GI- Antacids and Antiulcers Flashcards
Aluminum, calcium and magnesium based agents are considered what level of systemic levels
Low systemic
Sodium based agents are considered what levels of systemic agents
High systemic
What is the mechanism of action for antacids
Combine with already secreted hydrogen, but in no way affects the amount that is produced or secreted
What are the characteristics of calcium antacids
Rapid onset, long duration, with very good neutralizing ability
What are the characteristics of aluminum antacids
Slow onset, short duration and weak neutralizing
What are the characteristics of magnesium antacids
Rapid onset, long duration and good neutralizing ability
What are the characteristics of sodium antacids
Rapid onset, short duration, with fair neutralizing
What is the mechanism of action of simethicone
A surfactant that decreased surface tension and aids in expulsion of gas
What are the side effects of aluminum
Constipations and hypophosphatemia
What are the side effects of magnesium
Diarrhea and hypermagnesium
What are the side effects of calcium
Constipation, kidney stones, hypercalcemia and hypophosphatemia
Are antacids used in combination
yes
What is the protocol on administration of antacids and what is the reason
Lots of interactions, so taken 1-2 hours before all other medication and 2-4 hours after
What is the drug class of drugs ending in -tidine
H2 receptor antagonists
What is the drug class of drugs for drugs ending in -prazole
PPI
What class of drug is cimetidine
H2 antagonist
What class of drug is famotidine
H2 receptor antagonist
What class of drug is nizatidine
H2 receptor antagonist
What class of drug is ranitidine
H2 receptor antagonist
What class of drug is lanzoprazole
PPI
What class of drug is dexlansoprazole
PPI
What class of drug is omeprazole
PPI
What class of drug is esomeprazole
PPI
What class of drug is pantoprazole
PPI
What class of drug is Rabeprazole
PPI
What class of drug is misoprostol
PGE1 analogs
What is the mechanism of action of histamine type 2 blockers
Inhibits the H2 receptors and decreases the production of acid production by 20-50%
What are the adverse effects of histamine type 2 blockers
N/D/C
-Headaches
Which serious side effect is seen in administration of cimetidine
Decreases testosterone binding, so gynecomastia in men, galactorrhea in women
What enzymatic interaction does cimetidine have
Prototypical inhibator of CYP450s
What are the contraindications to histamine type 2 blockers
Pregnancy
Which histame type 2 blocker is the only one that can be given to pregnant women
Ranitidine
What is the mechanism of action of PPIs
Inhibition on the potassium/hydrogen ATPase that puts acid in to the lumen of the stomach
What are the adverse effects of PPI
Clostridium difficile assoacited diarrhea
What is the enzymatic interaction of omeprazole
CYP450 inhibators
What are the contraindications of PPI
Pregnant women
Which PPI can be given to pregnant women
Lasnoprazole
What is the mechanism of sucralfate
Creates a viscous coat that can cover an ulcer
What are the complications of sucralfate
Severe renal failure due to the aluminum
What is the mechanism of action for misoprostol
Prostaglandin analog that provides protection to mucosa and decreases gastric acid release a
When is misoprostol used
Prevention of NSAID induced gastric ulceration
What are the contraindications in mismatch compounds
Contains SAS, so look for allergy and Anticoagulant factors first
What is the combination that is a must in the treatment of H. Pylori
At least 2 antibiotics with an acid reducer (PPI or H2 blocker)
What is the triple therapy in the treatment of H pylori
PPI
Clarithromycin
Amoxicillin or metronidazole
What is the quadrupple therapy for H. Pylori
PPI
Metronidazole
Tetracyclines
Bismuth
What is the drug substitution for H pylori treatment in a patients with penicillin allergy
Substitute metronidazole
What is the drug substitution for H pylori treatment in a patients with metronidazole resistance
Tetracyclines
What is the drug substitution for H pylori treatment in a patients with clarithromycin resistance
Amoxicillin or tetracycline
In a pregnant patient without H pylori but PUD, what is the treatment
Short course of antacids or sucralfate (mild case)
Ranitidine (moderate)
Lansoprazole (severe)
