GI Drugs Flashcards
Gastric acid secretion has been shown to be most effectively reduced with the use of: o Adrenal stenosis o Anticholinergic drugs o Serotonin antagonists o H1 receptor antagonists o H2 receptor antagonists
H2 receptor antagonists
Which is an H2 receptor antagonist? o Cimetidine o Tripelennamine o Promethazine o Diphenhydramine o Chlorpheniramine
Cimetidine
What are the 4 types of drugs used to treat PUD?
Drugs that increase the pH of the stomach
Sucralfate
Cytotec (prostaglandin analog)
Antibiotics
Omeprazole (Prilosec)
Class: Proton pump inhibitor
Mechanism of action: Covalently bind to Na-K-ATPase (proton pump)
Indication: takes couple weeks to start working and its addictive
Pharmacological effects: inc pH of stomach
How this drug might effect dental treatment of patient
oAdverse effects you have to consider:
oContraindicated drugs:
oContraindications:
oWhich analgesic can the patient take
Ranitidine (Zantac)
Class: H2 receptor antagonists
Mechanism of action: competitive inhibitor of histamine 2 receptor.
Indication:
Pharmacological effects:Blocks gastric acid secretion
How this drug might effect dental treatment of patient
oAdverse effects you have to consider:
oContraindicated drugs:
oContraindications:
oWhich analgesic can the patient take
Magnesium salts (milk of magnesia)
Class: antacids, osmotic laxative
Mechanism of action: buffer gastric HCl, dec pepsin activity and inc prostaglandin production
Also increases water content of feces and intestinal lumen
oContraindicated drugs: dec antibiotic action
Sucralfate (Carafate)
Class: Gastro-protective. aluminum hydroxide and sulfated sucrose
Mechanism of action: forms viscous suspensin that binds at ulcer site, maintains mucosal vascular integrity and blood flow
Indication: not absorbed from GI tract so very safe, even prego women can take it
Pharmacological effects:
Misoprostol (Cytotec)
Class: Prostaglandin analog
Mechanism of action: Agonists at PGE2 and PGI2 receptors
Indication: only used in chronic nsaid therapy: history of PUD, on anticoagulant, over 60yrs, poor surgical risk
Pharmacological effects: Only moderately effective
How this drug might effect dental treatment of patient
oAdverse effects you have to consider:
oContraindicated drugs:
oContraindications:
oWhich analgesic can the patient take
What 4 types of drugs are used to treat GERD?
Drugs that inc pH of stomach
Sucralfate
Alginic Acid
Motility promoting drugs
Alka-Seltzer
Class: Alginic Acid
Mechanism of action: reacts with sodium bicarb to form sodium alginate, gastric pH causes alginate to precipitate which floats on the surface of gastric contents
Indication:
Pharmacological effects: forms neutral barrier btwn stomach and esophagus
Metoclopramide (Reglan)
Class: Central dopamine receptor antagonist
Mechanism of action: contraction of gastric muscle, relax of pyloric and duodenal segments, inc peristalsis
Indication: GERD, also as an anti-emetic
Pharmacological effects:
How this drug might effect dental treatment of patient
oAdverse effects you have to consider: dry mouth, nausea
Analgesics while on GERD drugs
Aspirin is contraindicated
NSAIDS used cautiously
Acetaminophen is best
Anti-emetic drugs
Dopamine receptor antagonists
Antihistamines
5-HT3 Antagonists
Prochlorperazine (Compazine)
Metoclopramide (Reglan)
Class: Dopamine receptor antagonists
Mechanism of action: inhibit stimulation of CTZ
Indication:
Pharmacological effects:
How this drug might effect dental treatment of patient
oAdverse effects you have to consider:
oContraindicated drugs:
oContraindications:
oWhich analgesic can the patient take
Diphenhydramine (Benadryl)
Promethazine (Phenergan)
Class: Antihistamines
Mechanism of action:
Indication: combined sedative and antemetic effects
Pharmacological effects:
oAdverse effects you have to consider: dry mouth
oContraindicated drugs:
oContraindications:
oWhich analgesic can the patient