GI Pharm Flashcards
Antacids used for the treatment of what?
ulcers
What meds are antacids? 3
- Aluminum salts
- Magnesium hydroxide
- Calcium carbonate
MOA: Antacids
- In general how do they work?
- How do they do this? 4
- In general work by neutralizing gastric acid
- Protect gastric mucosa against acute chemical injury
- Bind bile acids and inhibit peptic activity
- Promote angiogenesis in injured mucosa
- Heavy metals suppress H. pylori
- What substances are in magnesium salts?
- Brand names? 5
- Common side effects? 5
- Caution with what?
- Magnesium hydroxide/aluminum hydroxide
- Brand names
- Maalox,
- Alamag,
- Mag-Al,
- Mag-Al Ultimate,
- Mylanta - Common side effects:
- Diarrhea,
- constipation,
- abd cramps,
- N/V
- Hypermagnesemia - Caution with renal insufficiency
Aluminum salts
- Caution with what?
- Can block the intestinal absorption of what?
- Brand names? 2
- Caution in renal insufficiency
- Can block the intestinal absorption of phosphate
- Acid gone
- Gaviscon
Calcium carbonate
- Brand names? 6
- Indications? 2
- Most common side effects? 6
- Separate from other meds by what?
- Brand names
- Tums,
- Maalox regular chewable,
- Calci-chew,
- Rolaids,
- Chooz,
- Alka-Mints - Indications:
- Acid indigestion,
- heartburn - Most common side effects:
- constipation,
- bloating,
- gas,
- N/V,
- abdominal pain,
- xerostomia - Separate from other meds by 2 hours
H2 Blockers indications
3
- Treatment and maintenance therapy of peptic ulcer disease
- Treatment of GERD
- Management of dyspepsia
- MOA of H2 blockers?
2. When should we take these?
- 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 blocker side effects?
2
- Rare, severe adverse events, such as renal and hepatic toxicity
- Myelosuppression
H2 blocker SE: Myelosuppressio. What will you see on the CBC?
4
- Thrombocytopenia
- Neutropenia
- Anemia
- Pancytopenia
Rare CNS side effects with H2 blockers?
Rare cardiac side effects?
Can cause confusion, restlessness, somnolence, agitation, headaches, and dizziness and, with prolonged therapy, hallucinations, focal twitching, seizures, unresponsiveness, and apnea (primarily in the elderly with concomitant renal and/or hepatic failure)
Sinus bradycardia, hypotension, AV block, prolongation of the QT interval, and sinus and cardiac arrest have occurred with the rapid infusion
Cimetidine has some unique side effects such as?
5
- Can rarely cause gynecomastia and impotence
- Polymyositis
- Interstitial nephritis
- Cleared through the P450 system so has multiple drug interactions
- Giving rapidly IV can cause cardiac arrhythmias and hypotension
Absorption and distribution of H2 blockers: 1. How well is it absorbed? 2. Peak serum concentrations occur when? 3. Absorption is reduced by 10-20% if taken with what?
- Well absorbed after oral dosing
- Peak serum concentrations occur within one to three hours
- antacids
What are the H2 blockers?
4
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Famotidine (Pepcid)
- Nizatidine (Axid)
What are the Proton pump inhibitors?
6
- Omeprazole (Prilosec, Zegrid)
- Lansoprazole (Prevacid)
- Pantoprazole (Protonix)
- Esomeprazole (Nexium)
- Dexlansoprazole (Kapidex)
- Rabeprazole (AcipHex)