H2 Blockers and PPIs Flashcards

1
Q

Symptoms of GERD

A
Heartburn
Regurgitation, 
Vomiting, 
Pain on swallowing, 
Hoarseness

Less common: Stomach pain, non-burning chest pain, difficulty swallowing, chronic sore throat, cough

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2
Q

Antacids

Pharmacological Use

A

Short term relief of GERD symptoms

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3
Q

List a few antacids

A

Tums
Maalos
Mylanta

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4
Q

Antacids

Adverse Effects

A

Overdose can cause Milk-alkali Syndrome with Hypercalcemia, Alkalosis, and Renal impairment

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5
Q

H2 Antagonists

List them

A

Rantidine, Famotidine, Cimetidine, Nizatidine

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6
Q

H2 Antagonists

Indications

A

Reduce production of acid in stomach

Used for peptic ulcer disease

Prevents NSAID induced ulcers and allows for peptic ulcers to heal

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7
Q

H2 Antagonists

Adverse Effects

A

Very safe

Rare renal and hepatic toxicity

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8
Q

H2 Antagonists

When do they reach peak serum conc?

A

1-3 hours after dosing

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9
Q

PPIs

MOA

A

Block acid secretion by irreversibly binding to and inhibiting the H+/K+ ATPase pump on luminal surface of parietal cells

Needs to first be activated in acidic stomach environment

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10
Q

PPIs

When should they be taken?

A

Most effective 30-60 min before meals so they are in bloodstream when the parietal cells are stimulated

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11
Q

PPIs

List them

A
Omeprazole
Lansoprazole
Rabeprazole
Pantoprazole
Esomeprazole
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12
Q

PPIs

Indications

A

DOC for Zollinger-Ellison Syndrome and GERD that is not responsive to H2 antagonists

Used in combo treatment of H Pylori

Duodenal ulcers

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13
Q

PPIs

Drug Interactions

A

Should NOT be given simultaneously with H2 antagonists

Reduce absorption of ketoconazole

Increase digoxin absorption

Metabolized by CYP450 and can decrease metabolism and clearance of benzodiazepines, warfarin, and phenytoin

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14
Q

PPIs

Adverse Effects

A

Very mild- diarrhea, headache, drowsiness, muscle pain, constipation

Prolonged use may lead to B12 deficiency

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15
Q

What is the major mucosal protective agent?

A

Sucralfate

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16
Q

Sucralfate

MOA

A

Binds selectively to necrotic tissue to form a barrier against gastric acid

Pepto Bismol acts similarly

17
Q

Sucralfate

Indications

A

Duodenal ulcers

Suppression of H Pylori

18
Q

Sucralfate

Drug Interactions

A

Should not be given with cimetidine or ranitidine, but may be given 2 hrs prior