GI Drugs Flashcards
What are the 3 drugs used for Gastric acidity?
- Antacids
- H2 receptor blockers
- Proton pump inhibitors
What are the most commonly used drugs?
Proton pump inhibitors
Which drug blocks the stimulation to secrete acid?
H2 receptor blockers
Which drug blocks the direct secretion of acid into the stomach?
Proton pump inhibitors
What are the types of antacids used?
- Al, Mg, Ca
2. Hydroxide or carbonate
What drugs would you use to treat episodic minor gastric discomfort from overeating or from certain incompatible foods?
Antacid
What are some ADRs of Antacids?
- Al=constipation
- Mg = diarrhea
- Acid rebound due to negative feedback loop
- May alter metabolism of drugs that rely on acidic stomach
Which drug may have antibacterial actions against H. Pylori?
Proton pump inhibitor
What are some adverse effects of PPI?
- Acid rebound
2. osteoporosis
Bacteria thought to cause or potentate gastroduodenal ulcers?
H. pylori (treat with antibiotics and/or PPI)
What are some other, not often used, drugs for gastric ulcers
Anticholinergics and metoclopramide
Stimulates mucus secretions; helps with GI damage caused by NSAIDs
Prostaglandins
Disaccharide; protective effect on mucosa, may cause constipation
Sucralfate
How would you want to treat someone with diarrhea?
- Replace electrolytes
2. Replace fluids
Drugs used for diarrhea that decrease GI motility; may reduce fluid loss; low risk of tolerance and addiction
Opioid derivatives (lomitil, imodium)
Drugs used that absorbs irritants from GI tract to reduce diarrhea
Absorbents (Kaolin [clay], pectin [fruit], attapulgite)
Drug that stimulates water reabsorption; antibacterial; inhibits prostaglandin synthesis that irritates intestinal lining; used for mild-to-moderate diarrhea
Bismuth salicylate (pepto-bisomol); you can overdose if combined with aspirin
Drugs used to treat constipation
Laxatives (gentle)
cathartics (rapid)
What patients often used laxatives and cathartics
- Prolonged bed rest
- SCI
- Infrequent or painful bowel movements
- Pts who should avoid straining
Absorb water and stimulate intestinal motility
Bulk-forming laxatives (citrucel, fiber all, metamucil)
Draw water to GI tract, increase peristalsis
Hyperosmotic (milk of magnesia, epsom salt, miralax)
Facilitate entry of water into fecal mass; permit easier defication
lubricants and stool softeners (colace
Irritant or stimulate GI nerves (cathartic)
Stimulant laxatives (castor oil, exlax, purge, Percolace)
Induce vomiting
Emetics (apomorphine, ipecac)
Aid in digestion; main ones contain pancreatic enzymes or bile salts; used for CF and pancreatitis
Digestants
Decrease nausea and vomiting
Antimentics (antihistamines, anticholinergics, D2 blockers, 5-HT3 receptor blockers, cannabinoids)
Older drugs for Hep C
- Riravirn
- Interferon
ADR = flu like symptoms and emotional problems
Drug for Hep C; generic antiviral drug; treatment length depends on hep c genotype (1 ,4, 5, 6), prior tx, and cirrhosis; 93-99% success for 24 weeks but costs $94.5k or $189k
Harvoni (ledipasvir, sorosbuvir, with or without ribavarin)
What are some ADRs for Harvoni?
Most common: fatigue, headache, weakness
- Heart problems
What drugs should you take with food?
- Antibiotics [cefuroxime and erythromycin]
- High cholesterol medication [lovastatin]
- Mania medication [lithium]
What drugs should you take without food?
- Antibiotics [Ampicillin, ciprofloxaxin, azitrhomycin, doxycycline or tetracycline]
- HTN and heart failure [Captopril]
- HIV protease inhibitor [Indinavir]
What can happen if you have grapefruit juice with some drugs?
- it can increase effective drugs 5x
2. can block the enzyme involved with the metabolism of many drugs (doesn’t allow drug to have proper effect)
What can happen if you are taking Warfin and have a high protein diet?
Causes elevated serum albumin may decrease INR; increased risk of clot
What are two dietary things that will effect anti-coagulant drugs)?
- Dark-green leafy vegetables (antagonize effect of command by competitive inhibition, advisory is to keep intake level)
- Cranberry juice (increases half life)
What are some cardiac drugs that can be effected by diet?
- Anti-HT (sodium restricted diet)
- Propranolol ( serum level increase with high protein foods)
- Paleolitich diets
What drug can cause hypertensive crisis if you eat tyramine-containing foods (Matured cheese, red wine, ripe bananas, yogurt, salami)?
MAO - I
can get transdermal patch to eliminate food-drug interactions
What drug type is associated with glucose intolerance
atypical antipsychotic drugs (non-dopamine)
When should tetracyclines be taken?
1 hour before meal or 2 hours after meal (binds iron and calcium, reducing bioavailability)
Should tylenol be taken with food? NSAIDs?
No; yes
What drugs can be affected by black licorice?
anti-HT and anti-arrhythmic medications; may increase BP
