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PharmacologyII > Gastric acid > Flashcards

Gastric acid Flashcards

1
Q

what are 3 types of agents for neutralizing gastric acid secretion for treatment of peptic ulcers?

A

Antisecretory agents

  • Buffers
  • Cytoprotectants
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2
Q

What are 4 5HT H2 receptor antagonists?

A

Cimetidine

  • Ranitidine
  • Nizatidine
  • Famotidine
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3
Q

how do you treat an H. pylori Infection? and why is it beneficial to treat an H. pylori Infection?

A
  • Eradication of H. pylori infection promotes rapid and long-term healing of ulcers
  • If someone presents as positive for H. pylori infection, they will often undergo “triple therapy” with antibiotics to eradicate the infection and a proton pump inhibitors to reduce symptoms
some antibiotics:
– Amoxicillin 
– Metronidazole 
– Clarithromycin
 – Tetracycline
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4
Q

what are AE of Sucralfate?

A

Minimal systemic effects

• Constipation (rare and due to aluminum)

▪ Can result in aluminum toxicity in people with chronic kidney failure

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5
Q

what is the MOA of sucralfate?

A
  • A complex of aluminum hydroxide and sulfated sucrose that forms a viscous paste in acidic media (releases aluminum in the presence of acid)
  • Paste binds positively charged proteins in the ulcer, forming a protective barrier for ~6 hrs
  • Reduces the degradation of mucus via pepsin
  • Can stimulate the secretion of mucus, bicarbonate, and prostaglandins from the gastric mucosa
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6
Q

what are 2 drugs that protect the Mucosa?

A
  • Sucralfate

* Bismuth chelate

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7
Q

what is Sucralfate?

A

a drug that protects the Mucosa

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8
Q

what are AE of Bismuth chelate?

A
  • Nausea
  • Vomiting
  • Blackening of the tongue and feces
  • Tinnitus
  • Can result in encephalopathy (Reye’s Syndrome) if renal excretion is impaired
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9
Q

what is the MOA of Bismuth chelate?

A

Has toxic effects on bacillus and may prevent adherence of H. pylori to the gastric mucosa

  • Forms protective barrier over the ulcer and enhances secretion of prostaglandins, mucus & bicarbonate
  • May inhibit bacterial proteolytic enzymes
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10
Q

what is Bismuth Chelate?

A

OTC for treating mild GI symptoms - protects the mucosa!

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11
Q

what can be prescribed with antacids to relieve bloating sometimes associated with antacids?

A

simeticone

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12
Q

what are AE of Magnesium hydroxide and Aluminum hydroxide gel?

A

– Magnesium salts cause diarrhea
– Aluminum salts cause constipation
– Mixtures of the 2 can preserve normal bowel function

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13
Q

what is the MOA of magnesium hydroxide, and aluminum hydroxide?

A
  • Magnesium hydroxide is an insoluble powder that forms magnesium chloride in the stomach
  • Aluminum hydroxide gel forms aluminum chloride in the stomach
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14
Q

what are the Most common antacids?

A

salts of magnesium or aluminum

  • Magnesium hydroxide
  • Aluminum hydroxide
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15
Q

what is the simplest way to treat/reverse the symptoms of elevated gastric acid secretion>

A

antacids

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16
Q

what is the MOA of an antacid?

A
  • Neutralize acid and thereby inhibit the activity of peptic enzymes
  • Can also lead to healing of duodenal ulcers if given for a long enough time…BUT LESS EFFECTIVE FOR GASTRIC ULCERS
17
Q

what are AE of misoprostol?

A
  • Diarrhea
  • Abdominal cramps
  • Uterine contractions – Avoid in pregnancy
18
Q

which EP receptors does misoprostol work on?

A

prostaglandin EP2/3 receptor

19
Q

what is the MOA of misoprostol?

A

• Acts directly on the ECL cells to inhibit both basal and food-induced gastric acid secretion
– Via prostaglandin EP2/3 receptor

• May also contribute to maintenance of the mucosal barrier
– Leads to stimulation of mucin (EP4 receptor) and bicarbonate (EP1/2 receptor)

• Promotes the healing of ulcers
– Can also be used to prevent the gastric damage associated with chronic NSAID use

20
Q

what is misoprostol?

A

An oral stable analogue of prostaglandin E1

21
Q

why do proton pump inhibitors increase risk of gastric cancer?

A

they MASK gastric cancer - harder to recognize and realize something is wrong with your body

22
Q

what are AE of proton pump inhibitors?

A

• Generally well tolerated

• Uncommon 
– Diarrhea
– Rash 
– Nausea
– Abdominal pain 
– Dizziness 
– Somnolence 
– Headache 
– Mental confusion

• Less Common
– Hypergastrinemia

23
Q

in what manner do proton pump inhibitors bind to proton pumps?

A

(irreversibly)

24
Q

what is the MOA of proton pump inhibitors?

A

PPI ARE WEAK BASES

Accumulates in the acid environment of the canaliculi of the stimulated parietal cell

Binds to the proton pump irreversibly and reduce the amount of H+ pumped into the stomach lumen

25
Q

are proton pump inhibitors the most potent for inhibiting gastric acid secretions?

A

YESSSS!

26
Q

what are the 5 PPI (proton pump inhibitors) drugs? what is the common ending in their names?

A 
– Omeprazole
 – Esomeprazole
 – Lansoprazole 
– Pantoprazole 
– Rabeprazole

common ending is “PRAZOLE”

27
Q

what are AE of 5HT H2 receptor antagonists? are these rare?

A

yes they are rare
• Diarrhea

  • Dizziness
  • Muscle pain
  • Alopecia
  • Rash (transient)
  • Confusion in the elderly
  • Gynaecomastia, galactorrhea and a decrease (rarely) in sexual function in men (cimetidine only)
  • Thrombocytopenia
28
Q

what is the MOA of 5HT H2 receptor antagonists to reduce gastric acid secretions?

A

• Competitively antagonize histamine actions at all H2 receptors
– Reduces parietal cell cAMP levels
– Main clinical use is as inhibitors of gastric acid secretion

  • Reduce both histamine and gastrin-induced acid secretion
  • Decrease basal and food-stimulated acid secretion (60- 80%)
  • May also promote healing of gastric and duodenal ulcers
29
Q

what is an antacid?

A

a buffer

PharmacologyII (12 decks)

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