GI DRUGS Flashcards
List 4 -TIDINES, what class of drugs are these -TIDINES?
H2 blockers
(reversible)
“CFRN”-You have Cystic Fibrosis, go see an RN!
Cimetidine
Famotidine
Ranitidine
Nizatidine
Prokinetic Drug used for Colonic Pseudo-obstruction in hospitalized patients
Neostigmine
AchE Inhibitor
list 3 antacids
“A-M-C”
Al(OH)3
Mg(OH)2
CaCO3
The first-line regimen for eradication of H pylori should be
PPI plus clarithromycin, and either amoxicillin or metronidazole. (triple theraphy)
The recommended duration of treatment in the US is 14 days. International guidelines recommend 7-10 days. These treatments cure infection in > 95% of cases.
Whats the Quadruple therapy for H. Pylori?
a PPI, tetracycline and bismuth subsalicylate and metronidazole is also effective but more cumbersome.
AE of Mg(OH)2
•Mg(OH)2 → DIARRHEA-due to production of Mg2+ Salt which is very poorly absorbed.
its also an “osmotic agent” used as a LAXATIVE! makes sense!
what the MOA of Antacids?
They are Weak bases increase the pH of the stomach → PEPSIN INACTIVATION
Are antacids useful in the PREVENTION of GERD and can they heal erosive ulcers?
NOOOO!!! no to both.
Antacids remain an effective option for treating mild, infrequent heartburn
weak bases like _______have an increased absorption when taking antacids like
Al(OH)3
Mg(OH)2
CaCO3
Quinidine
“the Queen stands on a weak base when giving her speech, so people really absorb her message”
which Mucosal Protective Agents has the following AE’s
- DIARRHEA, abdominal cramping & nausea
- Abortifacient – induces uterine contractionsà CONTRAINDICATED IN PREGNANCY
- Exacerbation of IBD
Misoprostol
PGE1 analogue
Unlike Antacids, which drugs ARE indicated for molid to mod infrequent GERD sxs?
H2 blockers
(reversible)
[-TIDINE]
Cimetidine
Famotidine
Ranitidine
Nizatidine
Name the 3 D2 Blockers (antiemetics)
“PPD”
Prochlorperazine
Promethazine
Droperidol
Are D2 and M blockers
In contrast to H2 antagonists ________inhibit both fasting and meal-stimulated acid secretion because they block the final common pathway of acid secretion: which is the ________ Standard doses of PPIs inhibit more than 90% of 24-hour acid secretion.
PPIs [-PRAZOLE}-first blank
Proton Pump inhibitor
Standard doses of PPIs inhibit more than 90% of 24-hour acid secretion.
Which is the drug that has the following characterists
- Nearly 100% reduction in HCl in a single dose
- Activated after transport into parietal cell [prodrug]
inhibits metabolism of:
•Warfarin
•Phenytoin
•Diazepam
•Cyclosporine
Omeprazole
PPIs
[-PRAZOLE}
weak Acids like _______have an decreased absorption when taking antacids like
Al(OH)3
Mg(OH)2
CaCO3
Warfarin
whats the (prodrug) that gets converted to (6-MP) 6- Mercaptopurine?
•Azathioprine
How quickly do antacids start working adn how long do they last?
Antacids begin to provide relief of symptoms within 5 minutes but have a duration of effect of only 30 to 60 minutes.
SIDE NOTE: Because of their short duration of action and inability to heal erosive esophagitis, they are not an option for treating moderate to severe GERD.
Which drug has the following characteristics:
•Acts on Motilin receptor of GI
-Indicated for: Gastric emptying before endoscopy
Erythromycin
Protein Synthesis Inhibitor [50S]
Macrolide ABx
Which class of drugs has the following characteristics
- used to promote healing of gastric and duodenal ulcers and to treat GERD, including erosive esophagitis.
- approved as part of the combination therapy for eradication of H pylori infection.
- are superior to H2 antagonists in the healing of NSAID-induced peptic ulcers.
- are superior to H2 blockers for the control of gastric acid hypersecretion and are the DOC for controlling acid secretion in Zollinger-Ellison syndrome.
PPIs are generally well tolerated.
List the
[-PRAZOLES}
PPIs
Omeprazole
Esomeprazole
Lansoprazole
Rabeprazole
Pantoprazole
•DOC for Chemotherapy induced nausea/vomiting [CINV]
Glucocorticoid Agonists
Dexamethasone
Methylprednisolone
Due to their effectiveness as once a day therapy and rapid healing rates____ are usually the drugs of choice for NSAID-induced ulcers are gastric ulcers
PPIs
Omeprazole
Esomeprazole
Lansoprazole
Rabeprazole
Pantoprazole
AE of CaCO3
•CaCO3 → HYPERCALCEMIA, Nephrolithiasis & constipation → fecal impaction
Prolonged use of which two drug classses used in the treatment of PUD → ↓ bioavailability of B12, Digoxin and Ketoconazole and also Sucralfate bc acid is required for absorption?
PPI and H2 blockers
TIDINE that inhibits CYP450 and hasmany drug interactions with
“WIPPQBT”
- Warfarin
- Imipramine
- Phenytoin
- Procainamide
- Quinidine
- Benzos
- Theophylline
Cimetdine
AE of each of Al(OH)3
•Al(OH)3 → CONSTIPATION & Hypophosphatemia
this drug class is effective in reducing nocturnal acid secretion (fasting) but only modestly effective in reducing meal-stimulated acid secretion
H2 blockers
(reversible)
[-TIDINES]
effective in reducing nocturnal acid secretion (fasting) which depends largely on histamine), but only modestly effective in reducing meal-stimulated acid secretion (which is stimulated by gastrin and acetylcholine, as well as by histamine)
What are the potential renal adverse effects of NSAIDs?
- Decrease In Renal Blood Flow
NSAID-induced decreases in PGs may lead to sodium and water retention, edema, increased blood pressure, hyperkalemia, and acute renal failure.
- Analgesic Nephropathy
a condition in which chronic interstitial nephritis is caused by prolonged and excessive consumption of analgesics, particularly combinations of different agents.
