Foregut Pharmacology Flashcards
In a patient 50+ with upper abdominal discomfort, what is the “not to miss” dx?
AMI
What is the mechanism of action of PPIs? Side effects?
irreversibly binds to the proton pump (pump must be active)
onset is slow (hours) but durable (put to 12 hours)
side effects (minor) increased C. diff. enteric and pulmonary infections, cause abdominal pain or diarrhea, omperazole interfers with clopidegrel in certain pts
What is the MOA of H2- histamine receptor antagonists? Side effects?
blocks histamine 2 messenger pathway by binding and inhibiting histamine receptor (‘dines’)
faster onset but less potent (strong enough to heal ulcers)
Side effects: cimetidine interacts with warfarin
Give and example of a prostaglandin analog and its action/ side effects.
misoprostol (synthetic analog of PGE1) used to stimulate mucous production (NSAID protective)
side effects: abortifacient, diarrhea
How does sucralfate work?
an octasulfate of sucrose with aluminum hydroxide attached
sticks to inflamed mucosa as well as binds to HCl and bile salts (take 4x daily)
What are some side effects of antacids?
aluminum can constipate
magnesium can cause diarrhea
Give an example of a pro kinetic agent and its action/side effects.
metoclopramide improves stomach emptying by causing ACh release from enteric neurons
Side effects include confusion at high doses in elderly and Parkinson’s like syndrome/tardive dyskinesia
low dose erythromycin acts similar to motilin (IV), danger of tachyphylaxis
What is the action of a gastric stimulator?
improves the symptoms of gastroparesis but does not act as a pacemaker to improve motility
Name four examples of antiemetics and their general mechanism.
ondansetron: 5-HT3 receptor antagonist
prochlorperazine: dopamine receptor antagonist
antihistamine: H1-histamine receptor blocker
dronabinol (delta-9-THC): **note may cause cyclic vomiting symptom (key describer, better with a hot shower)
