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Pharmacology > Gastrointestinal Drugs > Flashcards

Gastrointestinal Drugs Flashcards

1
Q

Antacids Mechanism of Action

A

Promotes gastric mucosal defense mechanism

Mucus Secretion: Protective barrier against HCl

Bicarb: Helps buffer acidic properties of HCl

Prostaglandins: Prevent activation of Proton Pump, leads to decrease HCl Production

NOTE: Antacids don’t prevent overproduction of Acid, but they do neutralize acid once it is in the stomach

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2
Q

Antacid Drug Effects

A

Reduce pain associated with acid-related disorders

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3
Q

Antacids: Aluminum Salts

A

Carbonate, Hydroxide

Constipating Effects, used with magnesium to fight constipating effects.

Examples: Basaljel (carb) , Alternagel (hydroxid) , Maalox, Mylanta (both combo)

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4
Q

Antacids: Magnesium Salts

A

Carbonate, Hydroxide, oxide, trisilicate

Causes Diarrhea

Dangerous when used with Renal Failure

Example: Mag Hydroxide (MOM), Gaviscon, Combo: Maalox, Mylanta

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5
Q

Antacids: Calcium Salt

A

Carbonate, but there are many forms

Can cause Constipation, and may result in kidney stones

Extra source of Calcium

Example: Tums

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6
Q

Antacids: Sodium Bicarbonate

A

Very soluble

Buffers HCl

Quick onset, short duration

Causes metabolic alkalosis,** can cause problem inpatients with CHF, HTN, Renal insufficieny**

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7
Q

Antacids/Antiflatulents

A

Antiflatulents: used to relieve painful symptoms associated with gas.

OTC Drugs: Activated charcoal and Simethicone

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8
Q

Antacid Side Effects

A

Minimal

Aluminum/Calcium: Constipation

Magnesium: Diarrhea

Calcium Carbonate: Gas/belching

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9
Q

H2 Antagonists

A

Reduce acid secretion

Available OTC

Cimetidine/Tagamet

Famotidine/PEcid

Ranitidine/Zantac

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10
Q

H2 Antagonists: Mechanism of ACtion

A

Blocks Histamine (H2) at receptors of parietal cells which results in decreased production of HCl

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11
Q

H2 Antagonist Side Effects

A

Cimetidine: Impotence/Gynecomastia

Headache, lethargy, confusion, diarrhea, urticaria, swearing, flushing

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12
Q

H2 Antagonist Drug Interactions of Cimetidine/Tagamet

A

BInds with P450 in liver, results in inhibitied oxidation of drugs and increased level of drugs

All H2 antagonists inhibit absorption of drugs that require acidic GI for absorption

Smoking decreases the effectiveness of H2 Blockers (increases gastric acid production)

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13
Q

What is the action of the proton pump? Do H2 blockers and Antihistamines stop its action?

A

Parietal cells realese positive hydrogen during HCl production

They don’t stop the action.

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14
Q

Proton Pump Inhibitors: Mechanism of Action

A

Irreversible bind to H+/K+ ATPase enzyme

Causes achlorhydria: blocking of gastric acid secretion

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15
Q

PPI Drugs

A

“-prazole”

Prevacid, Prilosec, Nexium

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16
Q

Indications for PPIs

A

Gerd Maintenance therapy

Treatment of H. Pylori ulcers

erosive esophagitis

17
Q

PPI Side Effects

A

Safe for short term

Protonix/Nexium parenteral administration

Can increase levels of diazepam/phenytoin, increased chance of bleeding with warfarin

18
Q

Sucralfate/Carafate

A

Cryoprotective

used for stress ulcers, erosions

Don’t give with other medications

19
Q

Misoprostol/Cytotec

A

Used for prevention of NSAID-Induced gastric Ulcers

20
Q

Antidiarrheals: Adsorbents MOA

A

Coat walls of GI, bind to toxin and eliminate through stool

Pepto-Bismol, Activated Charcoal, Kaopectate

21
Q

Antidiarrheals: Anticholinergics MOA

A

Decrease intestinal muscle tone and peristalsis

Donnatal/Atropine

22
Q

Antidiarrheals: Intestinal Flora MOA

A

Lactobacillus: supplies missing bacterie to GI, suppress diarrhea causing bacteria

Lactinex

23
Q

Antidiarrheals: Opiates MOA

A

Decrease bowel motility/relieve rectal spasms

Codeine, Lomotil, Imodium

24
Q

Antidiarrheals

Side effects of Adsorbents

A

Increased bleeding time, constipation, dark stools, tinnitus, hearing loss

25
Q

Antidiarrheals

Anticholinergics Side effects

A

urinary retention, impotense, headache, dizziness, confusion, dry skin, rash, blurred vision photophobia, Hypotension, hypertension, brady/tachycardia

26
Q

Antidiarrheals

Opiates Side Effects

A

Drowsiness, sedation, dizziness, lethargy, N/V, bradycardia, palpitations, Hypotension

27
Q

Laxatives

Bulk forming MOA and SE

A

High fiber, absorbs water, distends bowel

Metamucil

SE: Impaction/ fluid overload

28
Q

Laxatives

Emollient MOA and SE

A

Stool softener/lubricant

more water/fat in stools

Colace/Surfak

Mineral oil

SE: Skin Rash, decreased vitamin absorption

29
Q

Laxatives

Hyperosmotic MOA and SE

A

Increase fecal water content

bowel distention, increased peristalsis

GoLytely

Sorbitol

SE: Abdominal bloating, rectal irritation

30
Q

Laxatives

Saline MOA and SE

A

increase osmotic pressure within intestinal tract, causes more water to enter intestines

Causes bowel distention, increased peristalsis, evacuation

Examples: Epsom salts, magnesium hydroixide, fleet enema

SE: magnesium toxicity, cramping, diarrhea, increased thirst

31
Q

Laxatives

Stimulant MOA and SE

A

Increase peristalsis via nerve stim.

Castor oil, Senokot

SE: nutrient malabsorption, skin rashes, gastric irritation, rectal irritation

32
Q

MOA of Antiemetic and Antinausea

A

Blocks vomiting pathway, blocks stimulus that induces vomiting

33
Q

Antiemetics/antinausea

Anticholinergic MOA/Indications

A

bind to ACh receptors in inner ear, blocks nauseating stimuli to CTZ

Scopolamin, used for motion sickness

34
Q

Antiemetics/antinausea

Antihistamine agents H1 blockers

A

inhibit ACh by binding to H1

Prevents stim in vestibular/reticular area

Benadryl, Phernergan

also for cough, allergies, sedation

35
Q

Antiemetics/antinausea

Neuroleptics MOA

A

Block dopamine receptors on CTZ

Thorazine, Compazine

Also psychotic disorders, intractable hiccups

36
Q

Antiemetics/antinausea

Prokinetic agents

A

Block dopamine in CTZ

stimulates peristalsis in GI

Reglan

37
Q

Antiemetics/antinausea

Serotonin Blockers

A

Anzemet, Kytril, Zofran

Used for N/V in patients getting chemo, also postop N/V

38
Q

Antiemetics/antinausea

THC MOA

A

Inhibits reticular formation, thalamus, cerebral cortex

Marinol

Used for N/V associated with chemo and anorexia with weight loss in AIDS patients

39
Q

Antiemetics/antinausea SE

A

Varies, due to nonseletive blocking

Cause drowsiness

Antiemetics + alcohol = CNS Depression

Pharmacology (12 decks)

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