GI Pharm Flashcards
Antacids MOA
work by neutralizing gastric acid
Heavy metals suppress H. pylori
Can bind with drugs taken at the same time decreasing absorption of that agent (bind with other Antacids)
Interact with many antibiotics
Magnesium salts use caution with
Renal Insufficiency
H2 Blockers MOA
Inhibit acid secretion by blocking histamine H2 receptors on the parietal cell
Generally dosed to take 30-60 min prior to a meal (if using for acid suppression with meals)
H2 Blockers
Cimetidine (Tagamet)- don’t use! Lots of SE
Ranitidine (Zantac)
Famotidine (Pepcid)
Nizatidine (Axid)
Proton pump inhibitors Indications
Treatment of all acid-related disorders:
peptic ulcer disease
gastroesophageal reflux disease
Zollinger-Ellison syndrome
Treating and preventing nonsteroidal anti-inflammatory drug (NSAID)-associated gastroduodenal mucosal injury
Eradication of Helicobacter pylori infection
Proton pump inhibitors MOA
Block acid secretion
irreversibly binds to and inhibits the hydrogen-potassium ATPase pump on the parietal cell membrane
Work best if parietal cell is active so don’t take with other meds that decrease acid secretions (H2 blockers)
Interactions with PPI’s
Omeprazole (Prilosec)- most (BBW with plavix)
Pantopranzole (Protonix)- least interactions
Long term administration of PPI’s may increase the incidence of
Infections: C. difficile, pneumonia Fractures: Hip, wrist, spine Malabsorption of: B12 (check levels) Magnesium (check levels esp. with diuretics and digoxin administration) Iron
Misoprostol (Cytotec)
Indicated for the prevention and treatment of NSAID induced ulcers
Pregnancy category X
Not 1st line
BBW: miscarriage
Prokinetic
Metaclopramide (Reglan: First line therapy for gastroparesis for no longer than 12 weeks unless benefits outweigh risks
Lots of SE/ Drug interactions because lots of receptor sites:
Anxiety
Depression
QT prolongation
Dystonia
Tardive dyskinesia
