GI Rx Flashcards
Cimetidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) potent cyt P450 inhibitor (Rx interactions); anti-androgenic effects (prolactin release, gynecomastia, impotence, decr libido in males); can X BBB (confusion, dizziness, HA) + placenta; decr renal exretion of Cr 4) N/A
Ranitidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) decr renal exretion of Cr 4) N/A
Famotidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) decr renal exretion of Cr 4) N/A
Nizatidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) decr renal exretion of Cr 4) N/A
Omeprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Lansoprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Esomeprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Pantoprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Dexlansoprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Bismuth
1) incr ulcer healing, traveler’s diarrhea 2) bind ulcer base to provide physical protection + let HCO3- secretion re-establish pH gradient in mucus layer 3) N/A 4) N/A
Sucrafate
1) incr ulcer healing, traveler’s diarrhea 2) bind ulcer base to provide physical protection + let HCO3- secretion re-establish pH gradient in mucus layer 3) N/A 4) N/A
Misoprostol
1) prevent NSAID-induced peptic ulcers; maintenance of patent ductus arteriosus; also induce labor (ripens cervix) 2) PEG1 analog: incr production + secretion of gastric mucus barrier; decr acid production 3) diarrhea; contraindicated in women of childbearing age (abortifacient) 4) N/A
Octreotide
1) acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors 2) long-acting somatostatin analog 3) nausea, cramps, steatorrhea 4) N/A
Aluminum hydroxide
1) esophageal reflux dz’s 2) antacid 3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; constipation + hypophosphatemia; proximal musc weakness; osteodystrophy; seizures 4) N/A
Magnesium hydroxide
1) esophageal reflux dz’s, constipation 2) antacid; osmotic laxative: provide osmotic load to draw out H2O 3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; diarrhea; hyporeflexia; hypotension; cardiac arrest; diarrhea, dehydration 4) may be abused by bulimics
Calcium carbonate
1) esophageal reflux dz’s 2) antacid 3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; hypercalcemia; rebound incr in acid 4) can chelate + decr effectiveness of other Rx (ie, tetracycline)
Magnesium citrate
1) constipation 2) osmotic laxative: provide osmotic load to draw out H2O 3) diarrhea, dehyration 4) may be abused by bulimics
Polyethylene glycol
1) constipation 2) osmotic laxative: provide osmotic load to draw out H2O 3) diarrhea, dehyration 4) may be abused by bulimics
Lactulose
1) constipation; hepatic encephalopathy 2) osmotic laxative: provide osmotic load to draw out H2O; gut flora degrades this Rx into metabolites (lactic acid, acetic acid) that promote nitrogen excretion as NH4+ 3) diarrhea, dehyration 4) may be abused by bulimics
Infliximab
1) Crohn’s dz, ulcerative colitis, rheumatoid arthritis 2) monoclonal ab to TNF-alpha 3) infct (including reactivation of latent TB); fever; hypotension 4) N/A
Sulfasalazine
1) ulcerative colitis, Crohn’s dz 2) combo of sulfapyridine (antibacterial) + 5-aminosalicylic acid (5-ASA, anti-inflammatory); activated by colonic bacteria (cleaves bond) 3) malaise; nausea; sulfonamide toxicity; reversible oligospermia 4) N/A
Ondansetron
1) control vomiting postoperatively + in pts undergoing CA chemo 2) 5-HT3 antagonist; powerful central-acting antiemetic 3) HA, constipation 4) N/A
Metoclopramide
1) DM, post-sx gastroparesis, antiemetic 2) D2 receptor antagonist: incr resting tone, contractility, LES tone, motility; doesn’t influence colon transport time 3) incr parkinsonian effects; restlessness; drowsiness; fatigue; depression; nausea; diarrhea; contraindicated in pts w/ small bowel obstruction or Parkinson’s dz 4) Rx interaction w/ digoxin + DM agents
