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Pharmacology II > Chapter 28 Gastrointestinal > Flashcards

Chapter 28 Gastrointestinal Flashcards

1
Q

Cimeditine (Tagamet)

A
  • H2 receptor antagonist
  • compete with histamine for H2 receptors on gastric parietal cells
  • inhibit meal stimulated and basal secretion
  • treat dyspepsia, PUD, GERD
  • less preferred to PPI due to slow healing rates
  • ADE: gynecomastia, inhibit many CYP
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2
Q

Famotidine (Pepcid)

A
  • H2 receptor antagonist
  • compete with histamine for H2 receptors on gastric parietal cells
  • inhibit meal stimulated and basal secretion
  • treat dyspepsia, PUD, GERD
  • less preferred to PPI due to slow healing rates
  • ADE: remarkably nontoxic
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3
Q

Nizatidine (Axid)

A
  • H2 receptor antagonist
  • compete with histamine for H2 receptors on gastric parietal cells
  • inhibit meal stimulated and basal secretion
  • treat dyspepsia, PUD, GERD
  • less preferred to PPI due to slow healing rates
  • ADE: remarkably nontoxic
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4
Q

Esomeprazole (Nexium)

A
  • proton pump inhibitor
  • bind to and antagonize proton pump (H+ K+ ATPase)
  • dose dependent inhibition of 95% acid secretion for 1-2 days
  • heal 80-90% of PUD in 2 wks with antibiotic combo
  • treat zollinger-ellison syndrome (gastrinoma), GERD, dyspepsia
  • ADE: minor GI/CNS, skin rash, increase LFT, hypomagnesemia
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5
Q

Omeprazole (Prilosec)

A
  • proton pump inhibitor
  • bind to and antagonize proton pump (H+ K+ ATPase)
  • dose dependent inhibition of 95% acid secretion for 1-2 days
  • heal 80-90% of PUD in 2 wks with antibiotic combo
  • treat zollinger-ellison syndrome (gastrinoma), GERD, dyspepsia
  • ADE: minor GI/CNS, skin rash, increase LFT, hypomagnesemia
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6
Q

Pantoprazole (Protonix)

A
  • proton pump inhibitor
  • bind to and antagonize proton pump (H+ K+ ATPase)
  • dose dependent inhibition of 95% acid secretion for 1-2 days
  • heal 80-90% of PUD in 2 wks with antibiotic combo
  • treat zollinger-ellison syndrome (gastrinoma), GERD, dyspepsia
  • ADE: minor GI/CNS, skin rash, increase LFT, hypomagnesemia
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7
Q

Rabeprazole (Aciphex)

A
  • proton pump inhibitor
  • bind to and antagonize proton pump (H+ K+ ATPase)
  • dose dependent inhibition of 95% acid secretion for 1-2 days
  • heal 80-90% of PUD in 2 wks with antibiotic combo
  • treat zollinger-ellison syndrome (gastrinoma), GERD, dyspepsia
  • ADE: minor GI/CNS, skin rash, increase LFT, hypomagnesemia
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8
Q

Lansoprazole (Prevacid)

A
  • proton pump inhibitor
  • bind to and antagonize proton pump (H+ K+ ATPase)
  • dose dependent inhibition of 95% acid secretion for 1-2 days
  • heal 80-90% of PUD in 2 wks with antibiotic combo
  • treat zollinger-ellison syndrome (gastrinoma), GERD, dyspepsia
  • ADE: minor GI/CNS, skin rash, increase LFT, hypomagnesemia
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9
Q

Dexlansoprazole (Dexvant)

A
  • proton pump inhibitor
  • bind to and antagonize proton pump (H+ K+ ATPase)
  • dose dependent inhibition of 95% acid secretion for 1-2 days
  • heal 80-90% of PUD in 2 wks with antibiotic combo
  • treat zollinger-ellison syndrome (gastrinoma), GERD, dyspepsia
  • ADE: minor GI/CNS, skin rash, increase LFT, hypomagnesemia
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10
Q

Sucralfate (Carafate)

A
  • cytoprotective for PUD
  • adheres to ulcer crater and creates protective barrier
  • stimulates PG synthesis in mucosal cells
  • caution in renal insufficiency
  • ADE: impair absorption other drugs (separate by 2 hours)
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11
Q

Misoprostol (Cytotec)

A
  • cytoprotective for PUD
  • inhibits gastric acid secretion
  • promotes secretion of mucus and bicarbonate
  • prevents NSAID induced ulcers
  • reserved for high risk (elderly or PUD Hx)
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12
Q

H. Pylori Regimen

A
  • PPI and 2 or more antimicrobials

- amoxicillin, clarithromycin, bismuth subsalicylate, metronidazole, tetracycline

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13
Q

Hydrocortisone / Prednisone

A
  • glucocorticoids
  • treat both UC and Crohn’s
  • induce remission but less effective in retaining
  • systemic ADE
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14
Q

Sulfasalazine / Mesalamine

A
  • aminosalicylates
  • induce remission in UC
  • less effective in Crohn’s
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15
Q

Infliximab / Azathioprine / Cyclosporine

A
  • immunomodulators

- UC / Crohn’s

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16
Q

Metoclopramide (Reglan)

