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Patho 1 > GI drugs > Flashcards

GI drugs Flashcards

1
Q

Cimetidine (Tagamet) and famotidine (Pepcid) class and MOA, indications

A
  • H2 rec antagonist
  • Block H2 receptors in the stomach and dec gastric acid secretion; inc stomach pH
  • GERD, PUD, ulcer prophylaxis (bc aspiration PNA risk–critically ill, ICU), heartburn/dyspepsia
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2
Q

Cimetidine (Tagamet) and famotidine (Pepcid) SE and NC

A
  • Well tolerated, CNS alter in old (LOC, alert), slight inc risk for PNA in old
  • PO or IV
  • give at least 1h apart from antacids
  • cimetidine is CPY450 inhibitors (older agents); Famotidine is NOT
  • can inc level warfarin, phenytoin, theophylline
  • give IV slow to avoid brady
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3
Q

Omeprazole, pantoprazole, esomeprazole class, indications, and MOA

A
  • PPI
  • Bind to proton pump and inhibit the hydrogen K ATPase enzyme system (pump) to irreversibly inhibit secretion of HCl
  • short term tx of PUD and GERD
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4
Q

Omeprazole, pantoprazole, esomeprazole SE and NC

A

Short-term (safe)
Long-term (may inc risk of PNA, bone loss/hip fx, stomach cancer)
- work better than H2RA
- OTC or rx
- benefits outweigh risks often
- few intx

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5
Q

Sucralfate class, indications, and MOA

A
  • mucosal protectant
  • duodenal and gastric ulcers
  • Alters when exposed to gastric acid and becomes stick, thick gel that makes protective barrier
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6
Q

Sucralfate SE and NC

A

No major fx, may cause constipation
- always PO tab or suspension
- take before eat
- can dec drug abs (take other drugs first)
- take 2h apart

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7
Q

Antacids MOA and indications

A

Neutralize gastric acid by 50% by doing chem chx
- PUD, GERD, stress ulcers (prophylaxis), may help with heartburn or indigestion

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8
Q

Antacids SE and NC

A

Diarrhea (magnesium), constipation (aluminum, Ca)
- rebound effect when stopped
- chelation–bind to other drugs when taken so separate from other drugs by 1-2h
- balanced antacid–Al+Mg (maalox and mylanta)

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9
Q

Ondansetron class, indications, and MOA

A
  • Sr blocker
  • N/V (esp chemo)
  • Blocks Sr rec in chemoreceptor trigger zone in brain and in afferent vagal nerves in stomach or sm intestine
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10
Q

Ondansetron SE and NC

A

Mild HA, diarrhea, dizzy, constipation; well tolerated
- PO or IV
- risk Sr syndrome
- careful with SSRIs, SNRIs, TCAs, MAOIs, buspirone, tramadol if daily use

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11
Q

Dimenhydrinate (Dramaine), meclizine, hydroxyzine class, indications, and MOA

A
  • Antihistamines
  • tx dizzy and nausea assoc with motion sickness
  • Block H1 receptors in inner ear
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12
Q

Dimenhydrinate (Dramaine), meclizine, hydroxyzine SE and NC

A

Sedation, drowsy, dizzy, anticholinergic
- fall risk bc ACh
- no hydroxyzine IV bc tissue damage, thrombosis, gangrene

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13
Q

Metoclopramide (Reglan) class, indications, and MOA

A
  • Prokinetic agent aka dopamine antagonist
  • GERD, diabetic gastroparesis, N/V assoc with chemo/radiation/opioids, GI motility issues (CF), paralytic ileus
  • Block dopamine rec, inc tone of lower eso sphincter, inc peristalsis in stomach and int
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14
Q

Metoclopramide (Reglan) SE and NC

A

Sedation
Severe - extrapyramidal sx EPS), restless, neuroleptic malignant syndrome
- EPS risk when also taking antipsychotics esp or Reglan (drug-induced mvt like akathasia, acute dystonia, parkinsonism, tardive dyskinesia, NEUROLEPTIC MALIGNANT SYNDROME–rigid, fever, drowsy, SZ)

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15
Q

Diphenoxylate with atropine, loperamide class, indications, and MOA

A
  • antidiarrheal
  • diarrhea
  • dec intestinal peristalsis, dec intestinal effluent
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16
Q

Diphenoxylate with atropine, loperamide SE and NC

A
  • Drowsy and constipation, anti-ACh with atropine, cardiac arrest and brady
  • Fall and driving precautions (esp with other CNS depressants)
  • cardiac arrest, brady risk
17
Q

Sulfasalazine class, indications, and MOA

A
  • 5-aminosalicylates
  • IBD
  • Sulfonamide abx that converts into 5-aminosalicylic acid and sulphapyridine - sulfasalazine works
18
Q

Sulfasalazine SE and NC

A
  • Sulfasalazine–nausea, fever, rash, HA, hematologic dx
  • Sulphapyridine has no therapeutic fx so some pt prefer mesalamine alone
  • not for pt with SULFA allergy or some anemias
19
Q

Infliximab (Remicade) class, indications, MOA

A
  • Disease modifying antirheumatic drug (DMARD)
  • IBD
  • Monoclonal antibody which neutralized TNF-alpha (inflam mediator) and dec inflam response
20
Q

Infliximab SE and NC

A
  • Immune suppression–infx, cancer, heart fail, infusion rxn, neutropenia
  • often require therapeutic drug monitor and biomarker monitoring for inflam (CRP)
  • need vax screen for disorders before starting (TB test)
  • infusions–weekly or monthly

Patho 1 (30 decks)

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