FA GI Pharm Flashcards
Reversible block of histamine H2-receptors –> decreased H+ secretion by parietal cells
H2 blockers
Irreversibly inhibit H+/K+ ATPase in stomach parietal cells
Proton pump inhibitors
Bind to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer
Bismuth, sucralfate
A PGE1 analog. Increased production and secretion of gastric mucous barrier, decreased acid production
Misoprostol
Long-acting somatostatin analog
Octreotide
Provide osmotic load to draw water out
Osmotic laxatives
treats hepatic encephalopathy since gut flora degrade it into metabolites (lactic acid and acetic acid) that promote nitrogen excretion as NH4+
Lactulose
Monoclonal antibody to TNF-alpha
Infliximab
A combination of sulfapyridine (antibacterial) and 5-aminosalicyclic acid (anti-inflammatory). Activated by colonic bacteria.
Sulfasalazine
5-HT3 antagonist; decreased vagal stimulation. Powerful central-acting antiemetic
Ondansetron
D2 receptor antagonist. Increased resting tone, contractility, LES tone, motility. Does not influence colonic transport time
Metoclopramide
CU: peptic ulcer, gastritis, mild esophageal reflux
H2 blockers
Ex: cimetidine, ranitidine, famotidine, nizatidine
H2 blockers
Ex: omeprazole, lanzoprazole, esmoeprazole, pantoprazole, dexlansoprazole
PPIs
CU: peptic ulcer, gastritis, esophageal reflux, ZES
PPIs
Tox: increased risk of C diff infxn, pneumonia, hip fractures, decreased serum Mg with long term use
PPIs
CU: increased ulcer healing, traveler’s diarrhea
Bismuth, sucralfate
Potent inhibitor of cytochrome P450; anti androgen effects; can cross BBB and placenta, decreases renal excretion of creatinine
Cimetidine
CU: prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production); maintenance of a PDA; also used to induce labor (“ripens cervix”).
Misoprostol
Tox: Diarrhea, abortifacient
Misoprostol
CU: acute variceal bleeds, acromegaly, VIPoma, carcinoid
Octreotide
Tox: nausea, cramps, steatorrhea
Octreotide
Tox (group): can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying; hypokalemia
Antacids
Tox: Constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures
Aluminum hydroxide
Tox: Hypercalcemia, rebound acid increase, can chelate and decrease effectiveness of other drugs (tetracycline)
Calcium carbonate
Tox: diarrhea, hyporeflexia, hypotension, cardiac arrest
Magnesium hydroxide
Cu: constipation
osmotic laxatives
Ex: Mg hydroxide, Mg citrate, polyethylene glycol, lactulose
osmotic laxatives
CU: Crohn’s, UC, RA, ankylosing spondylitis, psoriasis
Infliximab
CU: UC, Crohn’s
Sulfasalazine
CU: control vomiting postoperatively and in pts undergoing cancer chemotherapy
Ondansetron
CU: diabetic and post-surgery gastroparesis, antiemetic
Metoclopramide
Tox: diarrhea, dehydration; may be abused by bulimics
osmotic laxatives
Tox: infection, reactivation of latent TB, fever, hypotension
Infliximab
Tox: malaise, nausea, sulfonamide toxicity, reversible oligospermia
Sulfasalazine
Tox: headache, constipation
Ondansetron
Tox: increased parkinsonian effects. restlessness, drowsiness, fatigue, depression, nausea, diarrhea.
Metoclopramide
Metoclopramide is notable for drug interactions with what types of meds?
Digoxin, diabetic agents
Metoclopramide is contraindicated in what conditions?
Small bowel obstruction or Parkinson dz (D1-receptor blockade)
