GI drugs MOA, ADE, and interactions Flashcards

1
Q

Antacids MOA

A

composed of a metal ion + base that work by neutralizing (buffering) hydrochloric acid (HCl) and forming a salt and water

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2
Q

Histamine2-Receptor Antagonists (H2RA) MOA

A

reversibly compete with histamine at the H2 receptor sites in the parietal cell of the stomach to inhibit acid secretion

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3
Q

Proton Pump Inhibitors (PPIs) MOA

A

irreversibly inhibit the K+-H+-ATPase (proton pump) which inhibits the final step in the secretion of hydrogen ions into the gastric lumen

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4
Q

Synthetic Prostaglandin MOA

A

natural prostaglandins produced by gastric mucosa act to inhibit acid secretion and to protect deep mucosa against injury (cytoprotective); production of these prostaglandins blocked by NSAIDs

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5
Q

Sucralfate (Carafate®)

A

Large aluminum salt (aluminum sucrose sulfate) forms a protective barrier at the ulcer site by binding to necrotic ulcer tissue; May also stimulate endogenous prostaglandin synthesis and adsorb bile salts

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6
Q

Prokinetic Agents

A

Increase lower esophageal sphincter (LES) tone; Promote gastric emptying

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7
Q

Metoclopramide (Reglan®)

A

Central dopamine [and serotonin (5-HT3) antagonist]; also increases response of GI tissue to acetylcholine resulting in enhanced motility and gastric emptying

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8
Q

Erythromycin

A

Motilin agonist

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9
Q

Domperidone

A

Dopamine antagonist that acts peripherally (limits extrapyramidal symptoms)

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10
Q

Calcium ADE

A

Constipation

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11
Q

Aluminum ADE

A

Constipation

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12
Q

Magnesium ADE

A

Diarrhea

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13
Q

Sodium ADE

A

Fluid retention

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14
Q

Cimetidine ADE

A

Hematologic abnormalities, confusion, delusions, gynecomastia, increased etoh levels

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15
Q

Ranitidine ADE

A

Hematologic abnormalities, confusion, delusions, increased etoh levels

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16
Q

Nizatidine ADE

A

Hematologic abnormalities, confusion, delusions, increased etoh levels

17
Q

Famotidine ADE

A

Hematologic abnormalities, confusion, delusions

18
Q

Synthetic Prostaglandin ADE

A

GI effects common: diarrhea, abdominal cramping and nausea

19
Q

Sucralfate ADE

A

Al+ component can cause constipation and accumulates in patients with renal impairment

20
Q

Metoclopramide ADE

A

somnolence, increased prolactin, 2and extrapyramidal symptoms

21
Q

Erythromycin ADE

A

abdominal cramping, diarrhea

22
Q

Antacids + quinolone antibiotics, tetracycline, nitrofurantoin, isoniazid Drug interaction

A

Those drugs are bounded by antacids

23
Q

Which drugs require acidic environment?

A

iron supplements, ketoconazole, itraconazole capsule, sucralfate, calcium carbonate, levothyroxine

24
Q

Cimetidine Drug interaction

A
  • Inhibits metabolism of other drugs via CYP450 (theophylline, phenytoin, warfarin)
  • Drugs requiring acidic environment
25
Q

Ranitidine Drug interaction

A
  • Inhibits metabolism of other drugs via CYP450 (theophylline, phenytoin, warfarin)
  • Drugs requiring acidic environment
26
Q

Omeprazole Drug interaction

A
  • Drugs requiring acidic environment
  • Induces CYP1A4
  • Inhibits CYP2C8, 2C9, 2C19, 3A3/4
27
Q

Sucralfate Drug interaction

A

Binds certain antibiotics (quinolone antibiotics, tetracycline, nitrofurantoin, isoniazid)