Common drugs in GORD/PUD Flashcards

1
Q

What are the main receptors associated with a parietal cell?

A

Proton pump

H2 receptor

M3 receptor

CCK2 receptor

Prostaglandin receptor

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2
Q

List four protective substances in the stomach

A

Mucus

Bicarbonate

Prostaglandins

Mucosal blood flow

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3
Q

List four aggressive substances in the stomach

A

Acid

Pepsins

NSAIDs

H. pylori

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4
Q

What is the role of antacids?

A

To neutralise acid produced in the stomach

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5
Q

What is the role of alginates?

A

Increase viscosity of stomach content

Some form a “raft” to reduce symptoms of reflux

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6
Q

Give examples of antacids

A

Sodium Bicarbonate

Magnesium and Aluminium salts

Gaviscon

Rennie

Simeticone

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7
Q

Give an example of an alginate

A

Sodium alginate

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8
Q

What is the side effect of aluminium?

A

Constipation

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9
Q

What is the side of effect of magnesium?

A

Diarrhoea

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10
Q

What do alginates and antacids interact with?

A

Some antibiotics , i.e. coprofloxacin, tetracycline

Enteric coated preperations

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11
Q

What is the mechanism of action of sulcralfate?

A

Protect damaged mucosa by stimulating local production of prostaglandins and bicarbonate

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12
Q

What are the infications of sucralfate?

A

Treatment of peptic ulceration

Prophylaxis of stress ulceration

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13
Q

What are the side effects of sucralfate?

A

Constipation

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14
Q

What does sucralfate interact with?

A

Enteral feeds - “bezoar” formation

Digoxin, antibiotics, phenytoin - reduced absorption

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15
Q

What is the mechanism of action of misoprostol?

A

Prostaglandin analoge, i.e. prostaglandin receptor agonist

used in combination with NSAID, e.g. arthrotec

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16
Q

What are the side effects of misoprostol?

A

Diarrhoea and abdominal pain

17
Q

What are the contraindications of misoprostol?

A

Pregnant women / Women of child-bearing age

18
Q

Give examples of gastric stimulants

A

Domperidone

Metoclopramide

19
Q

What is the mechanism of action of gastric stimulants?

A

Increases peristalisis in duodenum and jejunum, thought to be due to stimulation of muscarinic receptors in GIT

20
Q

Give examples of H2-receptor antagonists

A

Ranitidine

Nizatidine

Famotidine

Cimetidine

21
Q

What are H2-receptor antagonists mechanism of action?

A

Reversibly and competitively bind to H2-receptor

  • suppresses gastric acid secretion
  • inhibits gastrin and ACh-mediated acid secretion
22
Q

What are the indications of H2-receptor antagonists?

A

PUD
GORD symptoms

HIgh dose in ZE syndrome

23
Q

How are H2-receptor antagonists excreted?

A

Renal and hepatic excretion

- important to know in case of renal/hepatic impairment

24
Q

What are the side effects of H2-receptor antagonists?

A

Diarrhoea/constipation
Headache
Confusion
Hallucinations

25
Q

How does Cimetidine affect the cytochrome-p450 system?

A

Inhibits it

26
Q

Give examples of PPIs?

A

Omeprazole

Lanzaprazole

Pantoprazole

Esomeprazole

27
Q

What are the indications of PPI?

A

PUD

Prevention and treatment of NSAID induced ulceration

Eradication of H.pylori (with Abx)

Severe GORD symptoms

Oesophagitis

ZE syndrome

Prevention of stress ulceration in critical care patients

28
Q

What are the side effects of PPI?

A

No obvious ones

Rare: rash, headache, diarrhoea, nausea

29
Q

List any interactions of PPIs?

A

Omeprazole with clopidogrel

30
Q

What are some of the functions of prostaglandins?

A

Protection of gastric mucosa

Platelet function

Pain, inflamamtion and fever

Renal homeostasis