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Pharm Final > Stomach Drugs > Flashcards

Stomach Drugs Flashcards

1
Q

what are the causes of peptic ulcer disease?

A
  • H. pylori
  • NSAID
  • Zollinger-Ellison syndrome
  • stress ulcers
  • smoking - increases pepsin production
  • increased age
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2
Q

what is the stomach’s natural defense against peptic ulcer disease?

A

mucus, bicarbonate, blood flow, and prostaglandins

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3
Q

what are the causes of GERD?

A
  • smoking
  • increased age
  • FOODS (chocolate and fat)
  • medications (B-blockers, calcium channel blockers, nitrates)
  • pregnancy
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4
Q

how should h. pylori be treated?

A

use a combination of antibiotics (2-3) with an acid reduction agent

  • bismuth (Pepto-Bismol)
  • clarithromycin - resistance
  • amoxicillin
  • tetracycline
  • metronidazole (Flagyl) - resistance
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5
Q

does a bland food and avoidance of caffeine best treat for PUD?

A

no, it doesn’t work for everyone since everyone is different
- eat smaller meals

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6
Q

what is the action of H2 blockers (-tidine)?

A

inhibition of gastric acid secretion by blocking H2 receptors

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7
Q

what are the benefits of H2 blockers (-tidine)?

A
  • easy to swallow
  • often a better choice than antacids
  • little-no effect from food
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8
Q

when does the dose of H2 blockers (-tidine) need to reduced?

A

in patients with renal impairment

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9
Q

what are the approved uses for H2 blockers (-tidine)?

A
  • PUD
  • esophagitis
  • acute stress ulcer - GI bleeding
  • Zollinger-Ellison syndrome
  • GERD
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10
Q

what are the side effects of cimetidine (H2 Blocker)?

A

headache, drowsiness, confusion (ESPECIALLY IV DOSE IN ELDERLY)
- seems to be dose-related
- fewer CNS problems with other H2 blockers
antiandrogenic effects
- gynecomastia and decrease libido in males
many drug interaction r/t CP450 inhibition

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11
Q

what other examples of other H2 blockers besides cimetidine?

A

ranitidine (Zantac) and famotidine (Pepcid)

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12
Q

how do ranitidine (Zantac) and famotidine (Pepcid) work?

A

generally act the same as cimetidine but more potent, fewer side-effects, fewer drug interactions

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13
Q

what are the actions of proton-pump inhibitors (PPIs) (-prazole)?

A

binds to and inhibits enzymes on the parietal cell membrane and moderates acid secretion

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14
Q

what are the benefits of proton-pump inhibitors (PPIs) (-prazole)?

A
  • more effective because they last longer

- last 2 weeks after the last dose - taper off to rebound hypersecretion

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15
Q

what are examples of proton-pump inhibitors (PPIs)?

A
  • omeprazole (Prilosec)
  • lansoprazole (Prevacid)
  • Pantoprazole - most common because it can be given PO and IV
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16
Q

what is omeprazole (Prilosec) used for?

A 
PPI 
- PUD
- GERD
- erosive esophagitis 
- Zollinger-Ellison syndrome 
NOT STRESS
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17
Q

what are the side effects of omeprazole (Prilosec)?

A
  • N/V
  • diarrhea
  • headache
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18
Q

what are the consequences of long-term use of omeprazole (Prilosec)?

A
  • association with C.diff

- maybe stomach ulcers and STOMACH CANCER

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19
Q

what are drug interactions with omeprazole (Prilosec)?

A
  • clopidogrel - antiplatelet
  • phenytoin - anti seizure
  • warfarin
  • benzodiazepines
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20
Q

do critically ill patients need to be treated prophylactically to prevent stomach ulcers?

A

probably not

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21
Q

what is the action of sucralfate (Carafate)?

A

ulcer coating drug - NO MORE THAN 8 WEEKS

  • combines with chemicals from damaged cells in ulcer craters and forms a coating over the ulcer
  • when there is a pH less than 4 it results in a product that is viscous and sticky and adheres to an ulcer crater
  • doesn’t decrease acid production but creates a protective barrier
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22
Q

what is the negative about administration with sucralfate (Carafate)?

A
  • taken 1 hour before meals without other drugs

- 2-4 times per day before meals and bed

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23
Q

what form does sucralfate (Carafate) come in?

A

pill or liquid

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24
Q

what is the main side effect of sucralfate (Carafate)?

A

constipation

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25
Q

what is the action of misoprostol (Cytotec)?

A

analog of prostaglandin E1 which increases protective mucous

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26
Q

what is the only approved use of misoprostol (Cytotec) in the US?

A

gastric ulcers caused by long term NSAIDs

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27
Q

what are the side effects of misoprostol (Cytotec)?

A
  • diarrhea

- miscarriage - category X for women of childbearing age, can be used improperly for abortion or stimulate labor

28
Q

what are most antacids made of?

