Gastrointestinal Flashcards
Cimetidine
Reversible H2-blockers; decreases H+ secretion by parietal cells
Toxicity: Potent inhibitor of cytochrome P450; antiandrogenic effects (prolactin release, gynecomastia, impotence); can cross BBB and placenta
Omeprazole
Irreversibly inhibit H/K ATPase in stomach parietal cells
Toxicity: increased risk of C. diff infection, pneumonia, hip fractures; decreased serum Mg with long-term use
Misoprostol
PGE1 analog. Increases production and secretion of gastric mucous barrier and decreases acid production.
Toxicity: Diarrhea. C/I in pregnant women (abortifacient)
Octreotide
Long-acting somatostatin analog
Treats acute variceal bleeds, acromegaly, VIPoma, and carcinoid tumors
Aluminum hydroxide
Antacid
Toxicity: Hypokalemia, hypophosphatemia, constipation, proximal muscle weakness, osteodystrophy, seizures
Calcium carbonate
Antacid
Toxicity: hypokalemia, hypercalcemia, rebound acid production; can chelate and decrease effectiveness of other drugs (e.g. tetracycline)
Magnesium hydroxide
Antacid
Toxicity: diarrhea, hyporeflexia, hypotension, cardiac arrest
Lactulose
Treats constipation (osmotic laxative) and hepatic encephalopathy (gut flora degrade lactulose into lactate and acetic acid, which promote nitrogen excretion as NH4)
Infliximab
Monoclonal antibody to TNF-alpha
Treats Crohn disease, UC, RA, ankylosing spondylitis, psoriasis
Toxicity: Infection (reactivation of latent TB), fever, hypotension
Sulfasalazine
Combination of antibacterial and anti-inflammatory. Activated by colonic bacteria
Treats Crohn disease and UC
Odansetron
5-HT3 antagonist, decreases vagal stimulation
Powerful central-acting antiemetic
Metoclopramide
D2 receptor antagonist. Increases resting tone, contractility, LES tone, and motility. No affect on colon transport time
Treats diabetic and post-surgery gastroparesis; antiemetic.
Toxicity: increased Parkinsonsian effects. C/I in patients with small bowel obstruction or Parkinson disease
