Anti-ulcer Flashcards
H2 Receptor antagonists
- end with “tidine”
- reversibly inhibit H2 receptors on basolateral membrane of parietal cell
- Reduces acid secretion
Cimetidine
-H2 receptor antagonist
-decreases testosterone binding to androgen receptor and can cause:
–Gynecomastia in men
–Galactorrhea in women
-INHIBITOR of CYP450 enzymes
Ranitidine
- H2 receptor antagonist
- preferred for pregnant pts
Famotidine
-H2 receptor antagonist
Nizatidine
- H2 receptor antagonist
- oral only!
Proton Pump Inhibitors
PPIs
- end with “prazole”
- Block H+, K+ ATPase on parietal cells
- Reduces acid secretion
- Risk of CDAD (C. diff associated diarrhea)
- Associated with kidney dz, osteoprosis, MI
Omeprazole
- PPI
- oral only!
- INHIBITOR of CYP450
Esomeprazole
- PPI
- isomer of omeprazole
Lansoprazole
- PPI
- oral only!
- preferred for pregnant pts
Dexlansoprazole
- PPI
- oral only!
Pantoprazole
-PPI
Rabeprazole
- PPI
- oral only!
Sucralfate
- sulfated sucrose with Al(OH)3
- creates viscous polymer that adheres to epithelial cells around ulcer (keeps acid out)
- may stimulate prostaglandins, mucous production, and epidermal GF
- many off-label uses
- causes constipation
- can’t be used with renal failure
- can reduce other drug absorption
Misoprostol
- Prostaglandin E1 analog
- increases mucous production, decreases acid secretion
- prevents NSAID-induced gastric ulceration
- contraindicated in pregnancy and IBD
Bismuth salicylate
OTC: reflux, indigestion, diarrhea
Rx: combined with antibiotics to treat H. pylori
-constipation, and dark stools
-don’t combine with antiplatelet/anticoagulant
-contraindicated in severe renal failure and GI bleeding
