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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
Tricyclic antidepressants (nortriptyline, amitriptyline)
Norepinephrine and serotonin reuptake inhibitor, may have other modulatory effects on neurotransmission
26
Eluxadoline
Mixed K and mu opioid agonist, lambda opioid | antagonist
27
Lubiprostone
Secretagogue--Chloride Channel 2 activator
28
Linaclotide
Secretagogue--Guanylate cyclase 2C agonist
29
Plecanatide
Secretagogue—Uroguanylin analogue
30
Prucalopride
Prokinetic, some secretagogue activity, 5HT4 agonist
31
Emollients (stool softeners—docusate Na)
Anionic detergent, lowers stool surface tension, allows | penetration of stool by H2O and fats
32
Mg salts (mg citrate, milk of magnesia)
Osmotic effect—increases stool water retention. Possible CCK secretion stimulus, improving motility and gut secretion
33
Polyethylene glycol
Isotonic solution, so less electrolyte shifting, but produces osmotic effect drawing water into lumen
34
Stimulant cathartics (bisacodyl, anthraqinones—senna, cascara, aloe, Castor oil)
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
``` Nonabsorbable sugars (lactulose, glycerin, sorbitol, mannitol, lactose if intolerant) ```
Sugars not absorbed in small bowel, metabolized into | osmotically active organic fatty acids in colon, causes increased fluid secretion and motility
36
Rifaximin
Antibiotic against bacteria that produce H+ which can lead to bloat and diarrhea; also treats bacterial whose metabolites contribute to hepatic encephalopathy
37
dicyclomine, hyoscyamine
Anticholinergic in smooth muscle and CNS
38
naldemedine, naloxegol, methylnaltrexone
Peripheral mu opioid antagonists, do not enter CNS
39
sulfasalazine, mesalazine, olsalazine, balasalazide
(Aminosalicylates) Inhibits cytokines, proinflammatory prostaglandins/leukotrienes. Scavenging of free radicals, immunosuppression, impairment of leukocyte adhesion and function
40
prednisone, methylprednisolone, budesonide
(Corticosteroids) Suppresses PMNs, reverses reduced capillary permeability (suppresses mediators of inflammation)/reduces lymphatic activity and volume, suppresses adrenal function
41
6-mercaptopurine/azathioprine
Interference with DNA replication and purine synthesis.
42
Methotrexate
Immune modulator-- folate inhibitor; interferes with DNA synthesis, repair, and cell proliferation. Also, some anti-inflammatory function
43
Infleximab, adalimumab, golimumab
Inhibit TNF
44
certolizumab
Fc-free FAB fragment
45
vedlolizumab, natalizumab
Binds to gut mucosa-specific MAdCAM to inhibit a4b7 integrins— natalizumab also binds to a4b1 integrins
46
Ustekinumab
IL-12 and IL-23 blockade to inactivate T cells
47
Tofacitinib
Inhibits JAK1, 2, 3, disrupting cytokine signal transduction
48
Domperidone
D2 receptor antagonists, peripheral
49
Metoclopramide
Mixed central and peripheral D2 receptor antagonist, also mixed 5HT3 antagonism/5HT4 agonism. Some central antiemetic action, as well as prokinetic
50
Erythromycin
Motilin agonist
51
prochloperazine, thorazine, Promethazine
Central D2 antagonist; also, antihistamine and | anticholinergic. Promethazine may also have 5HT2 and a1 adrenergic antagonism
52
hydroxyzine, promethazine, diphenhydramine, meclizine, diphenhydrenate
Central H1 antagonists
53
scopolamine
Muscarinic antagonist
54
dronabinol
Cannabinoid agonist, possible 5HT effects, undefined
55
Pancrelipase
Pancreatic enzyme replacement
56
Entecavir
Nucleoside analog
57
Tenofovir disoproxil fumarate
Nucleotide analog RTI
58
Acetaminophen
Believed to be due to activation of descending serotonergic inhibitory pathways in the CNS
59
Azathioprine
Purine antimetabolite
60
Ursodiol
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
Obeticholic Acid
inhibits conversion of cholesterol to bile acids, reduces circulating bile acid pool

GI/Liver (7 decks)

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