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Module 9: Mali: GI > pharm chart > Flashcards

pharm chart Flashcards

1
Q

Anti-diarrheals Opioid

A

Loperamide [Imodium]

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2
Q

MOA of Loperamide [Imodium]

A

Inhibition of presynaptic cholinergic nerves in colonic submucosal and myenteric plexus slows transit time

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3
Q

Indications of Loperamide [Imodium]

A

Mild to moderate diarrhea w/o obstruction,

IBD, IBS

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4
Q

Anti-diarrheals Non- Opioid

A

Kaolin-Pectin

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5
Q

MOA of Kaolin-Pectin

A

A clay (Kaolin) and a plant polysaccride (Pectin) combination that absorbs fluids & bacterial toxins

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6
Q

indications of Kaolin-Pectin

A

Mild diarrhea

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7
Q

Anti-diarrheals Laxative

A

Dietary Fiber

[Metamucil, Citrucel, Fibercon]

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8
Q

MOA of Dietary Fiber

[Metamucil, Citrucel, Fibercon]

A

Absorb and bind fluids, provides stool bulk

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9
Q

Indications of Dietary Fiber

[Metamucil, Citrucel, Fibercon]

A

Mild to moderate diarrhea,

constipation

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10
Q

Anti-Diarrheal

Synthetic Somatostatin Analogue

A

Octreotide [Sandostatin]

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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

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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
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13
Q

Anti-diarrheals

A

Bismuth Subsalicylate [Pepto- Bismol]

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14
Q

MOA of Bismuth Subsalicylate [Pepto- Bismol]

A

Anti-secretory (salicylate) and anti-microbial (bismuth) action

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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

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16
Q

what are the 2 

5ASA Anti- Inflammatories

A
  1. Mesalamine or 5-ASA [Asacol]
  2. Sulfasalazine [Azulfadine]
    5-ASA + sulfapyridine
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17
Q

what is the MOA of the 5ASA Anti- Inflammatories

A

Local colon anti- inflammatory action and systemic prostaglandin inhibition

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18
Q

Inidacation of Mesalamine or 5-ASA [Asacol]

A

Ulcerative colitis, proctosigmoiditis, proctitis

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19
Q

Indication of Sulfasalazine [Azulfadine]

5-ASA + sulfapyridine

A

Ulcerative colitis,
rheumatoid arthritis,
Crohn’s disease, psoriasis

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20
Q

Purine Analogues Immunosuppressant

A

Azathioprine [Imuran]

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21
Q

MOA of Azathioprine [Imuran]

A

Inhibits synthesis of DNA, RNA, proteins

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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

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23
Q

Purine Analogues Anti-Inflammatory

A

Methotrexate [Rheumatriex]

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24
Q

MOA of Methotrexate [Rheumatriex]

A

Decreases protein synthesis via inhibition of dihydrofolate reductase;
inhibits interleukin-1;
incr release of anti- inflammatory adenosine

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25
Q

Indications of Methotrexate [Rheumatriex]

A

Crohn’s Disease;
+/- Ulcerative colitis;
psoriasis, rheumatoid arthritis

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26
Q

Anti-TNF Alfa Compounds

A

Infliximab [Remicade]

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27
Q

MOA of Infliximab [Remicade]

A

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

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28
Q

Indications of Infliximab [Remicade]

A

Acute and maintenance Tx mod to severe Crohn’s Disease & Ulcerative colitis

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29
Q

Anti-integrin

A

Natalizumab

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30
Q

MOA of Natalizumab

A

Inhibit integrins on leukocyte surface and inhibit their adhesion to vascular endothelium and their migration into tissue

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31
Q

Indications of Natalizumab

A

Subset of patients with mod to severe Crohn’s ds who have failed other therapies

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32
Q

Ursodeoxycholic Acid Gallstone Dissolution Agent

A

Ursodiol [Actigall]

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33
Q

MOA of Ursodiol [Actigall]

A

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

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34
Q

Indications of Ursodiol [Actigall]

A

Gallstones;
prevention of stones in rapid weight loss,;
primary billiary cirrhosis

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35
Q

Laxative Stimulant

A

Senokot [Senna]

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36
Q

MOA of Senokot [Senna]

A

stimulate enterocytes, enteric neurons,
GI smooth muscle inducing low-grade inflammation, fluid accumulation and
stimulate intestinal motility

