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Pharmacology > Drugs Used in Peptic Ulcer Disease > Flashcards

Drugs Used in Peptic Ulcer Disease Flashcards

1
Q

MOA of Antacids

A

react w/ protons in the lumen of the gut

neutralizes the produced acids

(+) mucosal prostaglandin production

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2
Q

ANTACIDS

A

Magnesium Hydroxide
Aluminum Hydroxide
Sodium Bicarbonate
Calcium Carbonate

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3
Q

Measures POTENCY of antacids

A

ACID NEUTRALIZING CAPACITY

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4
Q

pH goal for healing ulcer

A

pH - 3

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5
Q

pH goal for stress ulcer

A

pH - 4

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6
Q

pH goal for bleeding ulcer

A

pH - 6

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7
Q

Adverse effects of Sodium Bicarbonate

A

belching - HCO3 –> CO2
worsens HPN
milk alkali syndrome - metabolic alkalosis

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8
Q

Adverse effects of Calcium Carbonate

A

belching
hypercalcemia
nephrolithiasis

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9
Q

Adverse effects of Aluminum Hydroxide

A

ALang tae

constipation

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10
Q

Adverse effects of Magnesium Hydroxide

A

MAGtatae

diarrhea

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11
Q

MOA of H2 ANTAGONISTS

A

(-) basal acid production

(-) prandial acid release

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12
Q

H2 ANTAGONISTS

A

Cimetidine
Ranitidine
Famotidine
Nizatidine

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13
Q

H2 antagonists w/ THIAZOLE ring

oral but w/ almost 100%

A

FAMOTIDINE

NIZATIDINE

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14
Q

H2 antagonist w/ FURAN ring

A

RANITIDINE

mostly used

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15
Q

H2 antagonist w/ IMIDAZOLE ring

A

CIMETIDINE

1st H2 blockers

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16
Q

H2 antagonist that can cause endocrine side effects (alopecia, loss of libido, impotence, irregular menstruation)

A

CIMETIDINE

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17
Q

MOA of Proton Pump Inhibitors (PPI)

A

IRREVERSIBLY (-) H K ATPase pump

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18
Q

Proton Pump Inhibitors (PPIs)

fast acting and long duration - once a day dosing

ENTERIC COATED

A 
Omeprazole
Esomeprazole
Lansoprazole
Pantoprazole
Rabeprazole
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19
Q

