pharm chart Flashcards
1
Q
Anti-diarrheals Opioid
A
Loperamide [Imodium]
2
Q
MOA of Loperamide [Imodium]
A
Inhibition of presynaptic cholinergic nerves in colonic submucosal and myenteric plexus slows transit time
3
Q
Indications of Loperamide [Imodium]
A
Mild to moderate diarrhea w/o obstruction,
IBD, IBS
4
Q
Anti-diarrheals Non- Opioid
A
Kaolin-Pectin
5
Q
MOA of Kaolin-Pectin
A
A clay (Kaolin) and a plant polysaccride (Pectin) combination that absorbs fluids & bacterial toxins
6
Q
indications of Kaolin-Pectin
A
Mild diarrhea
7
Q
Anti-diarrheals Laxative
A
Dietary Fiber
[Metamucil, Citrucel, Fibercon]
8
Q
MOA of Dietary Fiber
[Metamucil, Citrucel, Fibercon]
A
Absorb and bind fluids, provides stool bulk
9
Q
Indications of Dietary Fiber
[Metamucil, Citrucel, Fibercon]
A
Mild to moderate diarrhea,
constipation
10
Q
Anti-Diarrheal
Synthetic Somatostatin Analogue
A
Octreotide [Sandostatin]
11
Q
MOA of Octreotide [Sandostatin]
A
Synthetic analogue of somatostatin with longer half-life;
inhibits bowel secretion;
dose related impact on motility;
splanchnic arteriole constriction
12
Q
Indications of Octreotide [Sandostatin]
A
Diarrhea sec to bowel dysmotility, carcinoid, VIP-oma, pancreatic fistulas, vagotomy, dumping syndrome, short bowel syndrome, HIV diarrhea; GI bleeding
13
Q
Anti-diarrheals
A
Bismuth Subsalicylate [Pepto- Bismol]
14
Q
MOA of Bismuth Subsalicylate [Pepto- Bismol]
A
Anti-secretory (salicylate) and anti-microbial (bismuth) action
15
Q
Indications of Bismuth Subsalicylate [Pepto- Bismol]
A
sxs treatment of mild, nonspecific diarrhea,
traveler’s diarrhea,
as part of multi- drug regimen for H. pylori
16
Q
what are the 2 
5ASA Anti- Inflammatories
A
- Mesalamine or 5-ASA [Asacol]
- Sulfasalazine [Azulfadine]
5-ASA + sulfapyridine
17
Q
what is the MOA of the 5ASA Anti- Inflammatories
A
Local colon anti- inflammatory action and systemic prostaglandin inhibition
18
Q
Inidacation of Mesalamine or 5-ASA [Asacol]
A
Ulcerative colitis, proctosigmoiditis, proctitis
19
Q
Indication of Sulfasalazine [Azulfadine]
5-ASA + sulfapyridine
A
Ulcerative colitis,
rheumatoid arthritis,
Crohn’s disease, psoriasis
20
Q
Purine Analogues Immunosuppressant
A
Azathioprine [Imuran]
21
Q
MOA of Azathioprine [Imuran]
A
Inhibits synthesis of DNA, RNA, proteins
22
Q
Indications of Azathioprine [Imuran]
A
Steroid sparing for steroid dependent Crohn’s Disease, Ulcerative colitis;
maintain remission in CD;
fistulizing CD;
kidney transplant, rheumatoid arthritis
23
Q
Purine Analogues Anti-Inflammatory
A
Methotrexate [Rheumatriex]
24
Q
MOA of Methotrexate [Rheumatriex]
A
Decreases protein synthesis via inhibition of dihydrofolate reductase;
inhibits interleukin-1;
incr release of anti- inflammatory adenosine
25
Indications of Methotrexate [Rheumatriex]
Crohn’s Disease;
+/- Ulcerative colitis;
psoriasis, rheumatoid arthritis
26
Anti-TNF Alfa Compounds
Infliximab [Remicade]
27
MOA of Infliximab [Remicade]
Decr TH1-cell activation/proliferation;
block TNF alfa receptor (TNFR) & decr cytokine (IL-12) release;
