GI Drugs (Exam #2) Flashcards
What are the two antacids, and what is the major AE of each?
- Magnesium hydroxide = diarrhea
- Aluminum hydroxide = constipation
What are the two primary H2 Histamine Antagonist drugs? What is the name hint?
“-tidine”
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
What are the two primary PPIs? What is the name hint?
“-prazole”
- Omeprazole (Prilosec)
- Esomeprazole (Nexium)
What is the MOA of Misoprostol, and what is its primary use?
PGE1 analogue
- Used to prevent NSAID-induced ulcers
What is the one CI associated with Misoprostol, and why?
PREGNANCY
- Can induce uterine contractions/abortion bc PG analogue
What is an important note with antacids and drug interactions?
Antacids DECREASE absorption of other drugs
What two GI drugs are NOT recommended in those with renal dysfunction, and why?
Magnesium and Aluminum (mostly long-term use)
- Excreted by kidneys so if poor renal function → toxicity
What is an important AE of Cimetidine? What is an alternative use of this medication?
Anti-androgen effect
- Can be used to treat masculinization in females
How does Cimetidine differ from other H2 Antagonists (think AEs)?
Drug interactions (inhibits CYP3A4) - Avoid with Warfarin, Phenytoin, Theophylline
What is the DOC for GERD? What is the MOA of these drugs?
PPIs
- IRREVERSIBLY inhibit proton pump
Chronic use of PPIs can lead to what three AEs?
Decreased absorption of…
- Ca = osteoporosis
- Mg = hypomagnesemia/muscle spasms
- B12 = Vitamin B12 deficiency
Which PPI is associated with drug interactions, and what are four examples of this?
Omeprazole = inhibits CYP2C19
- Phenytoin
- Diazepam
- Warfarin
- Clopidogrel
What four abx can be used to treat H. pylori-induced ulcers?
- Metronidazole (Flagyl)
- Amoxicillin
- Tetracycline
- Clarithromycin
What group of drugs are used to stimulate GI activity, and what are three examples?
Prokinetic Agents
- Metoclopramide (Reglan)
- Bethanechol
- Erythromycin
What is the MOA of Metoclopramide (Reglan), and what AE is associated with this?
D2 receptor antagonist
- EPS (Parkinson-like sxs) - especially old/hospitalized
What is the MOA of Bethanechol?
Muscarinic agonist
What group of drugs are used to inhibit GI activity, and what are two examples? What condition are they used to treat?
Antispasmodics for IBS
- Dicyclomine (Bentyl)
- Amitriptyline
What GI condition can Amitriptyline be used to treat? What symptom can it also relieve, and how?
IBS (antispasmodic)
- Reduce chronic pain via increased NE → stimulate alpha2 receptors
What group of drugs is primarily used to treat nausea/vomiting? What two types of N/V specifically (and which type are they NOT good for)?
What is the name hint of these drugs?
5HT3 Receptor Antagonists = “-setron”
- Good for N/V due to chemo or vagal stimulation
- NOT good for N/V due to motion sickness
Which two drugs are used to treat N/V by blocking D2 DA receptors, muscarinic receptors and H1 histamine receptors?
- Prochlorperazine (Compazine)
- Promethazine (Phenergan)
What is the main AE associated with Prochlorperazine (Compazine) and Promethazine (Phenergan), and why?
Sedation
- Due to blockade of muscarinic receptors and H1 histamine receptors
What drug is a form of THC used to treat chemo-induced N/V?
Dronabinol
What drug must ALWAYS be combined with a 5HT3 Antagonist and corticosteroid? What is the primary use of this drug?
Aprepitant
- Used for severe chemo-induced N/V
Under what three circumstances are laxatives NOT recommended for use?
- Intestinal blockage
- Perforation
- Toxic megacolon
