GI drugs

Question 1

Antacids (NaHCO3, AlOH3, MgOH)

Answer 1

MOA:
Weak bases, neutralize gastric acid

Clinical uses:
GERD, heartburn, upset stomach

Toxicity:
Carbonates: systemic effects AlOH3: constipation MgOH2: diarrhea

Extra info:
OTC symptomatic relief

Question 2

Ranitidine

Answer 2

MOA:
H2-histamine receptor antagonist

Clinical uses:
GERD, heartburn, gastric/peptic ulcer

Toxicity:
minimal toxicity

Extra info:
effective for blocking nocturnal GA secretion

Question 3

Omeprazole

Answer 3

MOA:
H+/K+ proton pump inhibitor

Clinical uses:
GERD, heartburn, gastric/peptic ulcer

Toxicity:
affects absorption of other drugs

Extra info:
blocks >90% GA secretion

Question 4

Sucralfate

Answer 4

MOA: sucrose-aluminum salt forms protective barrier

Clinical uses:
gastric/peptic ulcer, permits repair of stomach/intestinal lining

Toxicity: constipation, flatulence

Extra info:
insoluble, no systemic effects

Question 5

Misoprostol

Answer 5

MOA:
prostaglandin receptor agonist

Clinical use:
gastric/peptic ulcer, NSAID induced ulcer

Toxicity:
diarrhea, abdominal pain

Extra info:
contraindicated in pregnancy

Question 6

Bismuth Subsalicylate

Answer 6

MOA:
mucosal protective agent

Clinical uses:
dyspepsia, diarrhea

Toxicity:
black stools

Question 7

Prokinetics (Metoclopramide)

Answer 7

MOA:
5HT4 receptor agonist D2 dopamine receptor antagonist

Clinical uses:
prokinetic agent for GERD, gastritis, dyspepsia, antimetic

Toxicity:
extrapyramidal effects, hyperprolactinemia with chronic use

Extra info:
increases intestinal motility

Question 8

Pancrelipases

Answer 8

MOA:
pancreatic enzyme mixture (amylase, lipase, chymotrypsin) that aids in food digestion

Clinical uses:
chronic pancreatitis, cystic fibrosis, pancreatic duct obstruction

Toxicity: 
GI disturbances (cramping, nausea)	

Extra info:
delayed release capsules, 5-6x a day (with meals/snacks)