GIT Pharm Flashcards
Therapeutic uses of antacid?
Relief of heartburn, dyspepsia, and in GERD
Prevention of stress-induced ulcer
Name 4 Antacids
NaHCO3 , CaCO3, Mg(OH)2 , Al(OH)3
2 mechanism of action of antacids
Protect gastric mucosa by neutralising HCl to form salt and water
Inactivating pepsin
Name3 adverse effects of antacids?
Mg - Diarrhea
Al - Constipation + phosphate excretion
Gastric acid rebound secretion
Systemic effects
Sodium compounds may cause sodium overload, alkalosis on long term usage
Na Antacids are contraindicated in which group of patients?
heart failure
Ca Antacids are contraindicated in which group of patients?
renal failure - Ca Phosphate precipitate
Antacids DDI
may affect absorption and gastrointestinal transit of many drugs –> oral ketoconazole, isoniazid, digoxin etc…
How to reduce DDI with antacids and other medication
advice patient to take the antacids 2-3h before or after other medications
Name four Histamine type 2 receptor blockers
famotidine, nizatidine, ranitidine, cimetidine
Name 3 therapeutic uses of H2 antagonists
Peptic ulcers, reflux esophagitis, GERD
ZE syndrome (gastrinoma) - tumor in pancreasa or duodenum - gastrin hypersecretion
prevention of stress-induced ulcer
H2 antagonist mechanisms of action
competitively, reersibly blocks histamine stimulation of gastric acid secretion by reducing cAMP - attenuate protein kinases stimulation on H+K+ ATPase (proton pump)
When to take H2 antagonist?
Night time
How are H2 antagonist mainly excreted by?
Liver
adverse effects of H2 antagonist
constipation and headaches, more rarely, agitation
Name 3 adverse effects of Cimetidine
Headache, mental confusion in elderly, bowel movement disturbance
Antiandrogenic: impotence, gynecomastia
DDI of cimetidine?
Metabolising enzyme inhibitor of CYP450 (2D6, 1A2) increasing plasma concentration of e.g. anti-depressants, warfarin, theophylline, paracetamol, caffeine
Name 4 PPIs
omeprazole, esomeprazole, dexlansoprazole, rabeprazole
name four therapeutic uses of PPIs
peptic ulcer treatment and maintenance therapy
prevention of NSAID-induced ulcers and stress ulcers
treatment of GERD
ZE- syndrome and other gastrinomas
MOA of PPI
Inhibits proton pump … Smile crying emoji