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GI/Liver > Pharm Table MOA > Flashcards

Pharm Table MOA Flashcards

1
Q

nitrates, nitroglycerin

A

Direct smooth muscle relaxant

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2
Q

calcium channel blockers

A

Antagonism of voltage gated calcium channels on smooth muscle

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3
Q

Botulinum toxin-Botox

A

Interferes with ACh release

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4
Q

Steroids (fluticazone, budesonide)

A

Binds to glucocorticoid receptors, trigger gene expression to suppress inflammation

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5
Q

Antivirals - acyclovir, famcyclovir, valacyclovir

A

Competitive inhibition of HSV-specific DNA polymerases

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6
Q

Antifungals - clotrimazole, miconazole, fluconazole

A

Inhibits fungal CP450 12-alpha demethylase

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7
Q

CaCO3

A

Acid neutralizing

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8
Q

Mg2+/Al3+

A

Acid neutralizing

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9
Q

famotidine, ranitidine

A

Competitive H2 receptor antagonist, dose-dependent

inhibition of histamine-stimulated basal and postprandial acid secretion

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10
Q

omeprazole

A

Irreversible binding to H+/K+ ATPase of parietal cells, causes dose related inhibition of gastric acid secretion

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11
Q

sucralfate

A

(Sulfated polysaccharide) Adherent mucosal gel binding electrostatically to ulcer craters and epithelium, inhibits pepsin, adsorbs bile salts

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12
Q

misoprostol

A

(Synthetic prostaglandin analogue) Direct inhibition of

basal/nocturnal gastric acid secretion by parietal cells, increases gastric mucous production and bicarbonate secretion

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13
Q

Bismuth subsalicylate

A

Weak antacid, bactericidal, promotes fluid and electrolyte absorption, inhibits bacterial adhesion

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14
Q

Amoxicillin

A

Bacterial cell wall synthesis inhibitor

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15
Q

Clarithromycin

A

Inhibits bacterial protein synthesis

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16
Q

Metronidazole

A

Disrupts helical DNA, inhibits bacterial protein synthesis

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17
Q

Tetracycline/Doxycycline

A

Inhibits bacterial protein synthesis, possible cytoplasmic impact

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18
Q

Orlistat

A

Inhibitor of gastric and pancreatic lipase, inhibiting dietary fat absorption

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19
Q

Vancomycin

A

Inhibiting bacterial cell wall synthesis

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20
Q

Bazetoxumab

A

IgG1 monoclonal antibody to C difficile toxin B

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21
Q

Fidaxomycin

A

Inhibits bacterial protein synthesis

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22
Q

Loperamide, diphenoxylate

A

Opioid agonist in GI tract smooth muscle—inhibits peristalsis and stool transit, reduces gut secretion, reduces fluid/electrolyte loss, increases anal sphincter
tone

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23
Q

Cholestyramine

A

Bile acid sequestrant, prevents bile acid induced colonic irritation producing diarrhea; may interfere
with absorption of other medication

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24
Q

Bulking agents (psyllium, methylcellulose)

A

Absorbs water in gut lumen, increases stool bulk/viscosity, facilitates peristalsis and stool transit

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25
Q

Tricyclic antidepressants (nortriptyline, amitriptyline)

A

Norepinephrine and serotonin reuptake inhibitor, may have other modulatory effects on neurotransmission

26
Q

Eluxadoline

A

Mixed K and mu opioid agonist, lambda opioid

antagonist

27
Q

Lubiprostone

A

Secretagogue–Chloride Channel 2 activator

28
Q

Linaclotide

A

Secretagogue–Guanylate cyclase 2C agonist

29
Q

Plecanatide

A

Secretagogue—Uroguanylin analogue

30
Q

Prucalopride

A

Prokinetic, some secretagogue activity, 5HT4 agonist

31
Q

Emollients (stool softeners—docusate Na)

A

Anionic detergent, lowers stool surface tension, allows

penetration of stool by H2O and fats

32
Q

Mg salts (mg citrate, milk of magnesia)

A

Osmotic effect—increases stool water retention. Possible CCK secretion stimulus, improving motility and
gut secretion

