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GI Drugs 1 Flashcards

1
Q

Mainstay Treatment for Acid Peptic Disorder

A

Antacids

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2
Q

Principal Mechanisms of Action of Antacids

A

Reduction of intragastric acidity

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3
Q

Mode of transmission of Antacids

A

After Meal Per Orem

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4
Q

NaHCO3(Baking Soda) Prototype Drug

A

Alka Seltzer

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5
Q

Contraindication/ Use with Caution of Baking Soda

A

Px with Renal Insufficiency

NaHCO3 Dose is High

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6
Q

Exacerbate Fluid Retention in patients with Hypertension, Heart failure, & Renal Insufficiency is due to

A

NaCl ABSORPTION from intake of Baking Soda (NaHCO3)

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7
Q

Mechanism of Action of Baking Soda

A

React RAPIDLY with HCL to form CO2 and NaCL

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8
Q

Adverse Effect of NaHCO3

A

Belching and Gastric Distention due to CO2 accumulation

Metabolic Alkalosis due to unreacted Alkaline

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9
Q

Ca Carbonate (TUMS) Mechanisms of Action

A

Reacts SLOWLY with HCL to form CO2 and CaCl2

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10
Q

Adverse Effect of Ca Carbonate

A

Excessive Belching and Metabolic Alkalosis

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11
Q

In patients with Osteoporosis and osteomalacia, what drug you will use?

A

Ca Carbonate

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12
Q

Contraindication/ Use with caution of Ca Carbonate (TUMS)

A

Hypercalcemia, Renal Insufficiency, Metabolic Alkalosis, Milk Alkaline Syndrome

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13
Q

In patients with Milk Alkaline Syndrome, what will you advice?

A

Do not drink too much milk

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14
Q

Prototype Drug of Magnesium Hydroxide/ Aluminum Hydroxide/ Magnesium + Aluminum Hydroxide

A

Maalox and Mylanta

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15
Q

MOA of Magnesium Hydroxide/ Aluminum Hydroxide/ Magnesium + Aluminum Hydroxide

A

Reacts SLOWLY with HCL to form MgCl2/AlCl3 and H20

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16
Q

Advantage of drug Mylanta and Maalox from other antacids?

A

Does NOT produce gas (CO2) = No BELCHING

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17
Q

Adverse Effect of MgCL2 (magnesium chloride)

A

Osmotic Diarrhea

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18
Q

Adverse Effect of AlCl3 (aluminum chloride)

A

Constipation

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19
Q

Contraindication/ use with caution of using Maalox & Mylanta

A

Px with Renal Insufficiency - will cause accumulation of ALUMINUM due to taking this drug for a long period

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20
Q

MINIMUM usage of Maalox or Mylanta

A

4 weeks

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21
Q

MAXIMUM usage of Maalox or Mylanta

A

6 weeks

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22
Q

H2 Receptor Antagonists Prototype Drug

A

Cimetidine

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23
Q

H2 Receptor Antagonists that undergo EXTENSIVE first pass effect

A

Cimetidine, Ranitidine, Famotidine

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24
Q

Bioavailability of H2 Receptor Antagonists

A

50%

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25
What circumstance does Dose Reduction Required when taking H2 Receptor Antagonists
Px with Moderate to Severe Renal Insufficiency
26
Adverse Effect of Cimetidine in Male?
Gynecomastia and Impotence
27
Adverse Effect of Cimetidine in Female?
Increase Milk Secretion / Galactorrhea
28
MOA of H2 Receptors Antagonists
COMPETITIVE Inhibitors if Parietal cell H2 receptor and suppress the Basal and Meal stimulating gastric acid secretion
29
H2 Receptors Antagonists affects?
H2 receptor and it will not affect H1 or H3 receptor
30
Does H2 Receptors Antagonists will cause Sedation?
No because it does not affect h1 or h3 receptor
31
H2 receptor antagonists reduce acid secretion stimulated by?
Histamine, Gastrin, Cholinomemetic Agents
32
Percentage of inhibit acid secretion of H2 receptor Antagonist per day?
60 - 70 percent
33
H2 receptor antagonist is effective during?
NOCTURNAL acid secretion stimulated by HISTAMINE
34
Histamine if effective during
Night Time (Nocturnal secretion)
35
Mode of Transmission of H2 Receptors Antagonists?
Bedtime
36
This drug have a modest impact on Meal Stimulated acid secretion?
H2 Receptors Antagonists
37
Indication of H2 Receptors Antagonists
GERD, PAD/ APD, Non ulcer Dyspepsia, Prevention of Bleeding from Stress related Gastritis
38
Meal acid secretion depends on?
Gastrin and Acetylcholine
39
What will you give to prevent bleeding from stress related gastritis
IV H2 Antagonists
40
H2 Receptors Antagonists should not be given in RAPID IV infusion because?
Lead to Bradycardia and Hypotension
41
Px in IV H2 antagonist will have a increase risk on
Nosocomial Pneumonia, Mental Status Change
42
H2 Receptors Antagonists used with caution on pregnancy because?
It crosses placenta and secreted into breast milk
43
This drugs undergo RAPID first pass effect
Omeprazole, Ezomeprazole, Lansoprazole
44
Prototype of Proton-Pump Inhibitor
Omeprazole
45
This drug is similar to H2 antagonists
Prototype of Proton-Pump Inhibitor
46
Bioavailability of Proton-Pump Inhibitor
Decreases with Food intake
47
This class of drug is taken on empty stomach 1HR before meal
Proton-Pump Inhibitor (PRODRUG)
48
Mode of Administration of Proton Pump Inhibitor
1hr Before Meal
49
MOA of Proton-Pump Inhibitor
Block Final Common Pathway of Acid Secretion | Inhibit Fasting and Meal stimulated secretion
50
This drug can be use in CKD (Chronic Kidney Disease)
Proton-Pump Inhibitor (Omeprazole)
51
Best Drug for Inhibiting Acid Secretion
Proton-Pump Inhibitor 90 - 98% inhibits acid secretion
52
Indication of Proton-Pump Inhibitor
GERD, PUD, Px undergo Endoscopy with VISUALIZED ulcers
53
If Infected of H. Pylori what drug you will use?
Proton Pump + 2 Antibioics- At Least TWO WEEKS Clarithromycin Amoxicillin / Metronidazole
54
Drug use in NSAID induced ulcers
H2 Antagonists/ Proton-pump Inhibitors + Discontinue NSAID If NSAID needed: NSAID + Proton-pump inhibitor
55
Px with stress related mucosal bleeding, what drug you will use?
Proton-pump inhibitor
56
Px with Gastrinoma, what drug you will use?
Proton-pump inhibitor
57
Adverse effect of Proton-pump inhibitor
Interstitial nephritis Reduction in oral cyanocobalamin => subnormal Vit B12 levels Reduce Ca absortion => Increase risk of rib fracture Increase Gastrin Increase risk of Community and Hospital acquired Pneumonia
58
Increase risk of Community and Hospital acquired Pneumonia may due to what drug?
Proton-pump inhibitor
59
Gastric Adenocarcinoma adverse effect of what drug
Proton-pump inhibitor
60
What drug does Omeprazole inhibits
Warfarin, Phenytoin, Diazepam
61
This drug Enhance clearance of Theophylline
Lansoprazole
62
This drug decreases Clopidogrel activation
PPi
63
PPi will decreased absorption of this drug?
Ketoconazole, Itraconazole, Digoxin, Atazanavir this drug needs acidic environment to be absorb

Pharma 4 (2 decks)

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