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PPNP drugs > Drugs to treat PUD > Flashcards

Drugs to treat PUD Flashcards

1
Q

Stomach wall cells secrete ______ to produce protective layer coating the surface of cells.

They also recruit _______ to _______

A

Stomach wall cells secrete mucus to produce protective layer coating the surface of cells.

They also recruit bicarbonate to buffer acidity

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2
Q

Prostaglandins promote:
1.
2.
3.

A
  1. Mucus secretion
  2. Bicarbonate secretion
  3. Blood flow
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3
Q

Can taking NSAIDs increase risk of damage to stomach?

A

yes

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4
Q

Parietal cells release

A

H+

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5
Q

Histamine activation of h2 receptors activates ______ to release H+

A

proton pumps

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6
Q

Agents that reduce gastric acidity/ neutralise acids

A
  • antacids
  • H2 receptor antagonists
  • PPIs
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7
Q

Antacids: they do NOT ___________, rather they ________

A

they do NOT prevent gastric acid production, rather they reduce gastric acidity

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8
Q

Rank most potent to least potent antacid

A
  1. Most: Sodium bicarbonate
    Calcium carbonate
    Mg OH
    Al OH
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9
Q

Liquid antacid or tablet is btr?

A

Liquid. Due to rate of dissolution

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10
Q

Some antacid preps contain _______ as an anti-foaming agent (ease release of gas)

A

simethicone

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11
Q

Adverse effects of antacids:

  1. Na+
  2. Ca++
  3. Carbonates & bicarbonates:
  4. Mg++
  5. Al++
A
  1. Na+: increase in Na in bloos and thus fluid retention, hypertension, CHF
  2. Ca++: hypercalcemia, rebound acid secretion
  3. Carbonates & bicarbonates: will produce CO2 gases which can lead to belging & flatulence
  4. Mg++: osmotic diarrhoea
  5. Al++: constipation
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12
Q

MOA of H2-receptor antagonists

A
  • competitive inhibitors of H2 receptors on parietal cells

- suppresses acid secretion by parietal cells

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13
Q

Efficacy of H2-receptor antagonists
Effective at:
Not effective at:

A

Effective at: inhibiting nocturnal acid secretion (due to histamine)

Not effective at: blocking secretion associated with meals

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14
Q

Rank most potent to least potent H2 receptor antagonist

A

Famotidine
Ranitidine
Cimetidine

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15
Q

Adverse effects of ___________
headache
nausea
dry mouth

rare:
tachycardia
blood dyscrasia
blurred vision
musculoskeletal pain
A

famotidine & ranitidine

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16
Q 
Adverse effects of \_\_\_\_\_\_\_\_\_\_\_
headache
nausea
diarrhoea
constipation
fatigue
mental confusion in critically ill pts
men: gynaecomastia, impotence
women: galactorrhea
A

cimetidine

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17
Q

Examples of PPIs

A

omeprazole

esomeprazole

18
Q

PPIs inhibit ________ in _____ cells

A

PPIs inhibit H+K+-ATPase (proton pumps) in parietal cells

19
Q

PPIs are reversible/irreversible

A

irreversible

20
Q

PPIs are ______ pro-drugs, hence _____ bioavailability; can/cannot absorb well

A

PPIs are inactive pro-drugs, hence good bioavailability; can absorb well

21
Q

PPIs are released and absorbed in _______

A

intestines

22
Q

PPIs are given during :

A

usually 1h before bfast; on empty stomach

23
Q

How many times of PPI is adminstered?

A

Once daily

24
Q 
Adverse effects of \_\_\_\_\_\_\_\_\_\_\_
headache
nausea
diarrhoea
flatulence
dizziness
rash
constipation
long term: osteoporosis

other concerns (bot not proven): gastric cancer, pneumonia, Fe deficiency, vit. B12 deficiency

A

PPIs

25
Q

Agents that protect gastric mucous

A
  • sulcrafate
  • bismuth compounds
  • misoprostol
26
Q

MOA of sucralfate

A

-vely charged sucrose sulphate binds postitively charged proteins at ulcer crater forming a viscous, tenacious gel that prevents further acid attack

stimulates mucosal prostaglandin & bicarbonate secretion

27
Q

Sucralfate are given during :

A

usually 1h before bfast; on empty stomach

28
Q

Adverse effects of sucralfate

A

constipation

impairs absorption of other drugs

29
Q

Bismuth compounds stimulate ______ & ______ secretion.

They also has direct anti-microbial activity against ________.

A

stimulate mucus &. bicarbonate secretion

against H.pylori

30
Q

Misoprostol is given how many times a day?

A

4 times daily

31
Q

Misoprostol is to prevent _____-induced peptic ulcers

A

NSAID

32
Q

  • low dose:
  • high dose:
A
  • binds to PGE2 receptors
  • low dose: increases mucus & bicarbonate secretion,, enhances mucosal blood flow
  • high dose: decreases acid secretion
33
Q 
Adverse effects of \_\_\_\_\_\_\_\_\_\_\_
abdominal pain
diarrhoea
abortion (uterine contraction)
bone pain & hyperostosis (excessive bone growth)
A

misoprotol

34
Q

Triple-therapy for H pylori eradication

A

clarithromycin +
amoxicillin / metronidazole +
PPI

35
Q

h pylori multiply best at pH

A

6-8 (alkaline)

36
Q

Antibiotics typically administered ____ a day.

A

2x a day

37
Q

Antibiotics are given during :

A

with or w/o food within 1 hr

38
Q

Do you need to complete the course of antibiotic?

A

YES

39
Q

Esomeprazole is better suited for pts with ____ than omeprazole.

A

NGT

40
Q

PPIs lower ___________ of antibiotics against H pylori

A

minimum inhibitory concentration (MIC) (aka make antibiotics more effective)

41
Q

PPI takes about _____ days to fully inhibit acid secretion

A

3-4 days

PPNP drugs (7 decks)

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