peptic ulcer disease and GORD drugs Flashcards
what is Magnesium trisilicate
an antacid
what does Aluminum hydroxide bind, aaaand
bile acids and growth factors and delivers growth factors to injured mucosa
what do antacids promote
angiogenesis
what do antacids inhibit
peptic activity
what do heavy metals suppress
H pylori
competitive H2 receptor antagonist example
ranitidine
ranitidine target
Histamine H2 receptor in gastric parietal cell
what does ranitidine binding do
reduces stimulation of gastric acid secretion
when to give ranitidine
GORD; Peptic Ulcer Disease; Dyspepsia
common ranitidine side effects
Diarrhoea, Headache, Dizziness
bad ranitidine side effects
Gynaecomastia, impotence
which H2 receptor antagonist causes impotence
cimetidine
when not to give ranitidine
pregnancy
hepatic/renal impairment
why be cautious about giving ranitidine
it may mask the symptoms of malignancy
important thing about ranitidine apart from impotence
Cimetidine is a cytochrome P450 inhibitor = avoid in patients stablised on warfarin, theophylline and phenytoin
what drug is better than ranitidine
PPIs
omeprazole class
PPI
omeprazole target
H+ K+ ATPase pump at the secretory surface of gastric parietal cells
what does omeprazole do to help
stops H getting into the stomach
when to give PPI
gastric and duodenal ulcers Prevention and treatment of NSAID-associated ulcers Helicobacter pylori eradicaton (GORD) Zollinger-Ellison syndrome
when to give a lower dose of PPI
hepatic impairment
important side effects of omeprazole
Hepatitis
Interstitial nephritis
Blood disorders – leucopenia, leucocytosis, pancytopenia, thrombocytopenia,
Increased risk of C dif
when to be cautious about starting PPI
mask cancer
what do some PPI do to warfarin
increase anticoagulant effect
what do some PPIs do to clopidogrel
reduce antiplatelet effect
