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MS 2 - Unit 6 > Pharmacology - GI Drugs I & II - Patsy Iannolo > Flashcards

Pharmacology - GI Drugs I & II - Patsy Iannolo Flashcards

1
Q

Class: Calcium carbonate (Rolaids, Tums)

A

Antacid

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2
Q

Class: Sodium bicarbonate

A

Antacid

Rarely used due to causing systemic alkalosis

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3
Q

Class: Magnesium hydroxide, magnesium carbonate (Maalox, Mylanta)

A

Antacid

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4
Q

Class: Aluminum hydroxide (Alternagel)

A

Antacid

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5
Q

Use: Calcium carbonate (Rolaids, Tums)

A

Ulcer tx, GERD

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6
Q

Use: Sodium bicarbonate

A

Ulcer tx, GERD

Rarely used due to causing systemic alkalosis

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7
Q

Use: Magnesium hydroxide, magnesium carbonate (Maalox, Mylanta)

A

Ulcer tx, GERD

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8
Q

Use: Aluminum hydroxide (Alternagel)

A

Ulcer tx, GERD

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9
Q

Side Effects: Calcium carbonate (Rolaids, Tums)

A

Milk-alkali syndrome, nephrocalcinosis,
“rebound” acidity,
digitalis antagonism,
constipation

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10
Q

Side Effects: Sodium bicarbonate

A

Systemic alkalosis;
Enhanced effects of amphetamine, quinidine, and cinchophen

Rarely used due to causing systemic alkalosis

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11
Q

Side effects: Magnesium hydroxide, magnesium carbonate (Maalox, Mylanta)

A

Diarrhea;
Hypokalemia,
hypermagnesemia,
iron deficiency

Magnesium toxicity mostly in presence of renal disease; liquid-based, so act fast

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12
Q

Side effects: Aluminum hydroxide (Alternagel)

A

Phosphate depletion and sequelae (weakness, anemia, tetany, apnea);
Constipation

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13
Q

What antacid is safe for use in patients with renal failure?

A

Aluminum hydroxide

also eliminates phosphate

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14
Q

What antacid should not be used in patients that have renal failure?

A

Magnesium hydroxide, magnesium carbonate (Maalox, Mylanta)

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15
Q

Class: Cimetidine

A

Histamine (H2) receptor blocker

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16
Q

Class: Famotidine

A

Histamine (H2) receptor blocker

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17
Q

Class: Ranitidine

A

Histamine (H2) receptor blocker

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18
Q

Class: Nizatidine

A

Histamine (H2) receptor blocker

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19
Q

MOA: Histamine (H2) receptor blockers - Cimiidine, Ranitidine, Famotidine, Nizatidine

A

Inhibits 50-80% of 24 hour acid production

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20
Q

Use: Histamine (H2) receptor blockers - Cimiidine, Ranitidine, Famotidine, Nizatidine

A

Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD

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21
Q

Side Effects: Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD

A

Rebound acidity if stopped;

