Seegars - Antacids & Anti-Ulcer Drugs Flashcards
used for short-term, temporary releif of pild pain and symptoms ass’d with PUD/GERD
antacids
low-systemic antacids
- aluminum-salts
- calcium-salts
- Mg-salts
high-systemic antacids
Na-salts
supplemental agents - antacids
simethicone
good rule of thumb to use to avoid the drug interactions seen w/ antacid use (and for all these other drugs!)
- take 1-2 hr before other meds OR
- 2-4 hr after other meds
ending of anti-ulcer Histamine type-2 blocker
-tidine
histamine type 2- blocker that inhibits several CYP450 isoenzymes and therefore causes many drug-drug interactions
cimetidine
ending of PPI anti-ulcer drugs
-prazole
prototypical PPI that inhibits CYP450 and causes lots of drug-drug interactions
omeprazole
PPI used if needed during pregnanacy
lansoprazole (make sure you don’t sure omeprazole!)
sticky polymer what adheres to epithelial cells around ulcer crater
sucralfate
used in prevention of NSAID-induced gastric ulceration in pts at high risk of ulcerations and complications
Misoprostol
MOA: misoprostol
PGE1 analog > reduces gastric acid release from parietal cells
black/dark stools
Bismuth cmpds
absolute CIs: bismuth compounds
- GI bleeding
- salicylate HSN
combo therapy for H. pylori
- antibiotics & acid reducer
- need to use 2 abs
BID triple therapy for H. pylori
- PPI
- clarithromycin
- ammox or metronidazole
H. pylori with PNC allergy
-sub metrnidazole for ammox
H. pylori with metronisdazole resistance
- sub tetracycline
- consider quadruple therapy
H. pylori with clarithromycin resistance
- sub ammox or tetracycline
- consider quadruple therapy
quadruple therapy for H. pylori
- PPI or H2 blocker
- metrnidazole or clarithromycin
- ammox or tetracyclin
- bismuth subsalicylate
-PUD in pregnant pt w/out H. pylori
- short antacid course or sucalfate
- add ranitidine for moderate persistence
- add lansoprazole for severe persistence
PUD in pt with NSAID use
- NSAID not needed = d/c and use acetaminophen
- NSAID needed = COX-2 NSAID or PPI or Misoprostol
2 rapid onset antacids with good acid neutralizing capacity
Ca and Mg compounds
antacid cmpds that cause consipation
Al and Ca
antacid cmpds that casue diarrhea
Mg
antacid cmpds that cause gas
Na
AEs: histamine type-2 blockers
- GI related: N/V/const
- CNS related: drowsiness/HA
histamine type-2 blocker that can cuase gynecomastia
rimetidine
how often are PPIs dosed?
daily! DOA = 24h
pt on PPI presents with fever and diarrhea thats lasted 24+ hrs
CDAD: clostridium difficile ass’d diarrhea
AE: sucralfate
const
