GI Drugs Flashcards

1
Q

Cimetidine

A

Histamine-2 blockers

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2
Q

Ranitidine

A

Histamine-2 blockers

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3
Q

Famotidine

A

Histamine-2 blockers

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4
Q

Nizatidine

A

Histamine-2 blockers

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5
Q

Histamine-2 blockers ADR

A

Cimetidine- p450 inhibitor & anti-androgenic

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6
Q

Histamine-2 blockers mechanism

A

“Reversible block of histamine H2-receptors”

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7
Q

Omeprazole

A

Proton pump inhibitors

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8
Q

Lansoprazole

A

Proton pump inhibitors

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9
Q

Esomeprazole

A

Proton pump inhibitors

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10
Q

Pantoprazole

A

Proton pump inhibitors

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11
Q

Dexlansoprazole

A

Proton pump inhibitors

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12
Q

Proton pump inhibitors ADR

A

Inc risk of C. Diff & pneumonia (reduced antimicrobial environment in gut)
Long term may cause B12 deficiency
Impacts absorption of other drugs (increases dig, voriconazole)
Reduced Mg and Ca levels (increased risk of fracture)

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13
Q

Proton pump inhibitors mechanism

A

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

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14
Q

Aluminum hydroxide

A

Antacid

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15
Q

Calcium Carbonate

A

Antacid

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16
Q

Magnesium Hydroxide

A

Antacid

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17
Q

Aluminum hydroxide ADR

A

Constipation

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18
Q

Magnesium Hydroxide ADR

A

Diarrhea

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19
Q

Calcium Carbonate ADR

A

Hypercalcemia (milk-alkali syndrome)
CO2 generation (bloating/flatulance)
Constipation

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20
Q

Bismuth

A

Mucous protector - binds to site of ulcer

Some activity against H. Pylori

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21
Q

Sucralfate

A

Mucous protector - binds to site of ulcer

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22
Q

Mucous protector ADR

A

Ineffective in alkaline environments (not given with PPI)

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23
Q

Misoprostol

A

PGE-1 analog, incr. production of mucous barrier

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24
Q

Misoprostol ADR

A

Diarrhea

Abortifactant

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25
Q

Octreotide

A

Somatistatin analog, ultimately vasoconstrictive (anti-vasodilatory)

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26
Q

Octreotide ADR

A

Nausea, cramps, steatorrhea

Inc. risk of cholelithiasis (2/2 CCK inhibition)

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27
Q

Sulfasalazine

A

Sulfapyridine + 5-ASA

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28
Q

Sulfasalazine ADR

A

Malaise, nausea, sulfa toxicity, oligospermia

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29
Q

Loperamide

A

Opiod agonist, slows gut motility

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30
Q

Loperamide ADR

A

Constipation, nausea

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31
Q

Ondansetron

A

Seratonin Antagonist

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32
Q

Ondansetron ADR

A

Headache, constipation, QT elongation, serotonin syndrom

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33
Q

Metoclopramide

A

Dopamine Antagonist
Increase tone of esophaguses
Does not change colon transport time

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34
Q

Metoclopramide ADR

A

Parkinsonianism
Restlessness
Contraindicated in patients with bowel obstruction or parkinson

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35
Q

Orlistat

A

Inhibits gastric/pancreatic lipase

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36
Q

Orlistat ADR

A

abd pain, flatus, urgancy

Reduced vit ADEK

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37
Q

Psyllium

A

Bulk forming laxative

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38
Q

Methylcellulose

A

Bulk forming laxative

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39
Q

Mag Hydroxide

A

Osmotic laxative

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40
Q

Mag Cytrate

A

Osmotic laxative

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41
Q

PEG

A

Osmotic laxative

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42
Q

Lactulose

A

Osmotic laxative

Also used for encephalopathy (increases lactic acid, which increases NH4+ excretion)

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43
Q

Senna

A

Stimulant of enteric nerve

44
Q

Docusate

A

Emollient (incorporation of H20 into stool)

