Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gastro > Drugs for peptic ulcer disease > Flashcards

Drugs for peptic ulcer disease Flashcards

1
Q

Rank potency of gastric drugs from highest to lowest

A
  1. Proton pump inhibitors
  2. H2 receptor antagonist
  3. Antacids - neutralise acidity with base
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of antacids

A

NaHCO3
CaCO3
Mg(OH)2
Al(OH)3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Antacids MOA

A
  • weak base, neutralise gastric acid
  • reduce gastric acidity, DOES NOT prevent gastric acid production

potency
- NaHCO3 > CaCO3 > Mg(OH)2 > Al(OH)3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indication for antacid

A
  • non prescription remedy for HEART BURN, DYSPEPSIA
  • large, frequent doses required
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why do some antacids contain simethicone

A

simethicone: anti-foaming agent
- ease release of gas (CO2) within GI tract via burping/ flatulence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Na+, Ca2+ antacids adverse effects

A
  • Na+ antacids: fluid retention, hypertension, CHF
  • Ca2+ antacids: hypercalcemia, rebound acid secretion (after discontinuing medicine)

common to both:
- metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

HCO3-, CO3- antacids adverse effects

A
  • belching, flatulence from CO2 gas formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mg2+, Al3+ antacids adverse effects

A
  • Mg2+ antacids: osmotic diarrhoea
  • Al3+ antacids: constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

antacids contraindication

A
  • avoid LT use in RENAL INSUFFICIENCY
  • do not take within 2 HOURS of other medication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

H2 receptor antagonist examples

A

FAMOTIDINE (most potent), ranitidine, cimetidine (least potent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

H2 receptor antagonists MOA

A
  • competitive inhibitor of H2 receptors, suppress acid secretion by PARIETAL cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

H2 receptor antagonist efficacy

A
  • inhibit 60-70% of total gastric acid secretion
  • inhibit NOCTURNAL acid secretion
  • little effect on meal induced acid secretion (meals trigger acid secretion from other mediators - gastrin, AChE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when is the most appropriate time to take famotidine

A
  • at night before sleeping -> inhibit NOCTURNAL acid secretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

therapeutic index of H2 antagonists

A
  • high therapeutic index -> relatively safe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

H2 antagonists adverse effects

A

famotidine & ranitidine:
- headache, nausea, dry mouth
- (RARE, severe): tachycardia, blood dyscrasia, blurred vision, musculoskeletal pain

cimetidine:
- headache, nausea, diarrhea
- ANTI ANDROGENIC -> gynaecomastia (men); galactorrhoea (women)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PPI (proton pump inhibitor) examples

A

Omeprazole, Esomeprazole (S-isomer of omeprazole)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

omeprazole MOA

A
  • inhibit H+/K+/ATPase (proton pump) in PARIETAL cells
  • IRREVERSIBLE block
  • some antimicrobial activity (against H pylori, but insufficient)
18
Q

why do PPI contain enteric coating

A
  • protect against activation by stomach acidity before absorption (active drug very poorly absorbed)
19
Q

how is PPI activated

A
  • enteric coating protects drug from stomach -> prodrug is released and absorbed in small intestines
  • prodrug has good bioavailability in blood -> eventually enters PARIETAL CELL CANALICULUS -> protonated & activated
  • drug forms IRREVERSIBLE covalent disulfide bonds with proton pump in parietal cell
20
Q

can PPI be taken with food?

A

NO. bioavailability is decreased 50% by food
- give on EMPTY stomach (usually 1 hr before breakfast)

21
Q

Why must meals be taken 1 hour after PPI (and not longer?)

A
  • PPIs inhibit active pumps (not resting pumps) -> pumps active when food is present in stomach
  • PPIs have SHORT t1/2 (1-2hr) -> must give food soon after ingestion so PPI is still present in bloodstream to take effect
22
Q

PPI dosage

A

irreversible blockage -> 24hours block -> ONCE DAILY

23
Q

PPI adverse effects

A
  • headache, nausea, flatulence, diarrhoea, dizziness, rash
  • increase risk of C. difficile infection
  • hypomagnesemia

(RARE): acute interstitial nephritis, chronic kidney disease, SLE

24
Q

Gastric mucosal protection drug examples

A
  • Sucralfate
  • Bismuth compounds
  • Misoprostol
25
gastric mucosal protection drug indications
- PREEXISTING peptic ulcers (cannot be treated by gastric acid secretion drugs)
26
sucralfate MOA
- Negatively charged sucrose sulphate binds to positively charged proteins at ulcer crater forming a viscous, tenacious gel -> prevents further acid attack – Stimulates mucosal PG -> increase bicarbonate and mucus secretion
27
sucralfate systemic effects
- highly insoluble -> NO systemic effects
28
how is sucralfate administered
- on empty stomach (1hr before food) -> prevent binding to +ve charges on food
29
sucralfate adverse effects
- constipation (contain Al(OH)3) - impair absorption of other drugs
30
bismuth compounds MOA
- forms a protective layer protecting ulcers from acid and pepsin – stimulates mucus and bicarbonate secretion – directly anti-microbial activity against H. pylori
31
bismuth compounds adverse effects
- harmless blackening of stool, reversible blackening of tongue - ONLY short term use (prolonged use -> bismuth toxicity, encephlopathy) - AVOID in renal insufficiency
32
Misoprostol MOA
- PGE1 analogue (mimic endogenous PG) - Binds to PGE2 receptors (EP1-4) – Low dose (cytoprotective): promotes bicarbonate and mucus secretion, enhances mucosal blood flow – High dose (antisecretory): inhibits gastric acid secretion
33
Indications of misoprostol
- prevent NSAID induced peptic ulcers
34
Misoprostol adverse effects
- Abdominal pain – Diarrhoea – Abortion (uterine contraction) – Bone pain and hyperostosis (excessive bone growth)
35
what is the triple therapy for H pylori infection
- clarithromycin - amoxicillin or metronidazole - PPI (omeprazole/ esomeprazole) (2 antibiotics + 1 PPI), 7-14 days
36
why are 2 antibiotics used in triple therapy against H pylori
- H pylori becomes resistant to metronidazole & clarithromycin when given alone
37
PPI MOA in triple therapy
- increase gastric acid pH (H pylori multiplies better at higher pH) - antibiotics work best when H pylori is MULTIPLYING after completion of triple therapy, PPI is continued to ensure complete healing: – 4-8 weeks for duodenal ulcers – 8-12 weeks for gastric ulcers
38
administration of antibiotic in triple therapy
- twice a day - with/ after food within 1 hour (reduce GI effects)
39
administration of PPI
- twice a day - after 2 hours fasting, + 30min-1hr before food
40
second line quadruple therapy drugs
– 1 Bismuth + 2 antibiotics + 1 PPI or H2 antagonist (10-14 days

Gastro (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions