GI drugs I Flashcards
1
Q
Calcium Carbonate (Tums)
A
Acid-Neutralizing Agents
2
Q
Magnesium hydroxide /Aluminum hydroxide (Maalox, Gaviscon, etc)
A
Acid-Neutralizing Agents
3
Q
Cimetidine (Tagamet®)
A
H2 Histamine Antagonists
4
Q
Ranitidine (Zantac®)
A
H2 Histamine Antagonists
5
Q
Nizatidine (Axid®)
A
H2 Histamine Antagonists
6
Q
Omeprazole (Prilosec®)
A
Proton Pump Inhibitors
7
Q
Esomeprazole (Nexium®)
A
Proton Pump Inhibitors
8
Q
Rabeprazole (Aciphex)
A
Proton Pump Inhibitors
9
Q
List the three Cytoprotective Agents
A
- Sucralfate (Carafate®)
- Misoprostol (Cytotec®)
- Bismuth Subsalicylate (Pepto Bismol®)
10
Q
List the three Prokinetic Agents
A
- Bethanechol (Urecholine®)
- Metoclopramide (Reglan®)
- Erythromycin
11
Q
Glycopyrrolate (Robinul®)
A
- muscarinic antagonists
- Antispasmodics used for IBS
12
Q
Dicyclomine (Bentyl®)
A
- muscarinic antagonists
- Antispasmodics used for IBS
13
Q
Amitriptyline (Elavil)
A
Tricyclic Antidepressants
14
Q
Ondansetron (Zofran)
A
- Serotonin Antagonists
- Anti-Nausea; Anti-Emetic
15
Q
List 4 Anti-Nausea; Anti-Emetic
A
- Ondansetron (Zofran)
- Promethazine (Phenergan)
- Prochlorperazine (Compazine)
- Dronabinol (Marinol)
16
Q
Psyllium (Metamucil®)
A
Laxative
17
Q
Senna (Senokot®)
A
laxative
18
Q
Magnesium hydroxide (Milk of Magnesia®)
A
laxative
19
Q
Sodium phosphate and biphosphate (Fleet)
A
laxative
20
Q
Lactulose (Chronolac®)
A
Laxative
21
Q
Polyethylene glycol
A
- (Colyte®; Miralax)
- laxative
22
Q
, Docusate sodium
A
Laxative
23
Q
Lubiprostone
A
anti-constipation
24
Q
Loperamide (Imodium®)
A
opioid used as anti-diarrheals
25
Diphenoxylate plus atropine (Lomotil®)
anti-diarrheals
26
Sulfasalazine (Azulfidine)
anti-inflammatory
27
Infliximab (Remicade)
anti-inflammatory
28
MOA of antacids
* neutralize acids by directly binding to HCl
29
side effect of magnesium and aluminum
* magnesium: diarrhea
* aluminum: constipation
\* often combined to cancel each other's effect on GI motility out
30
important to remember that antacids have what problem
* **drug interactions**
* ****affect absorption of drugs or form insoluble complexes
31
Uses of antacids
* heartburn
* gastritis
* temporary fix, adjuct to other drugs because effect is quick
32
use of sodium bicarbonate as an antacid should be cautioned in people with
CHF
33
list pathway of histamine causing gastric acid secretion
1. histamine binds to H2 receptor on parietal cell
2. activates cAMP dependent pathway
3. stimulates H+K+ ATPase which releases H+ into gastric lumen
34
MOA of H2 antagonist
* decrease GI acid formation through H2 receptor blockade
* **Nocturnal** acid reduced best
35
List the H2 antagonists
* Cimetidine
* Ranitidine
* Famotidine
* Nizatidine
\*OTC
36
Unique side effects of Cimetidine
* **anti-testosterone effect**
* Gynecomastia, loss of libido, impotence with **chronic, high dose use**
37
drug interaction with Cimetidine
* **inhibit CYP3A4..know this!**
* inhibits metabolism of warfarin, phenytoin, theophylline, digoxin
## Footnote
****
38
Uses of H2 antagonists
* ulcers
* adjuct for
* GERD
* short bowel syndrome
* zollinger-ellison syndrome
39
In severe allergic reaction, need to give along with H1 blocker
* H2 blocker
* vasodilation involves both H1 and H2
40
What are the proton pump inhibitors common name
"Prazole"
* ex: omeprazole
41
MOA of proton pump inhibitors? effect lasts how long
* irreversible block of acid formation in gastric parietal cell
* long lasting effect: 24-48 hours
42
when should proton pump inhibitors be taken
* best to take on empty stomach 30 minutes prior to eating
43
how long does it take for proton pump inhibitors to reach a max effect
* can be given once a day, takes 2-5 days for maximum effect
44
drug of choice for GERD
* proton pump inhibitors
* acute and maintenance
45
side effects of proton pump inhibitors
* nausea, diarrhea, colic
* dec absorption of calcium -\> osteoporosis (long term concern)
* dec magnesium absorption: add Mg if muscle spasms
* inc risk of PNA
46
Omeprazole can have what drug interaction
* inhibit CYP450
* concern with warfarin
47
When are PPIs used to treat ulcers? how long does it take to treat duodenal and gastric ulcer?
* ulcers that haven't responded to H2 antagonist
* duodenal ulcer: 4 weeks
* gastric ulcer: 8 weeks
48
MOA of Sucralfate
* provides a protective barrier in ulcer base
49
side effects of Sucralfate
* causes constipation (contains aluminum)
* take on empty stomach
50
MOA of Misoprostol
* prostaglandin E1 analogue
* prevent ulceration induced by NSAID
51
contraindication of Misoprostol
* **PREGNANCY**..know this
* can induce abortion
52
MOA and use of Metoclopramide
* D2 antagonist: increases ACh release
* use: post surgical patients -\> antiemetic and causes diarrhea
53
adverse effects of Metoclopramide
* **parkinson's-like symptoms**
* methemoglobinemia in infants: do not use in pregnancy
54
MOA and use: Bethanechol
* muscarinic agonist
* prokinetic agent -\> diarrhea
55
Use of Erythromycin as an prokinetic agent
diabetic gastroparesis
56
Mainstay of treatment for IBS
* tricyclic antidepressants
* act as analgesic and antimuscarinic