All PPIs are renally excreted EXCEPT

A

Lansoprazole - biliary excretion

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20
Q

MOA of MISOPROSTOL

A

Prostaglandin Analog

INC MUCUS/HCO3

uterine contraction
abortifacient

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21
Q

MOA of SUCRALFATE

A

sucrose complex w/ sulfated aluminum hydroxide

binds to injured tissue and forms a protective covering over ulcer beds

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22
Q

Side effects of SUCRALFATE

A

constipation

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23
Q

MOA of BISMUTH SALICYLATE

A

Slurry prep

Coats the mucosa

24
Q

Mucosal protectant w/ ANTIMICROBIAL EFFECTS

A

BISMUTH SALICYLATE

25
Side effects of BISMUTH SALICYLATE
ASA hypersensitivity BLACK STOOLS DARKENING of TONGUE ENCEPHALOPATHY - ataxia, headaches, confusion, seizures
26
PROMOTE GASTRIC MOTILITY
GAM gastrin Ach motilin
27
INHIBIT GASTRIC MOTILITY
Dopamine Di gagalaw
28
Cholinergic Agonists (PARA)
DIRECT Pilocarpine Betanechol INDIRECT Neostigmine
29
D2 Antagonists
METOCLOPRAMIDE crosses BBB; antiemetic for gastroparesis DOMPERIDONE does NOT cross BBB for (+) of postpartum lactation and gastroparesis
30
Side effects of Metoclopramide
extrapyramidal symptoms (EPS) endocrine side effects - dopamine - D2 antagonists --> DEC DOPA --> INC prolactin galactorrhea
31
Motilin Stimulator promotes MOTILIN release
MACROLIDE ERYTHROMYCIN
32
BULK FORMING LAXATIVES absorb H20 --> SOFTEN and ENLARGE stool --> fecal swelling --> PROMOTES PERISTALSIS PWEDENG FOR CHRONIC USE
Psyllium Methylcellulose Polycarbophil
33
OSMOTIC LAXATIVES causes DUODENAL SECRETION of CCK --> INC fluid secretion and motility poorly absorbed salts remain in fecal matter --> pull H20 into the lumen
Lactulose Magnesium Oxide Sorbitol Magnesium Citrate
34
SURFACTANT (STOOL SOFTENING) LAXATIVES lowers surface tension facilitates H20 penetration --> liquefaction of stool
Docusate Glycerin Suppository Mineral Oil
35
STIMULANT/CATHARTIC LAXATIVES (+) peristalsis
Bisacodyl Aloe Senna Castor Oil
36
Side effects of Senna
MELANOSIS COLI - benign disorder of colonic pigmentation - d.t. intake of anthraquinone-containing laxative (SENNA)
37
LUBRICANT LAXATIVES (-) H20 and fat absorption
Mineral Oil
38
ANTIFLATULENT
Al (OH)3(MgOH)2 - Simethicone
39
BOWEL EVACUANT
Polyethylene glycol Sodium phosphate ENEMA (fleet)
40
Loperamide stimulates opioid receptors in enteric nervous system slows motility w/ negligible CNS effects
``` Diphenoxylate Kaolin + Pectin Colloidal Bismuth Difenoxin Loperamide ```
41
MOA of 5 HT3 RECEPTOR ANTAGONISTS 5 HT3 receptor - located on the CTZ on the floor of the 4th ventricle of the brain
``` Ondansetron Granisetron Dolasetron Palonosetron Alosetron Tropisetron ``` blocks chemoreceptor trigger zone (CTZ) and enteric nervous system
42
Drugs used in IBD that (-) synthesis of prostaglandin and leukotrienes Immunomodulator
Mesalamine (5-ASA) - 5-aminosalicylic acids Balsalazide Sulfasalazine - causes SJS Mesalazine
43
Pentasa (Mesalamine)
JEJUNUM to RECTUM
44
Sulfasalazine | Mesalazine
COLON
45
Asacol (Mesalamine Delayed-Release Tablets) | Lialda (Mesalamine)
ILEUM to RECTUM
46
Rowasa (Mesalamine Rectal Suspension Enema)
SIGMOID TO RECTUM
47
Canasa (Mesalamine)
RECTUM
48
MUCOSAL PROTECTIVE AGENTS
Sucralfate Misoprostol Bismuth Salicylate
49
TRIPLE THERAPY
Bismuth subsalicylate PLUS Metronidazole PLUS Tetracycline Ranitidine bismuth citrate PLUS Tetracycline PLUS Clarithromycin or Metronidazole Omeprazole PLUS Clarithromycin PLUS Metronidazole OR Amoxicillin
50
SE of PPI
``` diarrhea headache abdominal pain malabsorption - daily long term use (3 years) -- Vit B12 deficiency infections hypergastrinemia atrophic gastritis fractures of hip and spine (increases risk for osteoporosis) ```
51
QUADRUPLE THERAPY
Tetracycline Omeprazole Metronidazole Bismuth subsalicylate
52
PROKINETIC AGENTS block D2 receptors stimulates motilin receptors
Metoclopramide Domperidone Erythromycin
53
ANTIDIARRHEAL AGENTS Activates opioid receptors in enteric nervous system Slows motility with negligible CNS effects
OPIOID: Diphenoxylate Loperamide NON OPIOID: Kaolin + Pectin, Colloidal bismuth, Difenoxin
54
Decreases the cholesterol content of bile by reducing cholesterol secretion USES: Dissolution of small cholesterol gallstones in patients with symptomatic gallbladder disease who refuse surgery or are poor surgical candidates
Ursodiol (Ursodeoxycholic Acid) - URSA
55
Metabolized to bicarbonate -- alkalinizes urine and raises urinary citrate USES: Hypocitraturic calcium oxalate nephrolithiasis Renal tubular acidosis with calcium stones Uric acid lithiasis
Potassium citrate ``` SE: hyperkalemia abdominal discomfort vomiting/nausea diarrhea LBM ```

Pharmacology (72 decks)

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