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37
Q

INdications of Senokot [Senna]

A

constipation (without bowel obstruction)

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38
Q

Laxative Calcium Channel Activator

A

Lubiprostone [Amitiza]

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39
Q

MOA of Lubiprostone [Amitiza]

A

Activates calcium channels to increase bowel fluid secretion and motility

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40
Q

Indications of Lubiprostone [Amitiza]

A

Chronic idiopathic constipation;
IBS constipation- dominant in women >18yo;
opioid induced constipation

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41
Q

Laxative cGMP agonist

A

Linaclotide [Linzess]

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42
Q

MOA of Linaclotide [Linzess]

A

Agonizes guanylate cyclase-C (cGMP) on luminal surface of bowel epithilium, increases cGMP resulting in chloride and bicarbonate secretion into intestinal lumen

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43
Q

Indications of Linaclotide [Linzess]

A

IBS-C (in adults not responsive to PEG); or, Chronic Idiopathic Constipation (CIC) in adults

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44
Q

Osmotic Laxative; PEG

A 
Polyethylene Glycol (PEG) 3350
Electrolyte Solution [GoLYTELY] [MiraLax]
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45
Q

MOA of Polyethylene Glycol (PEG) 3350

Electrolyte Solution [GoLYTELY] [MiraLax]

A

Causes water retention in stool and incr stool frequency

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46
Q

Indications of Polyethylene Glycol (PEG) 3350

Electrolyte Solution [GoLYTELY] [MiraLax]

A

Occasional Constipation

Short Term Use

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47
Q

Osmotic Laxative

A

Lactulose [Enulose]

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48
Q

MOA of Lactulose [Enulose]

A

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

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49
Q

Indications of Lactulose [Enulose]

A

Px & Tx portal- systemic encephalopathy (PSE)

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50
Q

Magnesium Laxative

A

MgCitrate [Citroma]

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51
Q

MOA of MgCitrate [Citroma]

A

Osmotic retention of bowel fluid distending colon and increasing peristalsis

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52
Q

INdications of MgCitrate [Citroma]

A

Occasional constipation, study prep

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53
Q

Stool Softener

A

Docusate Na [Colase]

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54
Q

MOA of Docusate Na [Colase]

A

….

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55
Q

Indications of Docusate Na [Colase]

A

…..

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56
Q

Anticholinergic, Anti-emetic & anti-vertigo

dermal patch

A

Scopolamine [Transderm Scop]

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57
Q

MOA of Scopolamine [Transderm Scop]

A

Blocks activity of acetylcholine at PSNS sites in smooth muscle, secretory glands, and CNS
Fast onset, short duration

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58
Q

INdications of Scopolamine [Transderm Scop]

A

Nausea, vertigo

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59
Q

H1 Antagonist Antihistamine

A

Meclizine [Antivert]

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60
Q

MOA of Meclizine [Antivert]

A

Central anticholinergic blockage in chemoreceptor trigger zone and decreases excitability of vestibular- cerebellar pathways

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61
Q

Indications of Meclizine [Antivert]

A

Prevention & treatment of motion sickness

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62
Q

Phenothiazines

A

Promethazine [sPhenergan]

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63
Q

MOA of Promethazine [sPhenergan]

A

Blocks CNS dopamine receptors (D2); competes for H1 receptors in brain and systemically
(anti-histamine and anti-dopaminergic)

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64
Q

Indications of Promethazine [sPhenergan]

A

Anti-emetic, motion sickness,

sedative

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65
Q

Butyrophenones

Typical anti- psychotic

A

Haloperidol [Haldol]

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66
Q

MOA of Haloperidol [Haldol]

A

Blocks post-synaptic mesolimbic D1 & D2 receptors; also suppresses the reticular activating system (RAS) thereby reducing emesis

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67
Q

Indications of Haloperidol [Haldol]

A

Anti-emetic; schizophrenia Tourette’s disorder;

emergency sedation of agitated- aggressive patients (off label)

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68
Q

Benzamides

some refer to as pro kinetic

A

Metoclopromide [Reglan]

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69
Q

MOA of Metoclopromide [Reglan]

A

Blocks D and 5-HT receptors in CRTZ; overcomes inappropriate direction of peristalsis experienced with vomiting

