GI Pharmacology Flashcards
What is the MOA of H2 blockers?
Reversible block of histamine H2 receptors to decrease H+ secretion by parietal cells
What are the indications for H2 blockers?
Peptic ulcer, gastritis and esophageal reflux
What are the adverse effects of H2 blockers?
Prolactin release: Gynecomastia, decreased libido, impotence in males
Cimetidine inhibits P450
What are the H2 blockers?
Cimetidine, Ranitidine, Famotidine, and Nizatidine
What is the MOA of PPIs?
Irreversibly inhibit H+/K+ ATPase in stomach parietal cells
Decreases proton secretion by parietal cells
What are the inidications for PPIs?
Peptic ulcer, gastritis, mid-esophageal Reflux and Zollinger-Ellison syndrome
What are some PPIs?
Omeprazole, Lansoprazole
What is the MOA of Misoprostol?
PGE1 analog, increase production and secretion of gastric mucous barrier, decreased acid production
What are the indications for Misoprostol?
Prevents NSAID-induced peptic ulcers, maintenance of a Patent Ductus Arteriosus
Induce labor
What are the Adverse Effects of Misoprostol?
Diarrhea; Contraindicated in women of childbearing potential abortion inducing drug
What is the MOA of Octreotide?
Long-acting somatostatin analog
What are the indications for Octreotide?
Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
What are the Adverse Effects of Octreotide?
Nausea, cramps, steatorrhea
What is the MOA of Bismuth and Sucralfate?
Bind to ulcer base, providing physical protection allows bicarbonate ion secretion to reestablish pH gradient in the mucous layer
What is Bismuth and Sucralfate used for?
Increase ulcer healing, traveler’s diarrhea
What is the MOA of Infliximab?
Monoclonal antibody to TNF-alpha
What are the Indications for Infliximab?
Crohn’s Disease, Rheumatoid arthritis
What are the Adverse Effects of Infliximab?
Respiratory infection (including reactivation of latent TB) fever, hypotension
What is the MOA of Sulfasalazine?
A combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammtory) activated by colonig bacteria
What are the indications for Sulfalazine?
UC, Crohn’s disease
What are the Adverse Effects of Sulfasalazine?
Malaise, nausea, Sulfonamide toxicity, reversible Oligospermia
What is the MOA of Odansetron?
5-HT3 antagonist, powerful central acting antiemetic
What are the indications for Odansetron?
Control vomiting in patients undergoing chemo therapy and postoperatively
What are the Adverse Effects of Odansetron?
Headache, constipation, dizziness
What is the MOA osmotic Laxatives?
Provide osmotic load to draw water out
Lactulose treats Hepatic encephalopathy: gut flora degrades it into metabolites (lactic acid and acetic acid) that promote Nitrogen excretion as NH4+
What is the indication for Osmotic Laxatives?
Constipation
What are the Adverse Effects of Osmotic Laxatives?
Diarrhea, dehydration, may be abused by bulimics
What are the Osmotic Laxatives?
Magnesium hydroxide, mag citrate, polyethylene glycol, Lactulose
What is the MOA of Metoclopramide?
D2 receptor antagonist; increase resting tone, contractility LES tone, motility
What are the indications for Metoclopramide?
Diabetic and post-surgery gastroparesis
What are the Adverse Effects of Metoclopramide?
Increased Parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrhea
Drug interaction with digoxin and diabetic agents
contraindicated in small bowel obstruction
