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STEP 1 > GI Drugs > Flashcards

GI Drugs Flashcards

1
Q

Name the H2 blockers

A

“-tidine”

cimetidine, ranitidine, famotidine, nizatidine

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2
Q

Mechanism of H2 blockers

A

reversible block of the histamine H2 receptors –> decrease H+ secretion by parietal cells

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3
Q

Use of H2 blockers

A

peptic ulcer, gastritis, mild GERD

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4
Q

Toxicity of cimetidine specifically

A 
inhibits cytochrome p450 (multiple drug interactions)
antiandrogenic effects (prolactin release, gynecomastia, impotence, decreased libido in males)
can cross BBB (cause confusion, dizziness, headaches) and can cross placenta
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5
Q

Toxicity of cimetidine and ranitidine

A

decrease renal excretion of creatinine

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6
Q

Name the proton pump inhibitors

A

“-prazole”

omeprazole, lansoprazole, esmeprazole, pantoprazole, dexlansoprazole

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7
Q

Mech of PPIs

A

irreversibly inhibit H+/K+ ATPase in stomach parietal cells

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8
Q

Use of PPIs

A

peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syndrome

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9
Q

Toxicity of PPIs

A

increased risk of C. difficile infection, pneumonia

decreased serum Mg2+ with long-term use

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10
Q

Mechanism of bismuth and sucralfate

A

bind to ulcer base, providing physical protection and allowing HCO3- secretion to reestablish pH gradient in the mucous layer

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11
Q

Use of bismuth and sucralfate

A

increase ulcer healing, travelers diarrhea

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12
Q

Mechanism of misoprostol

A

a PGE1 analog

increases production and secretion of gastric mucous barrier, decreases acid production

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13
Q

Use of misoprostol

A

prevention of NSAID-induced peptic ulcers (NSAIDs block PGE1 production); maintenance of a PDA

also off label for induction of labor (ripens cervix)

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14
Q

Toxicity of misoprostol

A

diarrhea

contraindicated in women of childbearing potential (abortifactant)

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15
Q

Mechanism of octreotide

A

long-acting somatostatin analog; inhibits actions of many splanchnic vasodilatory hormones

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16
Q

Use of octreotide

A

acute variceal bleeds, acromegaly, VIPoma, carcinoid tumor

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17
Q

Toxicity of octreotide

A

nausea, cramps, steatorrhea

18
Q

Concern with use of antacids

A

can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying

cause hypokalemia

19
Q

Toxicity of aluminum hydroxide

A

constipation and hypophosphatemia
proximal muscle weakness
osteodystrophy
seizures

20
Q

Toxicity of calcium carbonate

A

hypercalcemia

rebound acid

21
Q

Toxicity of magnesium hydroxide

A

diarrhea
hyporeflexia
hypotension
cardiac arrest

22
Q

Name the osmotic laxatives

A

Magnesium hydroxide, magnesium citrate, polyethylene glycol, lactulose

23
Q

Mechanism of osmotic laxatives

A

provide osmotic load to draw water into the GI lumen

24
Q

Use of osmotic laxatives

A

constipation

25
Q

Toxicity of osmotic laxatives

A

diarrhea, dehydration; may be abused by bulimics

26
Q

Specific use of lactulose

A

treats hepatic encephalopathy since gut flora degrade it into metabolites (lactic acid and acetic acid) that promote nitrogen excretion as NH4+

27
Q

Mechanism of sulfasalazine

A

combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory)
activated by colonic bacteria

28
Q

Use of sulfasalazine

A

ulcerative colitis, Crohn disease (colitis component)

29
Q

Toxicity of sulfasalazine

A

malaise, nausea, sulfonamide toxicity, reversible oligospermia

30
Q

Mechanism of ondansetron

A

5-HT3 antagonist
decreases vagal stimulation
powerful central-acting antiemetic

31
Q

Use of ondansetron

A

control vomiting postoperatively and in pts receiving cancer chemotherapy

32
Q

Toxicity of ondansetron

A

headache, constipation, QT interval prolongation

33
Q

Mechanism of metoclopramide

A

D2 receptor antagonist
increases resting tone, contractility, LES tone, motility
does NOT influence colon transport time

34
Q

Use of metoclopramide

A

diabetic and postsurgery gastroparesis, antiemetic

35
Q

Toxicity of metoclopramide

A

increased parkinsonian effects, tardive dyskinesia

restlessness, drowsiness, fatigue, depression, diarrhea

36
Q

Drug interaction of metoclopramide

A

with digoxin and diabetic agents

37
Q

Contraindication of metoclopramide use

A

in patients with small bowel obstruction or Parkinson disease (due to D1 receptor blockade)

38
Q

Mechanism of orlistat

A

inhibits gastric and pancreatic lipase –> decreased breakdown and absorption of dietary fats

39
Q

Use of orlistat

A

weight loss

40
Q

Toxicity of orlistat

A

steatorrhea, decreased absorption of fat soluble vitamins

STEP 1 (26 decks)

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