Pharmacology: GI agents Flashcards
Cimetidine
H2 blocker, reversible
Decreases H+ secretion
Inhibits P450! Anti-androgen effects (gynecomastia)! Decr renal excr of Cr (along with ranitidine)
Ranitidine
H2 blocker, reversible
Decreases H+ secretion
Decr renal excr of Cr (along with cimetidine)
Famotidine
H2 blocker, reversible
Decreases H+ secretion
Nizatidine
H2 blocker, reversible
Decreases H+ secretion
Omeprazole
PPI
Irreversibly inhibits H+/K+ ATPase
Lansoprazole
PPI
Irreversibly inhibits H+/K+ ATPase
Bismuth
Binds to acid base, provides physical protection, allowing HCO3- secretion to reestablish pH gradient in mucosal layer
Sucralfate
Binds to acid base, provides physical protection, allowing HCO3- secretion to reestablish pH gradient
Misoprostol
PGE1 analog
Increases production and secretion of gastric mucosal barrier, decreases acid production
- Prevent NSAID ulcers, maintain PDA OPEN, induces labor
Octreotide
Long-acting SST analog
Tx: Acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors
Atropine
Anti-muscarinic
Bethanechol
Cholinomimetic muscarinic agonist
Increases gastric acid secretion
Tx: ileus, urinary retention
Aluminum hydroxide
Antacid
SE: hypoK, constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures
Magnesium hyroxide
Antacid, osmotic laxative
Provides osmotic load to draw water out
SEs: hypoK, diarrhea, hyporeflexia, hypotension, cardiac arrest
Calcium carbonate
Antacid
SE: hypoK, hyperCa
Magnesium citrate
Osmotic laxative
Provides osmotic load to draw water out
Polyethylene glycol
Osmotic laxative
Provides osmotic load to draw water out
Lactulose
Osmotic laxative
Provides osmotic load to draw water out
Also treats hepatic encephalopathy (gut flora degrades lactulose into lactic acid and acetic acid, provides acid to trap nitrogen as NH4+ and excrete)
Infliximab
Anti-TNF
Tx: Crohn’s, RA
Increased risk of infection (reactivation of TB), fever, hypotension
Sulfasalazine
Sulfapyridine (antibiotic) + 5-ASA
Activated by colonic bacteria
For Crohn’s
Odansetrone
5-HT3 antagonist, central acting
For post-op vomiting and pts getting chemo
Metoclopramide
D2 receptor antagonist, central and GI enteric acting
- Antiemetic and gastroprokinetic