GI Flashcards
What ways do acid-reducing agents stop ulcers?
PPI, Histamine blockers, anticholinergic agents, prostaglandins also inhibit proton pump
Calcium Carbonate (Tums) MOA, Class, AE
Antacids.
MOA: neutralized gastric acidity
AE: Constipation
What happens to the absorption or Drug-drug interaction with Antacids?
increased pH causes reduced absorption of acidic drugs and increased absorption of basic drugs
What to look out for when taking Antacids?
Electrolyte imbalance
Avoid taking within 2 hours window of other oral medication
Ending for H2 Receptor Antagonists
(-tidine)
Primary use for H2 Antagonists
MOA
Primary use: treat acid reflux and heal ulcers
MOA: reduce secretion of stimulated acid
When do you take H2 receptor Antagonist with food?
90 min before eating
AE H2 Receptor Antagonists?
diarrhea, muscle pain, can cause gynecomastia b/c affinity to androgen receptors
PPI MOA:
irreversibly inhibits H+/K+ - ATPase pump on parietal cell membrane which blocks final step in acid secretion into lumen of stomach
Primary purpose PPI
treat acid reflux and heal ulcers (shown to be more effective than H2 receptor antagonists)
PPI endings
(-prazole)
Why dont you take PPI with food?
because it decreases the bioavailability
AE PPI
long-term use associated with gastric polyps, altered calcium metabolism (decreased bone mineralization), some cardiovascular abnormalities, long-term use has higher risk C.diff
MOA Bismuth chelate (pepto-bismol)
Appears to coat ulcer, enhance prostaglandin synthesis, increase gastric mucous epithelial cell growth to protect against H. pylori-induced ulcers.
Sucralfate MOA
An aluminum salt of sucrose that forms a protective coating over the ulcer; used for high-risk cases (trauma, burns, ARDS, major surgery, etc).
Misoprostol MOA
Synthetic prostaglandin analog (PGE2) that inhibits acid secretion; used to prevent NSAID-induced ulcers
H. pylori infection can cause
chronic gastritis, PUD, GERD, gastric cancer
Treatment for H. pylori
acid-controlling drug + antibiotic
Drug class to treat N/V (8)
Anticholinergics, Antihistamines, Neuroleptic, Prokinetic, Serotonin blockers, Neurokinin-1 receptor blockers, Cannabinoids, Phosphorated carbohydrate solution (Emetrol)
scopolamine (Transderm Scop)
MOA, drug class, AE
Anticholinergics
MOA: binds to ACh receptors on vestibular nuclei
AE: dizziness, drowsiness, dry mouth, blurred vision, dilated pupils, difficulty with urination
Meclizine drug class, MOA, AE
Antihistamines
MOA: inhibit vestibular input to the CTZ
AE: dizziness and sedation
Neuroleptic drugs MOA
block dopamine receptors in CTZ
Anticholinergic actions
Neuroleptic drugs AE
dry eyes, urinary retention, long-term use can lead to extrapyramidal symptoms, tardive dyskinesia
Prokinetic drugs ex
MOA
metoclopramide
block dopamine in CTZ
Prokinetic drug AE
sedation, diarrhea, weakness, Prolonged use causes extrapyramidal signs
Serotonin blockers end with
name one drug
-setron
ondansetron
Serotonin blockers MOA
block serotonin receptors in GI tract, CTZ, and vomiting center
Serotonin blockers AE
dizziness, diarrhea, [no extrapyramidal signs]
Serotonin blocker can be combined with to control chemo-induced emesis
Corticosteroids
Neurokinin-1 receptor blockers uses and MOA
drug to prevent emesis from chemotherapy
MOA: blocks Substance P from binding to NK-1 receptor, prevents both central and peripheral stimulation of vomiting centers
Neurokinin-1 receptor blockers AE
GI issues, Steven-Johnson syndrome
Cannabinoids uses
block acute and delayed emesis, used for chemo-induced nausea/vomiting
Cannabinoids AE
blurred vision, dry mouth, weakness, tachycardia or bradycardia, CNS symptoms (confusion, anxiety, mood changes)
Phosphorated carbohydrate solution (Emetrol) MOA and uses
MOA: relaxes GI tract smooth muscle
Used for mild cases of intestinal flu or food-borne causes
Classes that treat Diarrhea
Absorbents, Anticholinergics, Intestinal flora modifiers, Opiates
Absorbents drug examples, MOA
bismuth subsalicylate (Pepto-Bismol), attapulgite (Kaopectate) MOA: binds to bacteria causing diarrhea to carry them out with feces
Absorbents AE:
what to look out for
aspirin product: use with caution in children recovering from flu/chickenpox, increased bleeding time, GI bleed
Decrease effectiveness of many drugs
Anticholinergics drug ex, MOA,
What to look out for
atropine
MOA: reduce peristalsis of GI tract
Because of AE, rarely first choice for treatment
Intestinal flora modifiers uses
bacterial products obtained from Lactobacillus organisms (like probiotics)- great to use when someone is taking antibiotics
Normally resides in intestines to keep “bad” bacteria in check
Helps restore normal balance to suppress harmful organisms
Opiates drug ex, MOA
diphenoxylate (Lomotil)
decrease GI motility and propulsion
Slowing transit time in intestines = absorption of water and electrolytes
Opiates AE
sedation, dizziness, constipation, nausea, vomiting, respiratory depression, bradycardia, hypotension, urinary retention
What Laxatives to treat constipation
Bulk-forming, Emollient, Hyperosmotic, Saline, Stimulant
Bulk-Forming Laxatives drug ex, MOA
Require to?
methylcellulose (Citrucel)
MOA: increase water absorption softens and increases bulk of intestinal contents
Require to drink lots of water
Hyperosmotic Laxatives drug ex,
MOA
lactulose, polyethylene glycol (Miralax)
creates gradient that draws fluid into colon to increase stool fluid content and stimulate peristalsis
Hyperosmotic Laxatives AE
abdominal bloating, rectal irritation, electrolyte imbalance
Saline laxatives
MOA
Similar to hyperosmotic– osmotic pressure pushes water/electrolytes into intestines
Saline laxatives AE
salts may cause issues with individual with diminished cardiac or renal function, electrolyte imbalance
Emollient Laxatives ex, MOA
docusate sodium (Colace) facilitate water and fat absorption into stool, lubricate fecal matter and intestinal wall
Emollient Laxatives AE
decreased vitamin absorption, electrolyte imbalance
Stimulant laxative ex, MOA
Senna
MOA: stimulates peristalsis through enteric nervous system
Stimulant laxative AE
Danger of long-term use: dependence and damage to intestinal cells/loss of colon function
Position avoided when with patients with GERD
should avoid lying flat (supine)
Avoid increased intra-abdominal pressure
Avoid exercise immediately after meals
Vomiting and diarrhea lead to…
make sure to …
Dehydration and electrolyte imbalance
Encourage fluids during PT sessions
smoking decrease effectiveness in what drug class
H2 Blockers
