GI Pharmacology 1 Flashcards

1
Q

antacids - MOA

A

directly neutralize acid in the stomach (antacids are weak bases)

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2
Q

antacids - specific drugs

A

*calcium carbonate!! (tums)
*magnesium hydroxide
*aluminum hydroxide
*sodium bicarbonate (no longer recommended)

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3
Q

antacids - uses

A

*dyspepsia
*GERD

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4
Q

antacids - adverse effects

A

*belching
*metabolic acidosis
*diarrhea (Mg)
*constipation (Ca & Al)

note - oftentimes Mg and Al are combined to avoid diarrhea vs. constipation

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5
Q

antacids - drug interactons

A

*di- and tri-valent cations bind drugs (fluoroquinolones; tetracyclines)
*some drugs require acid for absorption (ketoconazole)

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6
Q

famotidine - drug class & MOA

A

*drug class: H2-receptor antagonist
*MOA: competitive inhibition of parietal cell H2-receptor

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7
Q

famotidine - uses

A

*GERD (PPIs are better)
*peptic ulcer disease (PPIs are better)
*non-ulcer dyspepsia
*stress GI bleeding prevention

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8
Q

proton pump inhibitors (PPIs) - drugs in class

A

*omeprazole
*pantoprazole
*lansoprazole

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9
Q

proton pump inhibitors - MOA

A

block the final common pathway of acid secretion by IRREVERSIBLY inactivating the parietal cell proton pump (H+/K+ ATPase)

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10
Q

proton pump inhibitors - uses

A

*GERD
*peptic ulcer disease
*esophagitis
*dyspepsia
*hypersecretory diseases
*stress GI bleeding prevention

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11
Q

proton pump inhibitors - unique facts

A

*products are inactive prodrugs (need to be activated)
*acid labile (oral products are in “acid resistant” form)
*give on empty stomach

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12
Q

proton pump inhibitors - adverse effects

A

*decreased vitamin B12 absorption
*osteoporosis
*increased risk of C. diff

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13
Q

omeprazole - drug class & MOA

A

*proton pump inhibitor
*irreversibly inactivates the parietal cell proton pump (H+/K+ ATPase)

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14
Q

pantoprazole - drug class & MOA

A

*proton pump inhibitor
*irreversibly inactivates the parietal cell proton pump (H+/K+ ATPase), reducing production of gastric acid

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15
Q

sucralfate - drug class & MOA

A

*drug class: mucosal protective agent
*MOA: forms a viscous paste that binds to injured tissues such as ulcers

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16
Q

sucralfate - uses

A

*prevent stress ulcer bleeding

17
Q

misoprostol - drug class & MOA

A

*drug class: mucosal protective agent
*MOA: analogue of prostaglandin E (PGE1); counteracts the effects of NSAID-inhibition of prostaglandin synthesis

18
Q

misoprostol - uses

A

*prevent NSAID-related ulcers
*not used a lot now

19
Q

misoprostol - key think to know

A

abortifacient (can cause spontaneous abortion) - don’t give to a pregnant patient

20
Q

celecoxib - MOA, uses

A

*COX-2 inhibitor (NSAID that hits COX-2)
*used as an anti-inflammatory with less GI toxicity

21
Q

bismuth compounds - MOA, uses, drugs in class

A

*MOA: coats ulcers, kills H. pylori, etc
*uses: dyspepsia, traveler’s diarrhea, tx H. pylori
*drug = Pepto-bismol (bisubsalicylate)

note - can turn tongue & stool black

22
Q

neostigmine - drug class, MOA, uses, ADEs

A

*drug class: promotility agent
*MOA: acetylcholinesterase inhibitor (cholinomimetic); enhances emptying of stomach, small bowel, & colon
*uses: post-surgical ileus or acute colonic pseudo-obstruction
*ADEs: increased salivation, nausea, vomiting, diarrhea, bradycardia

23
Q

metoclopramide - drug class, MOA, uses, ADEs

A

*drug class: promotility agent
*MOA: D2 receptor antagonist
*uses: impaired gastric emptying & diabetic gastroparesis
*ADEs: restlessness, drowsiness, insomnia, agitation, EPS

24
Q

H. pylori treatment strategy

A

*generally 2+ antibiotics and a PPI, +/- bismuth
*currently, BISMUTH + TETRACYCLINE+ METRONIDAZOLE + PPI (proton pump inhibitor)

25
Q

erythromycin - drug class, MOA, uses, ADEs

A

*drug class: macrolide + promotility agent
*MOA: directly stimulates motilin receptor
*uses: gastroparesis
*ADEs: nausea & vomiting

26
Q

ondansetron - drug class, MOA, uses, ADEs

A

*drug class: 5-HT3 antagonists
*MOA: block peripheral 5-HT3 receptors
*uses: chemo-induced & post-op nausea & vomiting
*ADEs: well-tolerated, but: headache, constipation, diarrhea, QTc prolongation

27
Q

what anti-emetic is used for chemotherapy-induced nausea and vomiting

A

ONDANSETRON (serotonin 5-HT3 antagonist)

28
Q

prochlorperazine & promethazine

A

*block dopamine receptors
*used to treat nausea & vomiting
*drug class = phenothiazine
*ADEs: EPS, sedation

29
Q

dronabinol (THC)

A

*major psychoactive ingredient in marijuana
*used clinically as appetite stimulant & antiemetic
*ADEs: euphoria, dysphoria, sedations, hallucinations, dry mouth, tachycardia

30
Q

ursodeoxycholic acid (ursodiol) - drug class, MOA, uses, ADEs

A

*drug class: bile acid
*MOA: incorporated into bile acid pool
*uses: dissolve or prevent gallstones; PRIMARY BILIARY CHOLANGITIS!!
*ADEs: diarrhea

31
Q

cholestyramine - drug class, MOA, uses, ADEs

A

*drug class: bile acid binder
*MOA: bind bile acid in GI tract (anion exchange resin)
*uses: bile acid diarrhea; pruritis due to partial biliary obstruction
*ADEs: bloating, flatulence, constipation, fecal impaction
*note - binds and prevents absorption of many drugs

32
Q

what drug is used to treat primary biliary cholangitis

A

URSODIOL [ursodeoxycholic acid] (replaces the more toxic endogenous bile acids and has anti-inflammatory effects)

33
Q

treatment strategy for eosinophilic esophagitis

A

*ALWAYS: proton pump inhibitor AND topical steroids

*sometimes:
-systemic steroids
-montelukast
-mepolizumab