70
Q

Indications of Metoclopromide [Reglan]

A

Anti-emetic;
diabetic gastroparesis (decreased stomach emptying d/t inadequate peristalsis),
GERD
cancer chemo-induced emesis & radiation sickness

71
Q

Corticosteroid

A

Dexamethasone [Maxidex]

72
Q

MOA of Dexamethasone [Maxidex]

A

Enhance effect of 5- HT3-receptor (in heart, stomach, brain: area postrema & nucleus of tractus solitarius) antagonists CRTZ

73
Q

Indications of Dexamethasone [Maxidex]

A

Anti-emetic pre- chemo;

immune modulation

74
Q

Cannaboids
Tetrahydrocanna binol (THC)
Dopamine antagonist

A

Dronabinol [Marinol]

75
Q

MOA of Dronabinol [Marinol]

76
Q

INidcations of Dronabinol [Marinol]

A

Appetite stimulant;
anti-emetic (Chemo related);
adjunct to surgical anesthesia

77
Q

Serotonin Antagonists

A

Ondansetron [Zofran]

78
Q

MOA of Ondansetron [Zofran]

A

Peripheral and CRTZ 5-HT3 receptor blockade

79
Q

Indications of Ondansetron [Zofran]

A

ONLY for post- op, radiation & chemotherapy induced N/V

80
Q

Neurokinin-1 Antagonist

A

Aprepitant [Emend]

81
Q

MOA of Aprepitant [Emend]

A

Blocks central NK1 receptors

Augments anti- emetic effect of 5- HT3 receptor antagonism & corticosteroids

82
Q

Indications of Aprepitant [Emend]

A

Prevention chemo induced N/V;

post-op N/V

83
Q

Peripherally- acting Opioid Antagonist

A

Naloxegol [Movantik]

84
Q

MOA of Naloxegol [Movantik]

A

Mu-opioid receptor antagonist (conjugated with PEG reducing its ability to cross BBB) so acts peripherally in GI tract

85
Q

Indications of Naloxegol [Movantik]

A

Opioid Induced Constipation

86
Q

H Pylori Combo- Triple Drug and 4 drug combo

A
  1. Omeprazole Amoxicillin Clarithromycin

2. Omeprazole Metronidazole Tetracycline Bismuth SS

87
Q

MOA of H Pylori Combos

A

Raise gastric pH and antibiotic action on H pylori

88
Q

Indications of H Pylori Combos

A

Eradication of H pylori-associated ulcers

89
Q

H2R Antagonists

in another drug table this is under: Gastric Acid Suppressants and it is a H2 Receptor blocker

A

Ranitidine [Zantac]

90
Q

MOA of Ranitidine [Zantac]

A

Competitive inhibition of H2-receptors of gastric parietal cells reduce basal and stimulated acid production

91
Q

Indications of Ranitidine [Zantac]

A

Peptic ulcer disease, GERD

92
Q

2 drugs that are in the class:

Proton Pump Inhibitors (PPI)

A
  1. Omeprazole [Prilosec]

2. Pantoprazole [Protonix]

93
Q

mOA of Proton Pump Inhibitors (PPI)

A

Inhibits basal and stimulated parietal cell proton pump acid secretion

94
Q

Indications of Proton Pump Inhibitors (PPI)

A

Peptic ulcer disease, GERD;
prevention of NSAID ulcers;
stress ulcer prophylaxis in critically ill

95
Q

Mucosal Surfactants

A

Sucralfate [Carafate]

96
Q

MOA of Sucralfate [Carafate]

A

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
Q

Indications of Sucralfate [Carafate]

A

Duodenal or gastric ulcers or erosions, stomatitis (off label)

98
Q

Muscarinic Antagonists

Anti- Spasmodic

A

Dicyclomine [Bentyl]

99
Q

MOA of Dicyclomine [Bentyl]

A

M receptor anticholinergic drug

100
Q

Indications of Dicyclomine [Bentyl]

A

Irritable Bowel Syndrome (cramps)

101
Q

Antacids

A

AlOH [Alternagel]

Aluminum Hydroxide

102
Q

MOA of AlOH [Alternagel]

Aluminum Hydroxide

A

Neutralizes HCl in stomach to form Al(Cl)3 & H20

103
Q

Indications of AlOH [Alternagel]

