GI drugs

Question 1

Deferasirox (use)

Answer 1

Hemochromatosis

Question 2

Deferoxamine (use)

Answer 2

Hemochromatosis

Question 3

Cimetidine and other “-dine” (mechanism)

Answer 3

H2 blocker (reversible)

Question 4

Cimetidine and other “-dine” (3 uses)

Answer 4

Peptic ulcer
Gastritis
Mild reflux

Question 5

Cimetidine and other “-dine” (side effects)

Answer 5

Cimetidine only: P450 inhibitor, antiandrogenic, crosses BBB and placenta
Cimetidine and ranitidine: decreases renal excretion of creatinine

Question 6

-prazole (mechanism)

Answer 6

PPI - irreversibly inhibit H+/K+ ATPase in parietal cells
So will inhibit acid secretion in response to ACh, histamine, and gastrin (unlike atropine, which only blocks ACh pathway, or H2 blockers, which only block histamine pathway

Question 7

-prazole (4 uses)

Answer 7

Peptic ulcer
Gastritis
Eso reflux
ZE

Question 8

-prazole (side effects)

Answer 8

Increased risk of C diff and pneumonia
Hip fx
Lowers serum Mg2+ w/ long term use

Question 9

Bismuth (mechanism)

Answer 9

Binds to ulcer base (physical protection for mucous layer)

Question 10

Bismuth (2 uses)

Answer 10

Ulcer healing

Travelers’ diarrhea

Question 11

Sucralfate (mechanism)

Answer 11

Binds to ulcer base (physical protection for mucous layer)

Question 12

Sucralfate (2 uses)

Answer 12

Ulcer healing

Travelers’ diarrhea

Question 13

Misoprostol (mechanism)

Answer 13

PGE1 analog -> better gastric mucous barrier, decreases acid production

Question 14

Misoprostol (3 uses)

Answer 14

Prevent NSAID-induced peptic ulcers
Maintain PDA
Induce labor (ripens cervix)

Question 15

Misoprostol (side effects)

Answer 15

Diarrhea

Abortion

Question 16

Aluminum hydroxide (use)

Answer 16

Antacid

Question 17

Aluminum hydroxide (side effects)

Answer 17

Constipation, hypophosphatemia, prox m. weakness, osteodystrophy, seizures, hypokalemia

Question 18

Calcium carbonate (use)

Answer 18

Antacid

Question 19

Calcium carbonate (side effects)

Answer 19

Rebound increase in acid
Reduces effectiveness of other drugs (tetracycline)
Hypokalemia

Question 20

Magnesium hydroxide (2 uses)

Answer 20

Antacid

Osmotic laxative

Question 21

Magnesium hydroxide (side effects)

Answer 21

Diarrhea, cardiac arrest, hyporeflexia, hypotension, hypokalemia

Question 22

Magnesium citrate (use)

Answer 22

Osmotic laxative

Question 23

PEG (use)

Answer 23

Osmotic laxative

Question 24

Lactulose (2 uses)

Answer 24

Osmotic laxative
Hepatic encephalopathy or hyperammonemia in general (ACIDIFIES INTESTINAL CONTENT b/c it gets degraded by bac into acetic acid and lactic acid -> NH3 moves in from blood and gets converted to NH4+ -> body poops it out)

Question 25

Infliximab (mechanism)

Answer 25

Monoclonal Ab to TNF-a

Question 26

Infliximab (5 uses)

Answer 26

``` Crohn UC RA Ankylosing spondylitis Psoriasis ```

Question 27

Infliximab (side effects)

Answer 27

Infection (TB reactivation), fever, hypotension

Question 28

Sulfasalazine (mechanism)

Answer 28

Salfapyridine (antibac) + 5-ASA (anti inflammatory) | Activated by colonic bac

Question 29

Sulfasalazine (2 uses)

Answer 29

UC | Crohn

Question 30

Sulfasalazine (side effects)

Answer 30

Sulfonamide toxicity, reversible oligospermia, malaise, nausea

Question 31

Ondansetron (mechanism)

Answer 31

5-HT3 ANTAgonist, decreases vagal stimulation

Question 32

Ondansetron (use)

Answer 32

Antiemetic in post-op chemo pts

Question 33

Ondansetron (side effects)

Answer 33

Headache, constipation

Question 34

Metoclopramide (mechanism and 2 uses)

Answer 34

``` D2 ANTAgonist (prokinetic and antiemetic), doesn't influence colon transport time For gastroparesis (in diabetic or post-surgery), antiemetic ```

Question 35

Metoclopramide (side effects)

Answer 35

Parkinsonian effects Interactions w/ digoxin and diabetic agents Contraindicated w/ small bowel obstruction or Parkinson disease

Question 36

Rifaximin (mechanism and use)

Answer 36

Kills intestinal bacteria | For hepatic encephalopathy

Question 37

Penicillamine (mechanism and use)

Answer 37

Copper chelator | Wilson disease

Question 38

Trientine (use)

Answer 38

Wilson disease

Question 39

Orlistat (mechanism and use)

Answer 39

Inhibits intestinal lipase -> inhibits fat absorption | Weight loss tx for obesity