Dr. Lee Flashcards
5-ASA aka Mesalamine
- Anti-inflammatory
- for mild-moderate UC
Sulfasalazine
- Anti-inflammatory
- for mild-moderate UC or RA
- HYPERSENSITIVITY TO SULFAPYRADINE
- OLIGOSPERMIA
- impair folate absorption
Ciprofloxacin
- inhibits both DNA gyrase and topoisomerase -> inhibit bacterial DNA synthesis
- for mild-moderate Crohn’s
- QT PROLONGATION - Arrythmia
- TENDON RUPTURE
Metronidazole
- forms toxic free radical metabolites -> disrupt DNA structure and inhibit replication
- NOT used w/ disulfiram (for EtOH intolerance) -> psychotic rxn
- METALLIC TASTE
Prednisone
- MOA: reduces PMN migration and reduces cap permeability -> anti-inflammatory…also suppresses immune system by reducing activity of lymphatic system
- for mild-severe IBD (induction of remission in Crohn’s)
Budesonide
- MOA: control rate of protein synthesis; prevent PMN and fibroblast migration; reduce cap permeability and lysosomal stabilization -> anti-inflammatory
- INDUCES REMISSION IN UC or for Asthma
6-MP
- MOA: metabolites incorporate into DNA and halt replication -> block purine synthesis
- for mild-moderate IBD
- cause pancreatitis + hepatitis + bone marrow suppression
Azathioprine
- same as 6-MP
- increased risk for MALIGNANCY
Inflixamab
- MOA: chimeric monoclonal Ab -> binds TNF-a inhibiting receptor binding and cytokine release
- for moderate-severe UC (mainstay Tx)
- increase risk for INFECTION
Adalimumab
- MOA: recombinant monoclonal Ab
- moderate-severe UC
- increase risk for INFECTION + HEADACHE
Antacids
- neutralize acid and increase pH
- for acute Tx of acid reflux and esophagitis
- AE: belching, nausea, abdominal distention, flatulence (CO2 release)
Calcium carbonate
- antacid
- AE: HYPERCALCEMIA (milk-alkali syndrome)…ptxs with uremia; rebound acid secretion
Aluminum hydroxide
-RELAXES gastric muscle -> slows gastric emptying -> CONSTIPATION
Magnesium (Mg2+) hydroxyde
-STIMULATES gastric muscle -> speeds up gastric emptying -> DIARRHEA
H2 receptor Antagonists/blockers
- MOA: bind to H2 receptor on BASOLATERAL membrane of PARIETAL cells -> prevent histamine binding -> suppress acid secretion by 70% of basal and nocturnal
- competitive, reversible inhibitors
Cimetidine
- CYP450 inhibitor
- antiandrogen -> GYNECOMASTIA and GALACTORRHEA
Famotidine
-NOT used w/ renal insufficiency and prolonged QT
Nizatidine
-vit. B12 malabsorption
Proton Pump Inhibitors
- MOA: IRREVERSIBLE binds to and inhibits the H+/K+ ATP pump on the luminal side of the parietal cells
- AE: GI (nausea/diarrhea), headache, OSTEOPOROSIS related FRACTURES
- inhibit CYP2C19
Omeprazole
-drugs that induce CYP2C19 or 3A4 (St. John’s Warts or Rifampin) decrease the [] of omeprazole
- Esomeprazole -> no interaction w/ St. Johns or Rifampin
- Lanso-, Panto-, Rabeprazole -> no Clopidogrel interaction
Clarithromycin
- MOA: bind to 50S ribosomal subunit -> inhibit translocation
- for respiratory infections or H. pylori PUD
- inhbit CYP3A4 -> MANY drug interactions
- AE: GI, jaundice, ototoxicity, prolonged QT
Amoxicillin
- aminopenicillin
- MOA: inhibit cell wall transpeptidases -> prevent bacterial cell wall synthesis
- for H. pylori PUD
- cross blood-brain and used w/ B-lactamase inhibitors
- DIARRHEA w/ cluvalonic acid
Penicillin side effects
- Hypersensitivities
- Diarrhea
- Nephritis
- Neurotoxicity
- Hematologic toxicities
Metronidazole
- MOA: form free radicals
- for H. pylori PUD
- NOT used w/ disulfiram (EtOH intolerance) -> psychosis
- METALLIC TASTE
triple therapy for H. pylori
- PPI
- Clarithromycin
- Either Amoxicillin or Metronidazole
quadruple therapy for H. pylori
- PPI
- Bismuth subsalicylate
- Tetracycline
- Metronidazole