Aluminum Hydroxide

A

hyperacidity, hyperphosphatemia

104
Q

Antacids Laxative

A

MgOH [MOM]

105
Q

MOA of MgOH [MOM]

A

reacts with HCl acid to form MgCl;

osmotic absorption of fluids distends colon and increases peristaltic activity

106
Q

Indications of MgOH [MOM]

A

dyspepsia; constipation

107
Q

Mucosal, NSAID Protectants

Prostaglandin

A

Misoprostol [Cytotec]

108
Q

MOA of Misoprostol [Cytotec]

A

synthetic prostaglandin E1 analog replaces protective PG inhibited by NSAID therapy

109
Q

Indications of Misoprostol [Cytotec]

A

NSAID-induced gastric ulcers;

people at high risk for NSAID induced bleeding

110
Q

GLP-1 Receptor Agonist

A

Liraglutide [Saxenda]

111
Q

MOA of Liraglutide [Saxenda]

A

incr glucose dependent insulin secretion;
decr inappropriate glucagon secretion;
incr Beta-cell growth & replicaton;
decr gastric emptying; decr food intake

112
Q

Indications of Liraglutide [Saxenda]

A

T2DM adjunct therapy;

weight loss

113
Q

Lipase Inhibitor

A

Orlistat [Xenical]

114
Q

MOA of Orlistat [Xenical]

A

Reversible inhibitor of gastric and pancreatic lipase resulting in ~30% reduction in fat absorption

115
Q

Indications of Orlistat [Xenical]

A

Management of obesity in individuals w/ BMI >30 or >27 with other risk factors (diabetes, HTN, dyslipidemia)

116
Q

Anorexiant

5HT2c Receptor Agonist

A

Lorcasarin [Belviq]

117
Q

MOA of Lorcasarin [Belviq]

A

Preferentially activates 5HT2C receptor initiating hormonal cascade resulting in decreased appetite, early satiety

118
Q

Indications of Lorcasarin [Belviq]

A

Wt management in individuals w/ BMI > 30 or > 27 with other risk factors (diabetes, HTN, dyslipidemia)

119
Q

what are the 3 weight loss agents?

A
  1. Liraglutide [Saxenda]
  2. Orlistat [Xenical]
  3. Lorcasarin [Belviq]
120
Q

Pancreatic Enzymes

A

Pancrelipase [Viokase]

121
Q

MOA of Pancrelipase [Viokase]

A

Supplemental enzymes (Lipase, Amylase, Protease)

122
Q

Indications of Pancrelipase [Viokase]

A

Chronic pancreatitis

123
Q

Opioid Analgesics Synthetic

A

Meperidine [Demerol]

124
Q

MOA of Meperidine [Demerol]

A

Binds to mu opioid receptors in CNS & inhibits ascending pain pathways

125
Q

INdications of Meperidine [Demerol]

A

Short-term use peri-op and acute pancreatitis

??less sphincter of Oddi spasm??

126
Q

Somatostatin Analogue

A

Octreotide [Sandostatin]

127
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

128
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
129
Q

Antibiotic
Anti- Pseudomonas
Anti-Anerobes

A

Imipenem- cilastin [Primaxin]

130
Q

MOA of Imipenem- cilastin [Primaxin]

A

Inhibits bacterial cell wall synthesis with lyses of bacterial cells

131
Q

Indications of Imipenem- cilastin [Primaxin]

A

Intra-abdominal infxns,
liver abcess,
lower respiratory tract and GYN organ infxns

132
Q

Antibiotic

Fluoroquinol one

A

Ciprofloxacin [Cipro]

133
Q

MOA of Ciprofloxacin [Cipro]

A

Inhibits DNA gyrase

134
Q

Indications of Ciprofloxacin [Cipro]

A 
Diverticulitis, mild;
traveler’s diarrhea;
UTIs,
Anthrax (inhalational, cutaneous, GI),
chlamydial infections,
cholera, salmonosis, shigella
135
Q

Misc ABX

A

Metronidazole [Flagyl]

136
Q

MOA of Metronidazole [Flagyl]

A

Disrupts DNA structure inhibiting protein synthesis producing cell death

137
Q

Indications of Metronidazole [Flagyl]

A

Anaerobic bacterial and protozoal infections:
Diverticulitis; C Diff; vaginitis;
brain abcess; rosacea, amebiasis,
giardiasis, trichomonas