Uncommon; headache, lethargy, confusion, depression, and hallucination

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22
Q

Class: Omeprazole

A

H/K/ATPase inhibitor

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23
Q

Class: Lansoprazole

A

H/K/ATPase inhibitor

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24
Q

Class: Rabeprazole

A

H/K/ATPase inhibitor

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25
Class: Pantoprazole
H/K/ATPase inhibitor
26
Class: Esomeprazole
H/K/ATPase inhibitor
27
MOA: H/K/ATPase inhibitors: | Omeprazole, Lansoprazole, Rabeprazole, Pantoprazole, Esomeprazole
Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate, selectively diffuse to acidic environments (don't take with antacids) **noncompetitive inhibitors
28
Uses: Omeprazole and Lansorazole
Ulcer treatment, treatment for H. pylori; GERD
29
Uses: Rabeprazole, Pantoprazole, Esomeprazole
Ulcer treatment; GERD
30
Side Effects: H/K/ATPase inhibitors: | Omeprazole, Lansoprazole, Rabeprazole, Pantoprazole, Esomeprazole
Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
31
What is Dexlansoprazole?
A rapid-formulation of slow release Lansoprazole
32
What is the only H/K ATPase inhibitor available for IV administration?
Pantoprazole
33
T/F: H/K ATPase inhibitors will heal H2 antagonist refractory ulcers.
True Also, better pain relief and faster healing rates than with H2 antagonists.
34
What H/K ATPase inhibitor has no P450 interaction?
Pantoprazole
35
What is the only drug that is FDA approved for the prevention of NSAID-induced gastric ulcers?
Misoprostol H2 antagonists and sucralfate are ineffective if NSAID therapy is being continued.
36
Class: Misoprostol
Prostaglandin E analog
37
MOA: Misoprostol
Decrease acid production, increase mucous and bicarbonate secretion
38
Use: Misoprostol
Ulcer treatment when prostaglandin production decreased (RA patients taking lots of NSAIDs)
39
What antacid should not be used in pregnancy?
Misoprostol
40
Side effects: Misoprostol
Transient diarrhea
41
What is the therapy for H. Pylori infection?
Quadruple therapy: A PPI twice a day Tetracycline HCl 500 mg 4 times a day Bismuth subsalicylate or subcitrate 4 times a day Metronidazole 500 mg 3 times a day
42
Class: Atropine sulfate
Anticholinergics
43
Class: Probantheline; | Metantheline bromide
Anticholinergics
44
MOA: Anticholinergics - Atropine sulfate; Probantheline; Metantheline bromide
Reduce acid secretion; | reduce spasm
45
Use: Atropine sulfate
Ulcer treatment
46
Side effects: Anticholinergics - Atropine sulfate; Probantheline; Metantheline bromide
Anticholinergic effects
47
What are the contraindications for Probantheline; | Metantheline bromide
Known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)
48
What are the contraindications for Atropine sulfate?
Aspirin; Belladonna; known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)
49
Use: Probantheline; | Metantheline bromide
Ulcer treatment (taken 15-30 minutes before meals, and before bed)
50
Class: Sucralfate (Carafate)
Mechanical protector
51
Class: Bismuth salts
Mechanical protector
52
MOA: Sucralfate
Coat the ulcer crater, increase mucosal resistance (requires acid environment)
53
MOA: Bismuth salts
Coat the ulcer crater, increase mucosal resistance
54
Side effects: Sucralfate
Aluminum toxicity possible in renal failure
55
Use: Sucralfate, Bismuth salts
Ulcer treatment, treatment for H. pylori
56
Side effects: Bismuth salts
Aluminum toxicity possible in renal failure; turns bowel movements (and sometimes tongues) black
57
Class: Ondansetron
Serotonin (5HT3) receptor antagonists
58
Class: Granesitron
Serotonin (5HT3) receptor antagonists
59
Class: Dolasetron
Serotonin (5HT3) receptor antagonists
60
Class: Promethazine
Phenothiazines (neuroleptic class)
61
Class: Prochlorperazine
Phenothiazines (neuroleptic class)
62
MOA: Prochlorperazine
Probable CNS interaction with dopaminergic receptor-antagonist (leading to reduction of stimulation in the CRTZ in the medulla)
63
Use: Prochlorperazine; Promethazine
Anti-emetic
64
MOA: Promethazine
Antihistamine (H1 receptor); | anticholinergic
65
Side effects: Prochlorperazine
Largely extra-pyramidal (torticollis!)
66
Side effects: Promethazine
Somnolence (esp in elderly)
67
MOA: Ondansetron; Granesitron; Dolasetron
Blocks serotonin at 5HT3 receptor (in central CRTZ)
68
Use: | Ondansetron;
Anti-emetic
69
Use: Granesitron; Dolasetron
Post-op anti-emetic
70
Class: Metochlopramide
Promotility agent (dopamine antagonist)
71
MOA: Metochlopramide
Increase motor tone in lower esophageal sphincter (prevent reflux) and stomch (esp. antrum: improves gastric emptying); peripheral (stomach) and CNS (vomiting, via CRTZ) dopamine antagonist
72
Use: Metochlopramide
GERD, anti-emetic, gastroparesis
73
Side effects: Metochlopramide
Hand tremor if used 4X/day (optimum use); possible extra-pyramidal symptoms, but not so severe
74
Class: Domperidone
Promotility agent
75
MOA: Domperidone
Improves gastric tone
76
Use: Domperidone
Gastroparesis
77
An important complication of Cisparide is:
possibility of sudden cardiac death
78
Class: Cisparide
Promotility agent (dopamine agonist)
79
MOA: Cisparide
Increase motor tone in lower esophageal sphincter and stomach
80
Use: Cisparide
GERD, gastroparesis
81
Class: Lubiprostone
...
82
Class: Linaclotide
...
83
Class: Naloxegol
Mu receptor antagonist
84
MOA: Lubiprostone
acts on chloride channel
85
MOA: Linaclotide
cGMP
86
Use: Lubiprostone
Anti-constipation
87
MOA: Naloxegol
...
88
Use: Naloxegol
Anti-constipation; | effective in opioid addicted population
89
Class: Sulfasalazine
Anti-inflammatory
90
Class: Olsalazine
Anti-inflammatory
91
Class: Mesalamine
Anti-inflammatory
92
Class: Prednisone
Corticosteroid
93
Class: Azathioprine
Immunosuppressive
94
Class: Cyclosporine
Immunosuppressive
95
Class: Infliximab
MAb Immunisuppressive
96
MOA: Sulfasalazine
Work from lumen to reduce inflammation
97
MOA: Olsalazine
Work from lumen to reduce inflammation; 5-ASA dimer Broken down into bowel by bacteria into 2 moleules of 5-ASA
98
MOA: Mesalamine
Work from lumen to reduce inflammation Delayed release 5-ASA, for terminal ileum, colon
99
MOA: Azathioprine
Purine antimetabolite; interferes with DNA synthesis
100
MOA: Cyclosporine
Suppresses T helper and T suppressor lymphocytes
101
MOA: Infliximab
Binds and neutralized TNFa
102
Use: Sulfasalazine; Olsalazine; Mesalamine
Acute IBD (UC)
103
Use: Prednisone
Acute and chronic IBD Can be given systemically or as enemas
104
Use: Azathioprine; Cyclosporine; Infliximab
Chronic IBD
105
Side Effects: Sulfasalazine
Toxicity coming from systemic absorption of sulfapyridine
106
T/F: Olsalazine has less toxicity that Sulfasalazine
True

MS 2 - Unit 6 (34 decks)

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