GI Flashcards
cimetidine (famotidine, ranitidine, -dine)
- H2-antagonist, CYP450 inhibitor, used for peptic ulcers
- increased prolactin leads to decreased libido, impotence, gynecomastia
bismuth
binds ulcers creating physical barrier
omeprazole
PPI, binds irreversibly to H+ pumps
misoprostol
- prostaglandin E1 analog, used specifically to treat NSAID ulcers, contraindicated in pregnant women
- used as medically induced abortive agent
ondansetron
5HT-3 antagonist, side effects: headache, constipation, urinary retention
statins (side effects)
myopathy, metabolized by CYP450 - interactions can lead to severe muscle pain
D-penicillamine
copper chelator - Tx for wilson’s disease
deferoxamine
iron chelator - Tx for hemochromatosis (bronze diabetes)
metronidazole
- tx for c. diff
- induces DNA damage in anaerobes
- combined with alcohol, disulfram reaction!
milk of magnesia
antacid that causes diarrhea
aluminum hydroxide
antacid that causes constipation
infliximab
- antibody directed at TNF-alpha
- Tx: refractory chrons
metocloprimide
- D2 receptor antagonist
- used to treat gastroparesis
- SE: extrapyramidal symptoms, parkinsonism, akasthesia
octreotide
- antagonizes serotonin at level of the receptor (Tx carcinoid)
- basically a synthetic somatostatin, decrease GI acid, motility, inhibit hypothalamus
- inhibits growth hormone at level of hypothalamus
gemfibrizole
- increase activity of lipoprotein lipase
- large decrease in triglycerides, small decrease in LDL, small increase in HDL
- contraindicated in Tx of high cholesterol with gallstones
azathiopine
- immuno suppressive, works by inhibiting purine synthesis
sulfasalazine
- combination of anti-bacterial/anti-inflammatory
- used in Tx of UC
rifaximin
- not systemically available antibiotic
- used to treat GI infections, especially E. coli (not 0157:H7)
ezetimibe
- prevents cholesterol absorption at brush border, mild reduction in LDL
- NOT helpful in decreasing CV events
- appropriate Tx for LDL w/concern for gall stones, PROTECTIVE
itraconozole
- anti-fungal
- potent CYP450 inhibitor
macrolides
-erythromycin: more side effects, acute liver tox possible inhibits 50s subunit of ribosome
pegylated interferon
- used in tx of HCV
- SE: flu like symptoms (fever/chills) and severe depression
NAC (N-Acetylcystine) - MOA
-reducing agent, promotes formation of glutathione
ketoconazole
- antifungal, MOA: inhibit fungal CYP450
- some cross reactivity with liver CYP450
- gynecomastia due to hormone synthesis inhibition
infliximab
- monoclonal chimeric antibody
- tx for autoimmune (refractory chron’s, but also other autoimmute)
- MOA: binds and inactivates free TNF-alpha
nystatin
- antifungal, tx for candida albicans
- binds ergosterol and forms pores in membranes
tetracyclines
- inhibit 30s subunit of ribosomes
- tx: mycoplasma pneumonia, rickettsia rickettsii, chlamydia, borellia burgdorferi
floroquinolones
- inhibit toposiomerase II
- tx: shigella
- SE: prolong QT interval
penicillamine
-tx: for copper overload, Wilson’s Dz
orlistat
- inhibits pancreatic lipase
- leads to intentional malabsorption of fats (and fat soluble vitamins)…steatorrhea
