systemic antacids
sodium salts
MOA of antacids
combine with H+ to produce - H20 -CO2 -chloride salts increase LES tone rebound acid production possible
Calcium carbonate
rapid onset long DOA very good acid neutralizing adverse effects -constipation -hypercalcemia causing nephropathy and met alk - hypophosphatemia -calcium kidney stones
Aluminum hydroxide
slow onset short DOA fair/weak acid neutralizing adverse effects: - constipation -hypophosphatemia -renal osteodystrophy -encephalopathy
Magnesium hydroxide/carbonate/trisilicate
Rapid onset long DOA good acid neutralizing adverse effects - diarrhea (stool softener) - hypermagnesemia
Sodium bicarbonate
rapid onset short DOA fair/good acid neutralizing adverse effects: - gas (bicarb burp) - hypernatremia -met alk
simethicone
surfactant that aids in expulsion of gas
H2 antagonists
Cimetidine
famotidine
nizatidine
ranitidine (zantac)
PPI’s
lansoprazole dexlansoprazole omeprazole esomeprazole pantoprazole rabeprazole
surface acting agent
sucralfate
contraindicated in renal failure (contains aluminum)
-avoid aluminum antacids
PGE1 analog
misoprostol increases mucosal defense used for NSAID induced ulcers pregnancy termination post-pardum hemorrhaging IBD exacerbations
bismuth compound
bismuth subsalicylate
antimicrobial
antidiarrheal
used in combo with abx for Hpylori
lots of drug interactions
contraindicated in severe renal failure and coagulopathies (salicylate)
absolute contraindicated in GI bleeds and salicylate hypersensitivity
H2 antagonists adverse effects
N/V diarrhea, constipation
gynecomastia in men
galactorrhea in women
blood dyscrasias (neutropenia, thrombocytopenia)
LOTS of drug interactions due to inhibition of CYP(much less so with ranitidine)
contraindicated in pregnancy
PPI adverse effects
diarrhea, nausea C diff headache, dizziness rare- myopathies, fatigue associations with increases HR: - kidney disease - bone fractures - MI Omeprazole is inhibitor of CYP - many drug interactions contraindicated in pregnancy (can use lansoprazole)
