Pharm: GIT drugs Flashcards
Major antacids
MOA antacids
Major AE’s
- Weak bases that ract with HCl to form salt/water
MgOH: diarrhea
AlOH: constipation, dec PO4
CaCO3: hyperCa, nephrolithiais, constipation - Can chelate tetracyclins *
What drugs are known chelators of tetracyclins?
Antacids
Who are the major H2 antagonists? What are the major uses?
Cimetidine, ranitidine, famotidine, nizatidine
- Acute stress ulcers 2/2 trauma or ICU stay
- Prevent aspiration PNA
- GERD
What are the major AE’s of cimetidine? Any involvement of CYP450?
Anti-androgen; confusion in elderly
* Inhibits CYP450
DOC treatment of acute stress ulcer (Curling/Cushing)
H2 antagonists
MOA PPI’s
Inhibit 100% acid secretion; irreversible inactivation H/K ATPase; transported into parietal cell
Uses PPI
GERD, ulcers, MEN1, ZES, H. pylori (with ABX), NSAID-induced ulcers, platelet aggregation/maintenance clots
Major AE’s PPI
Hypomagnesemia (increased hip fractures); pancreatitis/hepatotoxicity/TIN-renal
Omeprazole inhibits the metabolism of…
Warfarin, clopidogrel, phyytoin, diazepam, cyclosporin
ABX used for H. pylori (in addition to PPI)
Clathromycin, amoxicillin
Mucosal protection agents
Sucralfate: selectively bind to necrotic tissue = barrier to acid; only works in acidic environment
Bismuth
Misoprostol
What is the most important fact about sucralfate?
Only works in acidic environment; requires acid to be activated
What are the drugs of choice to prevent gastric ulcer induced by NSAID?
H2 antag, PPI, [Misoprostol]
Misoprostol MOA
PGE1 agnoist: mucin, bicarbonate
2 cholinomimetic prokinetics, major uses
Neostigmine: colonic pseudoobstruction
Bethanachol: post-op bowel/bladder atony
