GI Pharmacology Flashcards
Sodium Bicarbonate
Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: FAST
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: Metabolic alkalosis, excessive NaCl absorption, gas/bloating
Indication: GERD, peptic ulcers, dyspepsia
Calcium Carbonate
Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: MODERATE
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: acid rebound, gas/bloating, hypercalcemia (hi doses), hypophosphatemia (rare)
Indication: GERD, peptic ulcers, dyspepsia
Magnesium Hydroxide
Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: SLOW
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: Osmotic diarrhea, hypermagnesemia (hi dose over extended periods of time)
Indication: GERD, peptic ulcers, dyspepsia
Aluminum Hydroxide
Antacid: neutralize gastric acid & stimulate PGE2
Duration of Action: 1-2hrs
Rate of Reactivity: SLOW
Common Adverse Effects: Reduced drug bioavailability and enteric infection
Specific Adverse Effects: constipation, Al toxicity (w/ impaired renal function), hypophosphatemia, bone resorption , hypercalcemia
Indication: GERD, peptic ulcers, dyspepsia
Cimetidine
H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)
Specific Adverse Rxns:
CNS effects = confusion, hallucinations, agitation
Endocrine effects = inhibition of androgen receptors, estradiol metabolism, increase prolactin levels
Inhibit CYP metabolism
Ranitidine
H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)
Nizatidine
H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)
Famotidine
H2-Receptor Antagonist
Duration of Action: 10hrs vs 6hrs OTC
Common Adverse Rxns: headache, diarrhea, fatigue, constipation, infection, drug kinetics, bradycardia & hypotension (only w/ IV administration)
Omeprazole
Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)
Lansoprazole
Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)
Rabeprazole
Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)
Esomeprazole
Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)
Pantoprazole
Proton Pump Inhibitor (PPI)
Duration of Action: 1dose = 24hrs, 3-4days = max effect
Common Adverse Rxns: very safe, decereased drug bioavailability, diarrhea, headache, abd pain
Adverse Rxns: decreased nutrient absorption (vitB12, iron, calcium, zinc), enteric and resp infection
Indications: GERD, peptic ulcers d/t H Pylori & NSAIDs, dyspepsia, gastritis, hypersecretory diseases (zollinger-ellison syndrome)
Misoprostol
Mucosal Protective Agent (not a physical barrier)
Prostaglandin derivative, stimulates epith cells of gastric mucosa to secrete mucus and HCO3-, decreases activation of H+/K+ ATPase in parietal cells
Duration of Action: 6hrs
Common Adverse Rxns: Cramping, diarrhea
Adverse Rxns: abortificient
Indications: NSAID-assoc ulcers
Sucralfate
Mucosal Protective Agent (forms a physical barrier)
Stimulates mucus and HCO3- production thru unknown mechanism
Duration of Action: 6hrs
Common Adverse Rxns: Constipation, impaired drug absorption
Adverse Rxns: caution w/ renal insufficient pts
Indications: used to prevent stress-related bleeding in critically ill hospitalized pts where suppression of acid not desired
Bismuth Subsalicylate (mucosal protective agent use)
Mucosal Protective Agent (forms a physical barrier)
PEPTO-BISMOL: Stimulates mucus and HCO3- production thru unknown mechanism
Duration of Action: 6hrs
Common Adverse Rxns: black stool & tongue
Adverse Rxns: high doses salicylate toxicity
Indications: dyspepsia, antibacterial actions that are useful w/ H Pylori or traveler’s diarrhea
Metoclopramide
D2 Antagonist - Prokinetic Agent (promote cx of GI sm)
(prevents dopamine from suppressing ACh release)
Indications: GERD, impaired gastric emptying, dyspepsia, antiemetic
Adverse rxns: CNS: restless, drowsy, insomnia, anxiety, parkinsonian sx (d/t dopamine antagonist action)
Bethanechol
M3 Agonist - Prokinetic Agent (promote cx of GI sm)
Indications: GERD, gastroparesis
Adverse rxns: cholinergic side effects
Neostigmine
AchE Inhibitor - Prokinetic Agent (promote cx of GI sm)
Indications: non-obstructive urinary retention or abdominal distension
Adverse rxns: cholinergic side effects
Erythromycin
Motilin Receptor Agonist - And Antibiotic
Prokinetic Agent (promote cx of GI sm)
Indication: gastroparesis
Adverse rxn: erythromycin mediated side effects