A

a combination of aluminum and magnesium salts

29
Q

where do antacids work?

A

locally in the gut to neutralize acid and reduce pain

30
Q

how long does it take for antacids to work?

A
  • relief of pain in 1-2 days

- complete ulcer healing 8-10 weeks if taken 8-10 times a day

31
Q

what is an example of antacids?

A

magnesium hydroxide (Mylanta)

32
Q

what is the benefit of hydroxide (Mylanta)?

A
  • potent and rapid-acting

- Mg is absorbed quickly into the blood

33
Q

what is the negative of hydroxide (Mylanta)?

A
  • can reduce the absorption of other drugs
  • contraindicated in renal patients
    increased gut motility - less time for other PO meds to be absorbed
34
Q

how does hydroxide (Mylanta) work?

A

increased gut motility - less time for other PO meds to be absorbed

35
Q

what kind of patient is hydroxide (Mylanta) contraindicated in?

A

patients with renal disease

36
Q

how does bismuth subsalicylate (Pepto-Bismol) work?

A
  • disrupts cell wall of H. pylori

- inhibits prostaglandin synthesis to decrease GI motility

37
Q

what does bismuth subsalicylate (Pepto-Bismol) treat?

A

diarrhea

38
Q

what allergy contraindication is there with bismuth subsalicylate (Pepto-Bismol)?

A

sulfa

39
Q

what side effects are there of bismuth subsalicylate (Pepto-Bismol)?

A

black discoloration of tongue and stool

40
Q

what do laxatives do?

A

produces soft stool

41
Q

what do cathartics do?

A

evacuate the stool

42
Q

what can cause constipation?

A
  • anesthesia/surgery, lack of mobility
  • dehydration
  • opioids
  • iron
  • calcium channel blockers
43
Q

what are the different types of laxatives/cathartics?

A
  • bulk-forming agents
  • saline laxative-cathartic
  • hyperosmotic agents
  • stimulant/irritants
  • stool softeners
  • lubricants
44
Q

what are bulk-forming laxatives used for?

A

used for diarrhea to absorb water

45
Q

how do bulk-forming laxatives work?

A

forms mass by absorbing water then gravity helps

- produces stool in 1-3 days

46
Q

what are examples of bulk-forming laxatives?

A
  • methylcellulose (Citrucel)

- psyllium (Metamucil)

47
Q

what education is needed with psyllium (Metamucil)?

A

the powder needs to be mixed in 8oz of water and followed by 8oz of water
- if it sits around it turns clumpy in the esophagus or a cup

48
Q

what is an example of surfactant laxatives?

A

docusate sodium (Colace)

49
Q

how does docusate sodium (Colace)?

A

softens stool by facilitating the penetration of water

- not for true constipation

50
Q

what are examples of stimulant laxatives?

A
  • bisacodyl
  • senna
  • castor oil
51
Q

how do stimulant laxatives work?

A

stimulate peristalsis and soften feces

- increases H2O and electrolyte secretion into the stool

52
Q

what is a side effect of senna?

A

cayuse a yellow/orange stool and urine

53
Q

how does saline cathartics work?

A

retains water and soften stools

- poorly absorbed

54
Q

what are examples of saline cathartics?

A
  • magnesium hydroxide (milk of magnesia)
  • polyethylene glycol (Miralax)
  • polyethylene glycol solution (CoLyte, Golytely)
55
Q

what is lactulose?

A

poorly absorbed and is more expensive with more side effects

  • flatulence and cramping - more than bulk-forming laxatives
  • also used to lower ammonia levels
56
Q

what are antimuscarinics used for?

A

motion sickness

57
Q

what are examples of antimuscarinics used for motion sickness?

A
  • scopolamine - related to atropine
  • Transderm-scop
  • topical prep
58
Q

what are the side effects of antimuscarinics topical prep?

A
  • dry mouth
  • blurred vision
  • contraindications to Atropine
  • more CNS depression
59
Q

what antihistamine is also used as an antiemetic?

A

hydroxyzine

60
Q

how does hydroxyzine work?

A
  • H1 receptor blocking agent

- blocks the action of acetylcholine in the brain

61
Q

what is a side effect of hydroxyzine?

A

drowsiness, caution with operating machinery

62
Q

what are 2 examples of 5-HT3 Receptor Antagonist?

A
  • hydroxytryptamine

- ondansetron (zofran)

63
Q

when is ondansetron (zofran) commonly used?

A

post-op

64
Q

what route does ondansetron (zofran) come?

A

IV or PO

65
Q

what is the action of ondansetron (zofran)?

A

inhibit the activation of serotonin receptors?

66
Q

what are the side effects of ondansetron (zofran)?

A

headache, dizziness, diarrhea, QT interval

Pharm Final (5 decks)

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