Ulcer Drugs

Question 1

Amoxicillin

Answer 1

Cell wall inhibitor, can give it with clavulanic acid to resist beta Lactamases. It is the most acid stable penecillin and get twice the blood levels with an oral dose.
AE: hypersensitivity reactions

Question 2

Bismuth Subsalicylate

Answer 2

Pepto bismo. Has antimicrobial action on Cell wall of H. Pylori, and also protects surface of stomach by coating surface and stimulates secretion of mucus, increases HCO3-
Bismuth is active ingredient in stomach, not in lower GI.
AE: subsalicyilate is like aspirin(tinnitus, vomiting, hyperthermia, respiratory alkalosis). Bismuth turns stool black.

Question 3

Clarithromycin

Answer 3

Macrolide 23 of 50S Ribosomal inhibitor. Most stable macrolide in acid. Bacteriostatic
AEL GI irritation

Question 4

Metronidazole

Answer 4

Unknown mechanism, damages bacterial DNA,

AE: inhibits CYP2C9, increases warfarin , decreases clearance of H2 blockers,

Question 5

Tetracycline

Answer 5

Inhibits the 30S subunit of the Ribosome inhibiting TRNA fusion. Do not give with any cations, will chelate. Includes antacids.
AE: inhibits bone formation and turns teeth black, do not give to pregnant women and children.

Question 6

Misoprostol

Answer 6

PGE1. Is used for NSAID induced ulcers, replaces prostaglandins in the mucosa of the stomach, side effects are abortifacent from uterine contraction, and systemic prostaglandin effects.

Question 7

Simethicone

Answer 7

Antifoaming agent, decreases gas pain

Question 8

Sucralfate

Answer 8

Promotes mucosal defense by brotecting ulcers surface. USED For stress ulcers in the ICU. Makes paste at bottom of the stomach. causes constipation and binds drugs.

Question 9

Aluminum Hydroxide

Answer 9

Antacid, buffers stomach acid, causes constipation, commonly given with MgOH to decrease constipation.

Question 10

Calcium carbonate

Answer 10

tums, buffers stomach acid, rapid onset, long duration, see belching, gastric distension, and rebound acid secretion POSSIBLE Mild systemic alkalosis.

Question 11

Magnesium Hydroxide

Answer 11

Antacid, buffers stomach acid Causes diarrhea, often given with Aluminum hydroxide.

Question 12

Sodium Bicarbonate

Answer 12

Alka Seltzer, buffers stomach acid, do not give in heart failure. Extremely rapid onset of action, belching, gastric distension, short duration of action. SEVERE Metabolic alkalosis, can see alkalinization of urine.

Question 13

Atropine

Answer 13

Muscarinic antagonist. Inhibits muscarinic receptor on the ECL cell and the Parietal cell inhibiting Acid release, AE: systemic, slows clearance from the stomach.

Question 14

Pirenzipine

Answer 14

Muscarinic antagonist. Inhibits muscarinic receptor on the ECL cell and the Parietal cell inhibiting Acid release, AE: systemic, slows clearance from the stomach.

Question 15

Cimetidine

Answer 15

H2 blocker on parietal cell. decreases intracellular cAMP. Oral admin, very little side effects, OTC. AE: GYNECOMASTIA, and gallactorrhea. CYP 450 bradycardia and hypotension on rapid infusion. Least Potent

Question 16

Famotidine

Answer 16

H2 blocker on parietal cell. decreases intracellular cAMP. Oral admin, very little side effects, OTC. AE: bradycardia and hypotension on rapid infusion. MOST POTENT

Question 17

Nizatidine

Answer 17

H2 blocker on parietal cell. decreases intracellular cAMP. Oral admin, very little side effects, OTC. AE: bradycardia and hypotension on rapid infusion.

Question 18

Ranitidine

Answer 18

H2 blocker on parietal cell. decreases intracellular cAMP. Oral admin, very little side effects, OTC. AE: bradycardia and hypotension on rapid infusion.

Question 19

Roxatidine

Answer 19

H2 blocker Oral admin, very little side effects, OTC.

Question 20

H2 blocker

Answer 20

-Tidine

Question 21

Lansoprazole

Answer 21

Proton Pump inhibitor

Question 22

Omeprazole

Answer 22

Irreversible Proton Pump inhibitor

Question 23

Esomeprazole

Answer 23

Proton Pump inhibitor which is a stereoisomer of omeprazole metabolized more slowly.

Question 24

Pantoprazole

Answer 24

Proton Pump inhibitor

Question 25

Rabeprazole

Answer 25

Proton Pump inhibitor

Question 26

Rifabutin

Answer 26

Rifamycin antibiotic, is bacteriocidal, inhibits DNA dependant RNA polymerase.
AE: hypersensitivity, CYP 450, Orange Secretions

Question 27

Glycopyrrolate

Answer 27

Muscarinic antagonist. Inhibits muscarinic receptor on the ECL cell and the Parietal cell inhibiting Acid release, AE: systemic, slows clearance from the stomach.