138
Q

Glycopeptide Antibiotic

A

Vancomycin [Vancocin]

139
Q

MOA of Vancomycin [Vancocin]

A

Inhibits bacterial cell wall synthesis by blocking glycopeptide polymerization

140
Q

Indications of Vancomycin [Vancocin]

A

PO treatment of staph enterocolitis or antibiotic- associated pseudomembra nous (C. Diff) colitis:
IV MRSA, HAP , meningitis,
pre-op Px infective endocarditis

141
Q

Synthetic Somatastatin Analogue

Anti-Diarrheal

A

Octreotide [Sandostatin]

142
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

143
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
144
Q

Interferon

A

Interferon-alpha & Pegylated Interferon- alpha

145
Q

MOA of Interferon-alpha & Pegylated Interferon-alpha

A

Multiple anti-viral, immune modulating, & viral anti- proliferative

146
Q

Indications of Interferon-alpha & Pegylated Interferon-alpha

A

Hepatitis B, Hepatitis C

147
Q

Quinolone Abx

A

Ofloxacin Floxin]

148
Q

MOA of Ofloxacin Floxin]

A

Inhibits bacterial DNA replication by binding to DNA gyrase & topoisomerase

149
Q

Indications of Ofloxacin Floxin]

A

Infections with susceptible GI, GU bacteria &

traveler’s diarrhea (off label)

150
Q

Cytosine Analogue Anti-Viral (NRTI)

A

Lamivudine [Epivir]

151
Q

MOA of Lamivudine [Epivir]

A

Inhibits HBV DNA polymerase (& HIV reverse transcriptase); suppresses HBV replication

152
Q

Indications of Lamivudine [Epivir]

153
Q

Guanosine Analogue Anti-viral

A

Ribavarin [Virazole]

154
Q

MOA of Ribavarin [Virazole]

A

Inhibits replication of wide range of DNA & RNA viruses

influenza A & B, RSV, parainfluenza virus

155
Q

Indications of Ribavarin [Virazole]

A

HCV, HIV;

goal is eradication of HCV

156
Q

Direct Acting Antiviral

Polymerase Inhibitor

A

Sofosbuvir [Sovaldi]

157
Q

MOA of Sofosbuvir [Sovaldi]

A

Inhibits HCV RNA-dependent RNA polymerase preventing HCV replication

158
Q

Indications of Sofosbuvir [Sovaldi]

A

Acute or Chronic Hepatitis C

159
Q

the other Direct Acting Antiviral
Polymerase Inhibitor
that is just one pill for it all!!!!

A

Ledipasvir/ Sofosbuvir [Harvoni]

160
Q

MOA of Ledipasvir/ Sofosbuvir [Harvoni]

A

Ledipsavir inhibits HCV protein needed for replication;

sofosbuvir inhibits RNA- dependent polymerase preventing replication

161
Q

Indications of Ledipasvir/ Sofosbuvir [Harvoni]

A

Chronic Hepatitis C, genotype 1

162
Q

Misc Antibiotic from Hepatic disorders drug table

A

Rifaximin [Xifaxan]

163
Q

MOA of Rifaximin [Xifaxan]

A

Inhibits bacterial RNA-synthesis by binding to bacterial RNA- polymerase

164
Q

Indications of Rifaximin [Xifaxan]

A

Hepatic encephalopathy,
IBS-Diarrhea predominant, Traveler’s diarrhea;
Off-label: C Diff associated diarrhea (CDAD)

165
Q

Hepatitis Vaccines:

Inactivated Vaccine

A

Hep A Vaccine [Havrix]

166
Q

MOA of Hep A Vaccine [Havrix]

A

Stimulates HAV antibody response

167
Q

Indications of Hep A Vaccine [Havrix]

A

Active HAV prophylaxis;
Pre- and post- exposure;
2 doses

168
Q

Hepatitis Vaccines:

Recombinant Vaccine

A

Hep B Vaccine [Engerix-B]

169
Q

MOA of Hep B Vaccine [Engerix-B]

A

Stimulates anti-HBV antibody formation

170
Q

Indications of Hep B Vaccine [Engerix-B]

A

Active HBV prophylaxis

3 doses

Module 9: Mali: GI (6 decks)

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