A
  • Prokinetic and blocks D2 / 5-HT3 receptors
  • accelerates gastric emptying
  • treats GERD, diabetic gastroparesis, intractable hiccups, constipation, antiemetic
  • ADE: drowsiness, EPSE, seizure, diarrhea, hematologic toxicity, hyperprolactinemia
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17
Q

Metamucil

A
  • bulk forming laxative
  • mechanically distends intestinal wall to stimulate peristalsis
  • must be taken with full glass of water
  • safest and preferred for chronic constipation
  • can mitigate diarrhea
18
Q

Docusate Sodium (Colace)

A
  • surfactant laxative (stool softener)
  • few adverse effects
  • reduce straining
19
Q

Docusate calcium (Surfak)

A
  • surfactant laxative (stool softener)
  • few adverse effects
  • reduce straining
20
Q

Magnesium oxide

A
  • osmotic laxative
  • increases water retainment to increase peristalsis
  • excessive use causes fluid and electrolyte loss
  • systemic absorption dangerous in renal failure
21
Q

Saline laxative

A
  • osmotic laxative
  • acts rapidly
  • increases water retainment to increase peristalsis
  • excessive use causes fluid and electrolyte loss
  • systemic absorption dangerous in renal failure
22
Q

Sodium Phosphate (Fleet’s Phospa-soda)

A
  • osmotic laxative
  • used to evacuate bowel for surgery or diagnostic study
  • increases water retainment to increase peristalsis
  • excessive use causes fluid and electrolyte loss
  • systemic absorption dangerous in renal failure
23
Q

Magnesium Citrate

A
  • osmotic laxative
  • increases water retainment to increase peristalsis
  • excessive use causes fluid and electrolyte loss
  • systemic absorption dangerous in renal failure
24
Q

Bisacodyl / Senna / Cascara

A
  • stimulant laxative

- can cause significant cramping, electrolyte and fluid depletion

25
Q

Linaclotide (Linzess)

A
  • Guanylate Cyclase-C Receptor Agonists
  • Rx only for severe chronic idiopathic constipation
  • once daily dosing
26
Q

Plecanatide (Trulance)

A
  • Guanylate Cyclase-C Receptor Agonists
  • Rx only for severe chronic idiopathic constipation
  • once daily dosing
27
Q

Lubiprostone (Amitiza)

A
  • locally acting chloride channel activator
  • indicated for opioid induced constipation
  • twice daily dosing
28
Q

Prucalopride (Motegrity)

A
  • 5-HT4 receptor agonist
  • stimulates peristaltic reflex
  • may be teratogenic
  • label warns worsening depression and SI
29
Q

Atropine / Hycoscyamine / Dicyclomine / Scopolamine

A

-antispasmodic (anticholinergic) for diarrhea

30
Q

Alosetron (Lotrenex)

A
  • 5-HT3 receptor antagonist
  • used in IBS for women with predominant symptom of diarrhea
  • can cause ischemic colitis which may require transfusion/surgery
  • restricted to failure of conventional antidiarrheal
31
Q

Diphenoxylate (Lomotil)

A
  • opioid
  • schedule V
  • control diarrhea of almost any cause
32
Q

Loperamide (Imodium)

A
  • opioid
  • OTC
  • control diarrhea of almost any cause
33
Q

Ondansetron (Zofran)

A
  • 5-HT3 receptor antagonist
  • blocks receptors on visceral afferent nerves of GI tract, solitary nucleus, and CTZ
  • ADE: QT prolong and chemotherapy doses, headache, constipation, diarrhea, anaphylaxis, increase LFT
34
Q

Granisetron (Kytril)

A
  • 5-HT3 receptor antagonist
  • blocks receptors on visceral afferent nerves of GI tract, solitary nucleus, and CTZ
  • ADE: headache, constipation, diarrhea, anaphylaxis, increase LFT
35
Q

Palonesetron (Aloxi)

A
  • 5-HT3 receptor antagonist
  • blocks receptors on visceral afferent nerves of GI tract, solitary nucleus, and CTZ
  • ADE: headache, constipation, diarrhea, anaphylaxis, increase LFT
36
Q

Dolasetron (Anzemet)

A
  • 5-HT3 receptor antagonist
  • blocks receptors on visceral afferent nerves of GI tract, solitary nucleus, and CTZ
  • common in cancer centers
  • ADE: headache, constipation, diarrhea, anaphylaxis, increase LFT
37
Q

Metoclopramide (Reglan)

A
  • D2 receptor antagonist
  • acts primarily at the CTZ
  • antiemetic, antipsychotic, anticholinergic, antihistamine, sedative
38
Q

Prochlorperazine (Compazine)

A
  • D2 receptor antagonist
  • acts primarily at the CTZ
  • antiemetic, antipsychotic, anticholinergic, antihistamine, sedative
39
Q

Promethazine (Phenergan)

A
  • D2 receptor antagonist
  • acts primarily at the CTZ
  • antiemetic, antipsychotic, anticholinergic, antihistamine, sedative
40
Q

Aprepitant (Emend)

A
  • Neurokinin-1 receptor antagonist

- Combined with 5-HT3 antagonists and dexamethasone for highly emetogenic chemotherapy

41
Q

Dimenhydrinate / Meclizine

A

-antiemetic for motion sickness

Pharmacology II (19 decks)

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