decr leukocyte migration, fibroblast collagen production, & hepatic acute phase reactants;
incr apoptosis of activated cells
28
Indications of Infliximab [Remicade]
Acute and maintenance Tx mod to severe Crohn’s Disease & Ulcerative colitis
29
Anti-integrin
Natalizumab
30
MOA of Natalizumab
Inhibit integrins on leukocyte surface and inhibit their adhesion to vascular endothelium and their migration into tissue
31
Indications of Natalizumab
Subset of patients with mod to severe Crohn’s ds who have failed other therapies
32
Ursodeoxycholic Acid Gallstone Dissolution Agent
Ursodiol [Actigall]
33
MOA of Ursodiol [Actigall]
Reduces hepatic secretion of cholesterol reducing enterohepatic circulation of cholesterol, reduces hepatic absorption of cholesterol;
metabolized to lithocolic acid by colonic bacteria; excreted in stool and bile
34
Indications of Ursodiol [Actigall]
Gallstones;
prevention of stones in rapid weight loss,;
primary billiary cirrhosis
35
Laxative Stimulant
Senokot [Senna]
36
MOA of Senokot [Senna]
stimulate enterocytes, enteric neurons,
GI smooth muscle inducing low-grade inflammation, fluid accumulation and
stimulate intestinal motility
37
INdications of Senokot [Senna]
constipation (without bowel obstruction)
38
Laxative Calcium Channel Activator
Lubiprostone [Amitiza]
39
MOA of Lubiprostone [Amitiza]
Activates calcium channels to increase bowel fluid secretion and motility
40
Indications of Lubiprostone [Amitiza]
Chronic idiopathic constipation;
IBS constipation- dominant in women >18yo;
opioid induced constipation
41
Laxative cGMP agonist
Linaclotide [Linzess]
42
MOA of Linaclotide [Linzess]
Agonizes guanylate cyclase-C (cGMP) on luminal surface of bowel epithilium, increases cGMP resulting in chloride and bicarbonate secretion into intestinal lumen
43
Indications of Linaclotide [Linzess]
IBS-C (in adults not responsive to PEG); or, Chronic Idiopathic Constipation (CIC) in adults
44
Osmotic Laxative; PEG
```
Polyethylene Glycol (PEG) 3350
Electrolyte Solution [GoLYTELY] [MiraLax]
```
45
MOA of Polyethylene Glycol (PEG) 3350
| Electrolyte Solution [GoLYTELY] [MiraLax]
Causes water retention in stool and incr stool frequency
46
Indications of Polyethylene Glycol (PEG) 3350
| Electrolyte Solution [GoLYTELY] [MiraLax]
Occasional Constipation
| Short Term Use
47
Osmotic Laxative
Lactulose [Enulose]
48
MOA of Lactulose [Enulose]
a) synthetic disaccharide (osmotic) laxative;
b) bacterial digestion of lactulose produces acid pH converting NH3 to NH4+ which can’t cross gut wall;
c) enhances diffusion NH3 from serum into gut lumen
49
Indications of Lactulose [Enulose]
Px & Tx portal- systemic encephalopathy (PSE)
50
Magnesium Laxative
MgCitrate [Citroma]
51
MOA of MgCitrate [Citroma]
Osmotic retention of bowel fluid distending colon and increasing peristalsis
52
INdications of MgCitrate [Citroma]
Occasional constipation, study prep
53
Stool Softener
Docusate Na [Colase]
54
MOA of Docusate Na [Colase]
....
55
Indications of Docusate Na [Colase]
.....
