GI Pharm Flashcards
A. Gastroesophageal reflux disease (GERD) is _______; “acid reflux” is ________(isolated incidents)
chronic
acute
*“heartburn” occurs in 7% of population daily
What are 8 aggravating factors of Acid reflux/GERD?
1-empty stomach 2-reclined, 3-increased age, 4-obesity, 5-fatty foods, 6-caffeine/alcohol/smoking, 7-large meals, 8-some drugs
What are 6 ways to help relieve GERD/Acid reflux?
1-small meals 2-reduced fat 3-reduced weight 4-elevate head of bed 5-avoid aspirin/NSAIDs 6-Stop smoking/drinking alcohol
What are the three main groups of medications used for GERD?
1-Antacids
2-H2 receptor blockers
3-Proton pump inhibitors (PPIs)
What are 4 types of antacids that neutralize gastric HCl?
1-magnesium salts (can cause diarrhea)
2-bicarbonate (causes gas)
3-calcium carbonate (chalky and constipation)
4-aluminum salts (not very effective)
What are the three H2 receptor drugs that block H2 receptors in the gut?
1-Cimetidine (Tagamet)
2-Ranitidine (Zantac)
3-Famotidine (Pepcid)
*Headaches, diarrhea, drowsiness
Which drugs act by disrupting hydrogen exchange for K in parietal cells, which blocks production and release of HCl into gut?
Proton Pump Inhibitors (PPIs)
*diarrhea, interferes with digestion, increases food allerges, oral sores/ulcers
What are 4 PPI drugs?
1-Omeprazole (Prilosec)
2-Omeprazole + sodium bicarbonate for fast release
3-Lamsoprazole (Prevocid)
4-Esomeprazole (Nexium)
What are three causes of Peptic ulcers (both gastric and duodenal)?
1-Inflammation of epithelium
2-Errosion
3-Infection by H. pylori (70-80% incidence)
What are 3 main symptoms of an Ulcer?
1-Epigastric burning (alleviated by eating or antacids)
2-Pain worse on empty stomach and at night
3-Pain often mistaken for a heart attack and vice versa
What are 3 drugs that can suppress the acidity to heal sores but not cure ulcers?
1-Antacids
2-PPIs
3-H2 Blockers
What are two treatments used to cure ulcers if they are caused by H. Pylori?
1-Prevpac (combo Iansoprazole, amoxicillin and clarithromycin)
2-Milk of magnesia
*especially contagious within family
Where are water and alcohol absorbed?
Stomach
Where are Fe, Ca, Mg, Na, Fats, water, proteins, and vitamins absorbed?
Duodenum
Where are carbohydrates and proteins absorbed?
Jejunum
Where are bile salts, B12 and Cl absorbed?
Ileum
Where are water and electrolytes absorbed?
Colon
Which laxative drug stimulates smooth muscle, is fast acting and is an OTC suppository/oral?
Bisacodyl
*Causes cramps
Which laxative acts by retaining more water in stools to soften them?
Docusate
*Dulcelax is an OTC version
What are three medications used for Diarrhea?
1-Loperamine (imodium, mild opioid agonist, can go strong if sever)
2-Bismuth subsalicylate (pepto-bismol)
3-Anti-cholinergics (atropine)
What syndrome has no structural defect, typically episodic pain and bloating in young adults-50 yr olds and is the most common GI disorder?
Irritable Bowel Syndrome (IBS)
*could be 5HT dependent neuromuscular disorder. affects 20%
What is the only FDA approved drug for IBS with constipation that is a guanylate cyclase-C agonist??
Linaclotide (Linzess)
*increase bowel movement, fluid secretion and reduce pain. Can cause diarrhea and gas
What chronic diarrheal disease affects mostly ileum and colon with intermittent strictures with swelling, scarring and ulcerations?
Crohn’s disease
*Perianal fissures/fistules
What are 3 conditions that are associated with Crohn’s disease?
1-Arthritis
2-Fatty liver
3-Colon Cancer
What are two anti-inflammatory drugs used for Crohns disease?
1-Mesalamine (topical anti-inflammatory)
2-Corticosteroids-act systemically
*Metronidazole also used
What disease is similar to Crohns disease but is limited to colon and is more generalized without strictures?
Ulcerative colitis
*treated with similar drugs to Crohns disease
Where is HBV virus most concentrated in the mouth?
Gingival sulcus
