Gastrointestinal Flashcards
Deferoxamine
Iron chelator
IV, iron poisoning
Deferasirox
Iron chelator
Oral, iron poisoning
Cimetidine
H2 blocker
Reversible block of H2 receptors, leading to decreased H secretion by parietal cells
Peptic ulcer, gastritis, mild esophageal reflux
Potent inhibitor of CYP450 (DDIs), antiandrogenic effects (prolactin release, gynecomastia, impotence, decreased libido), crosses BBB (confusion, dizziness, headaches) and placenta. Decreases renal excretion of creatinine.
Ranitidine
H2 blocker
Reversible block of H2 receptors, leading to decreased H secretion by parietal cells
Peptic ulcer, gastritis, mild esophageal reflux
Decreases renal excretion of creatinine.
Famotidine
H2 blocker
Reversible block of H2 receptors, leading to decreased H secretion by parietal cells
Peptic ulcer, gastritis, mild esophageal reflux
Relatively free of side effects
Nizatidine
H2 blocker
Reversible block of H2 receptors, leading to decreased H secretion by parietal cells
Peptic ulcer, gastritis, mild esophageal reflux
Relatively free of side effects
Omeprazole
Proton pump inibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells
Peptic ulcer, gastritis, esophageal reflex, Zollinger-Ellison syndrome
Increased risk of C. difficile infection, pneumonia. Hip fractures, decreased serum Mg with long term use.
Lansoprazole
Proton pump inibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells
Peptic ulcer, gastritis, esophageal reflex, Zollinger-Ellison syndrome
Increased risk of C. difficile infection, pneumonia. Hip fractures, decreased serum Mg with long term use.
Esomeprazole
Proton pump inibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells
Peptic ulcer, gastritis, esophageal reflex, Zollinger-Ellison syndrome
Increased risk of C. difficile infection, pneumonia. Hip fractures, decreased serum Mg with long term use.
Pantoprazole
Proton pump inibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells
Peptic ulcer, gastritis, esophageal reflex, Zollinger-Ellison syndrome
Increased risk of C. difficile infection, pneumonia. Hip fractures, decreased serum Mg with long term use.
Dexlansoprazole
Proton pump inibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells
Peptic ulcer, gastritis, esophageal reflex, Zollinger-Ellison syndrome
Increased risk of C. difficile infection, pneumonia. Hip fractures, decreased serum Mg with long term use.
Bismuth
Bind to ulcer base, providing physical protection and allowing HCO3 secretion to re-establish pH gradient in mucous layer
Increased ulcer healing, travelers diarrhea
Sucralfate
Bind to ulcer base, providing physical protection and allowing HCO3 secretion to re-establish pH gradient in mucous layer
Increased ulcer healing, travelers diarrhea
Misoprostol
PGE1 analog. Increases production and secretion of gastric mucous barrier, decreases acid production
Prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production), maintenance of a PDA. Also used to induce labor.
Diarrhea. Contraindicated in women of childbearing potential (abortifacient).
Octreotide
Long-acting somatostatin analog
Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
Nausea, cramps, steatorrhea
Aluminum hydroxide
Antacid
Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.
Hypokalemia, constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures
Calcium carbonate
Antacid
Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.
Hypokalemia, hypercalcemia, rebound acid increases, chelate and decrease effectiveness of other drugs (e.g. tetracycline)
Magnesium hydroxide
Antacid, osmotic laxative
Hydroxide binds and neutralizes H ions/provides osmotic load to draw water out
Heartburn, constipation
Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying. Hypokalemia, diarrhea, dehydration, abuse potential (bulimics), hyporeflexia, hypotension, cardiac arrest
Magnesium citrate
Osmotic laxative
Provides osmotic load to draw water out
Constipation
Diarrhea, dehydration, abuse potential (bulimics)
Polyethylene glycol
Osmotic laxative
Provides osmotic load to draw water out
Constipation
Diarrhea, dehydration, abuse potential (bulimics)
Lactulose
Osmotic laxative
Provides osmotic load to draw water out. Gut flora degrade it into metabolites (lactic acid, acetic acid) that promote nitrogen excretion as NH4
Constipation, hepatic encephalopathy
Diarrhea, dehydration, abuse potential (bulimics)
Infliximab
Monoclonal antibody to TNFα
Crohn disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriasis
Infection (including reactivation of latent TB), fever, hypotension
Sulfasalazine
Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory). Activated by colonic bacteria
Ulcerative colitis, Crohn disease
Malaise, nausea, sulfonamide toxicity, reversible oligospermia
Ondansetron
5-HT3 antagonist
Decreases vagal stimulation. Power central-acting anti-emetic.
Control vomiting postoperatively and in patients undergoing cancer chemotherapy
Headache, constipation
Metoclopramide
D2 receptor antagonist.
Increases resting tone, contractility, LES tone, motility. Does not influence colon transport time
Diabetic and post-surgery gastroparesis, antiemetic
Increases parkinsonian effects. Restlessness, drowsiness, fatigue, depression, nausea, diarrhea. Drug interaction with digoxin and diabetic agents. Contraindicated in patients with small bowel obstruction or Parkinson disease (D2 receptor blockade)