56
Anticholinergic, Anti-emetic & anti-vertigo
| dermal patch
Scopolamine [Transderm Scop]
57
MOA of Scopolamine [Transderm Scop]
Blocks activity of acetylcholine at PSNS sites in smooth muscle, secretory glands, and CNS
Fast onset, short duration
58
INdications of Scopolamine [Transderm Scop]
Nausea, vertigo
59
H1 Antagonist Antihistamine
Meclizine [Antivert]
60
MOA of Meclizine [Antivert]
Central anticholinergic blockage in chemoreceptor trigger zone and decreases excitability of vestibular- cerebellar pathways
61
Indications of Meclizine [Antivert]
Prevention & treatment of motion sickness
62
Phenothiazines
Promethazine [sPhenergan]
63
MOA of Promethazine [sPhenergan]
Blocks CNS dopamine receptors (D2); competes for H1 receptors in brain and systemically
(anti-histamine and anti-dopaminergic)
64
Indications of Promethazine [sPhenergan]
Anti-emetic, motion sickness,
| sedative
65
Butyrophenones
| Typical anti- psychotic
Haloperidol [Haldol]
66
MOA of Haloperidol [Haldol]
Blocks post-synaptic mesolimbic D1 & D2 receptors; also suppresses the reticular activating system (RAS) thereby reducing emesis
67
Indications of Haloperidol [Haldol]
Anti-emetic; schizophrenia Tourette’s disorder;
| emergency sedation of agitated- aggressive patients (off label)
68
Benzamides
some refer to as pro kinetic
Metoclopromide [Reglan]
69
MOA of Metoclopromide [Reglan]
Blocks D and 5-HT receptors in CRTZ; overcomes inappropriate direction of peristalsis experienced with vomiting
70
Indications of Metoclopromide [Reglan]
Anti-emetic;
diabetic gastroparesis (decreased stomach emptying d/t inadequate peristalsis),
GERD
cancer chemo-induced emesis & radiation sickness
71
Corticosteroid
Dexamethasone [Maxidex]
72
MOA of Dexamethasone [Maxidex]
Enhance effect of 5- HT3-receptor (in heart, stomach, brain: area postrema & nucleus of tractus solitarius) antagonists CRTZ
73
Indications of Dexamethasone [Maxidex]
Anti-emetic pre- chemo;
| immune modulation
74
Cannaboids
Tetrahydrocanna binol (THC)
Dopamine antagonist
Dronabinol [Marinol]
75
MOA of Dronabinol [Marinol]
Unknown
76
INidcations of Dronabinol [Marinol]
Appetite stimulant;
anti-emetic (Chemo related);
adjunct to surgical anesthesia
77
Serotonin Antagonists
Ondansetron [Zofran]
78
MOA of Ondansetron [Zofran]
Peripheral and CRTZ 5-HT3 receptor blockade
79
Indications of Ondansetron [Zofran]
ONLY for post- op, radiation & chemotherapy induced N/V
80
Neurokinin-1 Antagonist
Aprepitant [Emend]
81
MOA of Aprepitant [Emend]
Blocks central NK1 receptors
| Augments anti- emetic effect of 5- HT3 receptor antagonism & corticosteroids
82
Indications of Aprepitant [Emend]
Prevention chemo induced N/V;
| post-op N/V
83
Peripherally- acting Opioid Antagonist
Naloxegol [Movantik]
84
MOA of Naloxegol [Movantik]
Mu-opioid receptor antagonist (conjugated with PEG reducing its ability to cross BBB) so acts peripherally in GI tract
85
Indications of Naloxegol [Movantik]
Opioid Induced Constipation
86
H Pylori Combo- Triple Drug and 4 drug combo
1. Omeprazole Amoxicillin Clarithromycin
| 2. Omeprazole Metronidazole Tetracycline Bismuth SS
87
MOA of H Pylori Combos
Raise gastric pH and antibiotic action on H pylori
88
Indications of H Pylori Combos
Eradication of H pylori-associated ulcers
89
H2R Antagonists
in another drug table this is under: Gastric Acid Suppressants and it is a H2 Receptor blocker
Ranitidine [Zantac]
90
MOA of Ranitidine [Zantac]
Competitive inhibition of H2-receptors of gastric parietal cells reduce basal and stimulated acid production
91
Indications of Ranitidine [Zantac]
Peptic ulcer disease, GERD
92
2 drugs that are in the class:
| Proton Pump Inhibitors (PPI)
1. Omeprazole [Prilosec]
| 2. Pantoprazole [Protonix]
93
mOA of Proton Pump Inhibitors (PPI)
Inhibits basal and stimulated parietal cell proton pump acid secretion
94
