Drugs for acid related disorders 2 Flashcards
The 1st line treatment of heartburn and reflux
Gaviscon
MoA of Alginates (Alginic acid): Gaviscon
Gaviscon
* 1st line for heartburn & reflux
* MoA: contact with gastric acid = precipitation – sponge-like matrix that floats on top of stomach contents
Combination with antacids
Gelacid
When to take Gelacid
Take after each meal and before bedtime
Is Gelacid safe for pregnancy and lactation
yes
GI for gelacid
Patient on salt-restricted diets
MoA od H2 antagonist
MoA: Reduce gastric acid andnpepsin secretion by blocking the action of histamine at the H2- receptors in the parietal cells of the stomach
Drug interation for H2 antagonists
Drug interactions:
Inhibits hepatic microsomal enzymes (cytochrome P450) and has the potential for multiple drug interactions
Adverse effects for H2 antagonists
Adverse effects:
Headache, confusion, dizziness, diarrhoea, myalgia, skin rashes
Explain the dosage of H2 antagonists and their intended aim
Cimetidine (Intended for short-term relief of heartburn, dyspepsia and hyperacidity, max 200mg/dose & 800mg/day for max 14 days)
Lenamet®
Ranitidine (Intended for short-term relief of heartburn, dyspepsia and hyperacidity, max 75mg/dose & 300mg/day for max 14 days)
Zantac
Explain the dosage of proton pump inhibitors and their intended aim
Lansoprazole (Intended for short-term relief of heartburn, dyspepsia and hyperacidity, max 15mg/day for max 14 days)
Lanzor
Lansoloc OTC®
Pantoprazole (Intended for short-term relief of heartburn, dyspepsia and hyperacidity, max 20mg/day for max 14 days)
Pantoloc®
Topzole®
MoA of Proton pump inhibitors
Most potent suppressors of gastric acid secretion
Mechanism of action:
Inhibiting the H+/K+-ATPase enzyme of the gastric parietal cells.
Indications for Proton pump inhibitors
Indications:
* Short term management of PUD and GORD
* Long term prevention of relapse of GORD
* H. pylori eradication in combination with antibiotics
* Treatment of Zollinger-Ellison syndrome
* Treatment and prevention of NSAID-associated erosions and ulcers
* Omeprazole: children with severe ulcerative reflux oesophagitis
RoA for proton pump inhibitors
IV or Oral
DI for proton pump inhibitors
Drug interactions:
* Absorption of other drugs due to increased pH
* Agents metabolised in the liver via cytochrome P450 enzyme system
Common adverse effects for proton pump inhibitors
Common adverse effects:
diarrhoea, constipation, vomiting, flatulence, headache, vertigo, abdominal discomfort.
Mask symptoms of gastric cancer
List the proton pump inhibitors long term adverse effects
Consistent increased pH in stomach lead to reduced vitamin and mineral absorption:
* Iron (anaemia)
* Calcium (osteoporosis)
* Magnesium (muscle spasms)
* Vitamin B12 (anaemia)
Infections due to bacterial proliferation:
* C. diff infection
* Community acquired pneumonia
Alteration in pH-dependent drug
pharmacokinetics
CKD
Dementia
List other GORD drugs
Domperidone and metoclopramide
Sucralfate
Bismuth subcitrate
Explain what does Demperidone and metoclopramide do?
Domperidone & metoclopramide- facilitate gastric emptying (prokinetics) and increase gastrooesophageal tone, antiemetics. Used when other measures fail
Explain what sucralfate do?
Sucralfate:
* cytoprotective, forms a vicious paste & adheres to the base of the ulcer
* Requires strict and frequent admin
* Requires acid environment, take 1 hr before meals & before bedtime
* Constipation
Explain what does bismuth subcitrate do?
Bismuth subcitrate:
* has high affinity for damaged tissue
* forms a protective coating at the base of the ulcer
* Black discoloration of stool
