E2: GI Drugs Flashcards
_________: Weak bases that interact with stomach acid to form water and salt
Antacids
Where do antacids work?
locally
What do antacids do to stomach pH?
raise gastric pH
Antacids Do NOT inhibit ____ production by parietal cells
HCl
Best antacids are those that buffer to a pH of ___-___
pH of 3-4
What is a SIDE EFFECT of Antacids?
Constipation
Which one of these combinations is TUMS? Aluminum hydroxide, magnesium hydroxide or calcium carbonate
Calcium Carbonate
What are the 2 Magnesium antacid products?
Milk of Magnesia,Maalox
Which antacid can be used to remineralize enamel? Watch out! it can cause a gun metal grey stain for a bit…
milk of magnesia
Which part of Maalox absorbs the H+ ions?
The SILICA (magnesium trisilicate)
Aluminum is astringent to stop bleeding
Aluminum
Watch out! Aluminum Antacids interfere with absorption of which antibiotic???
tetracyclines
BOARDS loves this antacid: Forms complexes with albumin, fibrinogen and globulin on ulcer surface, thus creating protective barrier to acid and pepsin…. Interferes with the absorption of many medications…Also binds pepsin directly….Not absorbed
SU-CRAL-FATE (Carafate)
Which drug is preferred by Gastroenterologists? (brand name and class)
ZANTAC-a Histamine H2 Receptor Antagonist
Which drug class binds to H+/K+-ATPase enzyme system in parietal cells?
Proton Pump Inhibitors
Proton Pump Inhibitors are for ____ term acid suppression that has a _____ pace of onset.
long term…slow
What are 3 really popular Proton Pump Inhibitors?
1.Nexium 2.Prevacid 3.Prilosec
NEXIUM is Better at healing _________ than Prilosec
erosive lesions
Think this might be important?? THIS drug is Indicated for use for prevention and treatment of NSAID-induced gastrointestinal lesions
Nexium (proton pump inhibitors)
DENTAL considerations!!! Antacids neutralize pH = interferes with absorption of many drugs = wait ___ hours
2 hours
WHICH DRUG does Histamine antagonists decrease?
antifungals
WHICH DRUG does Histamine antagonists alter?
warfarin
Proton pump inhibitors decrease absorption of systemic _______
antifungals
Excessive salivation: mediated by ______ nerve in response to excessive gastric acid coming into oral cavity
vagus nerve
Which disease are these people most susceptible to?Smokers, Heavy drinkers, Hyperparathyroidism, Renal dialysis patients, Use of NSAIDS (chronic use)
Peptic Ulcer Disease
Etiology of Peptic Ulcer Disease–__________ infection is Present in 90% of cases
Helicobacter pylori
DID YOU KNOW Helicobacter pylori resides in our ______?!
oral cavity!?!
Use of NSAIDS for > 1 month can cause this stomach condition.
peptic ulcer disease
H pylori associated with cancer of gastric mucosa = ________
lymphoma
Peptic ulcers RARELY undergo transformation to carcinoma, BUT Ulcers in __________ of stomach more likely to become malignant
greater curvature
Atrophic gastritis caused by chronic use of PROTON PUMP INHIBITORS increases risk for _______ cancer
stomach
What are the 4 Antibiotics used in combination to treat peptic ulcers?
TCAM 1. Tetracycline 2.CLARithromycin 3.Amoxicillin 4.Metronidazole
The standard first-line therapy is a one week TRIPLE therapy consisting of the antibiotics:
CA: CLARithromycin, amoxicillin…a proton pump inhibitor Nexium, Prevacid, Protonix, Aciphex..Prilosec
What happens if I hit the peptic ulcer with the triple thereby and the H Pylori is resistant?
levofloxacin (Levaquin) added as part of the therapy
AVOID ______ and _______ with Peptic Ulcer disease
Avoid aspirin, NSAIDS
What are the 2 Oral manifestations of peptic ulcer disease??
- Vascular malformations of lip 2.Enamel erosion
________ antibiotics (erythromycin) cause GI distress and diarrhea = caution in patients with inflammatory bowel disease…IN FACT, they can cause THIS condition!
Macrolide antibiotics (erythromycin)…Pseudomembraneous colitis
What are the 2 distinct conditions of Irratable Bowel syndrome?
Ulceratic Colitis and Cj Crohn’s disease
What 2 drugs are FIRST LINE against Tx of IBS?
Anti-inflammatories; corticosteroids
What are the 3 drugs to stay away from when Rx’ing to a IBS dental Pt?
CorticoSteroids, Immunosup drugs, aspirin/NSAIDS
cobblestone mucosal lesions
Crohn’s Disease
Anti-Diarrheal: Bismuth subsalicylate (Pepto-Bismol)..Caution with _____ allergy
salicylate
codeine causes ________ as a side effect
constipation
loperamide(________)=OTC…Muscle relaxant…Relieves spasm and decreases gut motility
imodium
Laxatives: Bulk – carboxymethyl _______ with psyllium Absorb water to form softened stools by increasing bulk of intestinal contents
cellulose
Laxatives: Osmotic – _________ salts (magnesium citrate = OTC)…Used as prep for _________
magnesium…colonoscopy
Laxatives: Contact – bisacodyl (Dulcolax), _____ oil… bisacodyl also used in high doses as colonoscopy prep
castor
Laxatives: Lubricants – ______ oil, glycerin…Act as emollients
mineral