Indications of Proton Pump Inhibitors (PPI)
Peptic ulcer disease, GERD;
prevention of NSAID ulcers;
stress ulcer prophylaxis in critically ill
95
Mucosal Surfactants
Sucralfate [Carafate]
96
MOA of Sucralfate [Carafate]
In water or acidic solutions, forms a paste that forms barrier by binding selectively to gastric mucosal ulcers and erosions; stimulates mucosal prostaglandin & bicarb secretion
97
Indications of Sucralfate [Carafate]
Duodenal or gastric ulcers or erosions, stomatitis (off label)
98
Muscarinic Antagonists
| Anti- Spasmodic
Dicyclomine [Bentyl]
99
MOA of Dicyclomine [Bentyl]
M receptor anticholinergic drug
100
Indications of Dicyclomine [Bentyl]
Irritable Bowel Syndrome (cramps)
101
Antacids
AlOH [Alternagel]
| Aluminum Hydroxide
102
MOA of AlOH [Alternagel]
| Aluminum Hydroxide
Neutralizes HCl in stomach to form Al(Cl)3 & H20
103
Indications of AlOH [Alternagel]
| Aluminum Hydroxide
hyperacidity, hyperphosphatemia
104
Antacids Laxative
MgOH [MOM]
105
MOA of MgOH [MOM]
reacts with HCl acid to form MgCl;
| osmotic absorption of fluids distends colon and increases peristaltic activity
106
Indications of MgOH [MOM]
dyspepsia; constipation
107
Mucosal, NSAID Protectants
| Prostaglandin
Misoprostol [Cytotec]
108
MOA of Misoprostol [Cytotec]
synthetic prostaglandin E1 analog replaces protective PG inhibited by NSAID therapy
109
Indications of Misoprostol [Cytotec]
NSAID-induced gastric ulcers;
| people at high risk for NSAID induced bleeding
110
GLP-1 Receptor Agonist
Liraglutide [Saxenda]
111
MOA of Liraglutide [Saxenda]
incr glucose dependent insulin secretion;
decr inappropriate glucagon secretion;
incr Beta-cell growth & replicaton;
decr gastric emptying; decr food intake
112
Indications of Liraglutide [Saxenda]
T2DM adjunct therapy;
| weight loss
113
Lipase Inhibitor
Orlistat [Xenical]
114
MOA of Orlistat [Xenical]
Reversible inhibitor of gastric and pancreatic lipase resulting in ~30% reduction in fat absorption
115
Indications of Orlistat [Xenical]
Management of obesity in individuals w/ BMI >30 or >27 with other risk factors (diabetes, HTN, dyslipidemia)
116
Anorexiant
| 5HT2c Receptor Agonist
Lorcasarin [Belviq]
117
MOA of Lorcasarin [Belviq]
Preferentially activates 5HT2C receptor initiating hormonal cascade resulting in decreased appetite, early satiety
118
Indications of Lorcasarin [Belviq]
Wt management in individuals w/ BMI > 30 or > 27 with other risk factors (diabetes, HTN, dyslipidemia)
119
what are the 3 weight loss agents?
1. Liraglutide [Saxenda]
2. Orlistat [Xenical]
3. Lorcasarin [Belviq]
120
Pancreatic Enzymes
Pancrelipase [Viokase]
121
MOA of Pancrelipase [Viokase]
Supplemental enzymes (Lipase, Amylase, Protease)
122
Indications of Pancrelipase [Viokase]
Chronic pancreatitis
123
Opioid Analgesics Synthetic
Meperidine [Demerol]
124
MOA of Meperidine [Demerol]
Binds to mu opioid receptors in CNS & inhibits ascending pain pathways
125
INdications of Meperidine [Demerol]
Short-term use peri-op and acute pancreatitis
| ??less sphincter of Oddi spasm??
126
Somatostatin Analogue
Octreotide [Sandostatin]
127
MOA of Octreotide [Sandostatin]
Synthetic analogue of somatostatin with longer half-life;
inhibits bowel secretion;
dose related impact on motility;
splanchnic arteriole constriction
128
Indications of Octreotide [Sandostatin]
```
Diarrhea sec to bowel dysmotility, carcinoid,
VIP-oma, pancreatic fistulas,
vagotomy,
dumping syndrome,
short bowel syndrome,
HIV diarrhea; GI bleeding
```
129
Antibiotic
Anti- Pseudomonas
Anti-Anerobes
Imipenem- cilastin [Primaxin]
130
MOA of Imipenem- cilastin [Primaxin]
Inhibits bacterial cell wall synthesis with lyses of bacterial cells
131
Indications of Imipenem- cilastin [Primaxin]
Intra-abdominal infxns,
liver abcess,
lower respiratory tract and GYN organ infxns
132
Antibiotic
| Fluoroquinol one
Ciprofloxacin [Cipro]