45
Q

Bulk Laxative ADR

A

Bloating

46
Q

Bulk laxative mechanism

A

Inc fiber draws H20 into lumen

47
Q

Osmotic laxative ADR

A

Diarrhea, dehydration

48
Q

Osmotic laxative mechanism

A

Provide load to draw H20 into lumen

49
Q

Enteric Stimulant ADR

A

Diarrhea, melanosis coli

50
Q

Emollient ADR

A

Diarrhea

51
Q

Enteric stimulant mechanism

A

Increases colonic contractions

52
Q

Emollient mechanism

A

promotes incorporation of H20 in to stool

53
Q

PPI pregnancy

A

No adequate studies

54
Q

PPI PK

A

Onset 1 hr; duration <3 days

55
Q

H2RB PK

A

Onset 1 hr; duration 13 hours

56
Q

H2RB Pregnancy

A

No adequate studies

57
Q

Baclofen

A

GABA-B Agonist

58
Q

Baclofen MOA

A

suppresses transient LES relaxation - use in patients failing antacid tx

59
Q

Baclofen- ADR

A

MM relaxation, sedation

60
Q

Triple Therapy

A

PPI + clarithromycin + amoxicillin

61
Q

Quad therapy

A

PPI + Bismuth + metronidazole + tetracylcine

62
Q

Pregnancy NV

A

Dietary changes
B6 +/- Doxylamine
Promethazine
Ondansetron

63
Q

Hyperemesis Gravidarum

A

Ondansetron

64
Q

Postop NV

A
Prophylactic antiemetics 1-2+ depending risk:
Benzos prior to surgery
Scopolamine patch
NKI antagonists
Ondansetron post-op
Dexamethasone
65
Q

Refractory post op

A

Rescue therapy:

Phenothiazine, metoclopramide, or droperidol

66
Q

Post op emesis risk factors

A
<50 years old
Female
Non-smoker
Hx of PONV
Hx of Motion Sickness
General Anesthesia
NO2
67
Q

Acute (<24 hours of tx) Chemo induced NV

A
Seratonin antagonists (-setron)*
NK1 Antagonists*
Olanzapine
Dexamethasone*
Use * in combination for moderate or highly emetogenic
68
Q

Delayed (>24 hours of tx) Chemo-induced NV

A

Use adequate prophylaxis

69
Q

Anticipatory chemo-induced NV

A

Add benzodiaszepine AFTER trying nonpharm tx

70
Q

Breakthrough chemo-induced NV

A

Different class

71
Q

Refractory chemo-induced NV

A

Add prophylaxis + breakthrough

72
Q

Serotonin Antagonists

A

Inhibit vagal signals (periphery) and chemo trigger centrally

73
Q

Serotonin Antagonists ADR

A

HA, dizziness, constipation, prolonged QT

74
Q

Aprepitant

A

NK1 Receptor antagonists

75
Q

Fosaprepitant

A

NK1 Receptor antagonists

76
Q

Rolapitant

A

NK1 Receptor antagonists

77
Q

NK1 Receptor antagonists

A

Centrally acting antiemetic

78
Q

NK1 Receptor antagonists ADR

A

Fatigue, dizziness, diarrhea; CYP inhibitors (grapefruit) increase risk of toxicity

79
Q

Antihistamines

A

Block H1 receptor centrally (Both vestibular and vomiting center)

80
Q

Diphenhydramine

A

Antihistamines

81
Q

Dimenhydrinate

A

Antihistamines

82
Q

Meclizine

A

Antihistamines

83
Q

Scopalamine

A

Antimuscarinic

84
Q

Antimuscarinic

A

Block M1 receptor centrally (Both vestibular and vomiting center)

85
Q

Antimuscarinic ADR

A

Dizziness, dry mouth, mydriasis (anti-SLUD)

86
Q

Antihistamine ADR

A

Dizziness, dry mouth, sedation

87
Q

Prochlorperazine

A

Phenothiazine

88
Q

Promethazine

A

Phenothiazine

89
Q

Thiethylperazine

A

Phenothiazine

90
Q

Droperidol

A

Butyrophenone

91
Q

Haloperidol

A

Butyrophenone

92
Q

Metoclopramide

A

Substituted benzamide

93
Q

Trimethobenzamide

A

Substituted benzamide

94
Q

Phenothiazine MOA

A

Compete for dopamine, muscarine, and histamine

95
Q

Phenothiazine ADR

A

Sedation, dermatitis, dry mouth, dizziness

96
Q

Butyrophenone MOA

A

Competes for dopamine binding

97
Q

Butyrophenone ADR

A

Sedation, constipation

98
Q

Substituted benzamide MOA

A

Dopamine receptor antagonist

99
Q

Substituted benzamide ADR

A

HA, Somnolescence

Metoclopramide: CAN cause Parkinsonism

100
Q

Dexamethasone

A

Corticosteroid

101
Q

Corticosteroid ADR

A

Hypertension, abnormal vision

102
Q

Lorazepam

A

Benzodiazepine

103
Q

Diazepam

A

Benzodiazepine

104
Q

Benzodiazepine MOA

A

GABA-A Agonist - increases inhibitory signals

105
Q

Benzodiazepine ADR

A

Dizziness, sedation