33
Q

Polyethylene glycol

A

Isotonic solution, so less electrolyte shifting, but produces osmotic effect drawing water into lumen

34
Q

Stimulant cathartics (bisacodyl, anthraqinones—senna, cascara, aloe, Castor oil)

A

Bisacodyl and anthraqinones–direct stimulation of enteric neurons and muscle. Causes low grade
inflammation, alters water and electrolyte secretion causing fluid accumulation in gut lumen
Castor oil—Increases small bowl fluid and electrolyte secretion and speeds motility

35
Q 
Nonabsorbable sugars (lactulose, glycerin, sorbitol,
mannitol, lactose if intolerant)
A

Sugars not absorbed in small bowel, metabolized into

osmotically active organic fatty acids in colon, causes increased fluid secretion and motility

36
Q

Rifaximin

A

Antibiotic against bacteria that produce H+ which can lead to bloat and diarrhea; also treats bacterial whose
metabolites contribute to hepatic encephalopathy

37
Q

dicyclomine, hyoscyamine

A

Anticholinergic in smooth muscle and CNS

38
Q

naldemedine, naloxegol, methylnaltrexone

A

Peripheral mu opioid antagonists, do not enter CNS

39
Q

sulfasalazine, mesalazine, olsalazine, balasalazide

A

(Aminosalicylates) Inhibits cytokines, proinflammatory
prostaglandins/leukotrienes. Scavenging of free radicals,
immunosuppression, impairment of leukocyte adhesion and function

40
Q

prednisone, methylprednisolone, budesonide

A

(Corticosteroids) Suppresses PMNs, reverses reduced capillary permeability (suppresses mediators of
inflammation)/reduces lymphatic activity and volume, suppresses adrenal function

41
Q

6-mercaptopurine/azathioprine

A

Interference with DNA replication and purine synthesis.

42
Q

Methotrexate

A

Immune modulator– folate inhibitor; interferes with DNA synthesis, repair, and cell proliferation. Also,
some anti-inflammatory function

43
Q

Infleximab, adalimumab, golimumab

A

Inhibit TNF

44
Q

certolizumab

A

Fc-free FAB fragment

45
Q

vedlolizumab, natalizumab

A

Binds to gut mucosa-specific MAdCAM to inhibit a4b7 integrins— natalizumab also binds to a4b1 integrins

46
Q

Ustekinumab

A

IL-12 and IL-23 blockade to inactivate T cells

47
Q

Tofacitinib

A

Inhibits JAK1, 2, 3, disrupting cytokine signal transduction

48
Q

Domperidone

A

D2 receptor antagonists, peripheral

49
Q

Metoclopramide

A

Mixed central and peripheral D2 receptor antagonist, also mixed 5HT3 antagonism/5HT4 agonism. Some
central antiemetic action, as well as
prokinetic

50
Q

Erythromycin

A

Motilin agonist

51
Q

prochloperazine, thorazine, Promethazine

A

Central D2 antagonist; also, antihistamine and

anticholinergic. Promethazine may also have 5HT2 and a1 adrenergic antagonism

52
Q

hydroxyzine, promethazine, diphenhydramine, meclizine, diphenhydrenate

A

Central H1 antagonists

53
Q

scopolamine

A

Muscarinic antagonist

54
Q

dronabinol

A

Cannabinoid agonist, possible 5HT effects, undefined

55
Q

Pancrelipase

A

Pancreatic enzyme replacement

56
Q

Entecavir

A

Nucleoside analog

57
Q

Tenofovir disoproxil fumarate

A

Nucleotide analog RTI

58
Q

Acetaminophen

A

Believed to be due to activation of descending serotonergic inhibitory pathways in the CNS

59
Q

Azathioprine

A

Purine antimetabolite

60
Q

Ursodiol

A

Unknown, Ursodiol decreases the cholesterol content of bile and bile stones by reducing the secretion of
cholesterol from the liver and the fractional reabsorption of cholesterol by the intestines.

61
Q

Obeticholic Acid

A

inhibits conversion of cholesterol to bile acids, reduces circulating bile acid pool

GI/Liver (7 decks)

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