133
MOA of Ciprofloxacin [Cipro]
Inhibits DNA gyrase
134
Indications of Ciprofloxacin [Cipro]
```
Diverticulitis, mild;
traveler’s diarrhea;
UTIs,
Anthrax (inhalational, cutaneous, GI),
chlamydial infections,
cholera, salmonosis, shigella
```
135
Misc ABX
Metronidazole [Flagyl]
136
MOA of Metronidazole [Flagyl]
Disrupts DNA structure inhibiting protein synthesis producing cell death
137
Indications of Metronidazole [Flagyl]
Anaerobic bacterial and protozoal infections:
Diverticulitis; C Diff; vaginitis;
brain abcess; rosacea, amebiasis,
giardiasis, trichomonas
138
Glycopeptide Antibiotic
Vancomycin [Vancocin]
139
MOA of Vancomycin [Vancocin]
Inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization
140
Indications of Vancomycin [Vancocin]
PO treatment of staph enterocolitis or antibiotic- associated pseudomembra nous (C. Diff) colitis:
IV MRSA, HAP , meningitis,
pre-op Px infective endocarditis
141
Synthetic Somatastatin Analogue
| Anti-Diarrheal
Octreotide [Sandostatin]
142
MOA of Octreotide [Sandostatin]
Synthetic analogue of somatostatin with longer half- life;
inhibits bowel secretion;
dose related impact on motility; splanchnic arteriole constriction
143
Indications of Octreotide [Sandostatin]
```
Diarrhea sec to bowel dysmotility, carcinoid,
VIP-oma, pancreatic fistulas,
vagotomy, dumping syndrome,
short bowel syndrome,
HIV diarrhea; GI bleeding
```
144
Interferon
Interferon-alpha & Pegylated Interferon- alpha
145
MOA of Interferon-alpha & Pegylated Interferon-alpha
Multiple anti-viral, immune modulating, & viral anti- proliferative
146
Indications of Interferon-alpha & Pegylated Interferon-alpha
Hepatitis B, Hepatitis C
147
Quinolone Abx
Ofloxacin Floxin]
148
MOA of Ofloxacin Floxin]
Inhibits bacterial DNA replication by binding to DNA gyrase & topoisomerase
149
Indications of Ofloxacin Floxin]
Infections with susceptible GI, GU bacteria &
| traveler’s diarrhea (off label)
150
Cytosine Analogue Anti-Viral (NRTI)
Lamivudine [Epivir]
151
MOA of Lamivudine [Epivir]
Inhibits HBV DNA polymerase (& HIV reverse transcriptase); suppresses HBV replication
152
Indications of Lamivudine [Epivir]
HBV
| HIV
153
Guanosine Analogue Anti-viral
Ribavarin [Virazole]
154
MOA of Ribavarin [Virazole]
Inhibits replication of wide range of DNA & RNA viruses
| influenza A & B, RSV, parainfluenza virus
155
Indications of Ribavarin [Virazole]
HCV, HIV;
| goal is eradication of HCV
156
Direct Acting Antiviral
| Polymerase Inhibitor
Sofosbuvir [Sovaldi]
157
MOA of Sofosbuvir [Sovaldi]
Inhibits HCV RNA-dependent RNA polymerase preventing HCV replication
158
Indications of Sofosbuvir [Sovaldi]
Acute or Chronic Hepatitis C
159
the other Direct Acting Antiviral
Polymerase Inhibitor
that is just one pill for it all!!!!
Ledipasvir/ Sofosbuvir [Harvoni]
160
MOA of Ledipasvir/ Sofosbuvir [Harvoni]
Ledipsavir inhibits HCV protein needed for replication;
| sofosbuvir inhibits RNA- dependent polymerase preventing replication
161
Indications of Ledipasvir/ Sofosbuvir [Harvoni]
Chronic Hepatitis C, genotype 1
162
Misc Antibiotic from Hepatic disorders drug table
Rifaximin [Xifaxan]
163
MOA of Rifaximin [Xifaxan]
Inhibits bacterial RNA-synthesis by binding to bacterial RNA- polymerase
164
Indications of Rifaximin [Xifaxan]
Hepatic encephalopathy,
IBS-Diarrhea predominant, Traveler’s diarrhea;
Off-label: C Diff associated diarrhea (CDAD)
165
Hepatitis Vaccines:
Inactivated Vaccine
Hep A Vaccine [Havrix]
166
MOA of Hep A Vaccine [Havrix]
Stimulates HAV antibody response
167
Indications of Hep A Vaccine [Havrix]
Active HAV prophylaxis;
Pre- and post- exposure;
2 doses
168
Hepatitis Vaccines:
Recombinant Vaccine
Hep B Vaccine [Engerix-B]
169
MOA of Hep B Vaccine [Engerix-B]
Stimulates anti-HBV antibody formation
170
Indications of Hep B Vaccine [Engerix-B]
Active HBV prophylaxis
| 3 doses
