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Pharmacology > Unit 6-GI Drugs > Flashcards

Unit 6-GI Drugs Flashcards

1
Q

Calcium carbonate

Drug class

A

Antacid

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2
Q

Calcium carbonate

Uses

A

Ulcer treatment; GERD

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3
Q

Calcium carbonate

Side effects

A

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

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4
Q

Sodium bicarbonate

Drug class

A

Antacid

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5
Q

Sodium bicarbonate

Uses

A

Ulcer treatment; GERD

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6
Q

Sodium bicarbonate

Side effects

A

Systemic alkalosis
Enhanced effects of amphetamine, quinidine, and cinchophen
Rarely used due to causing systemic alkalosis

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7
Q

Magnesium hydroxide, magnesium carbonate

Drug class

A

Antacid

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8
Q

Magnesium hydroxide, magnesium carbonate

Uses

A

Ulcer treatment; GERD

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9
Q

Magnesium hydroxide, magnesium carbonate

Side effects

A

Diarrhea (laxative effects)
Hypokalemia, hypermagnesemia, iron deficiency
Magnesium toxicity mostly in presence of renal disease; liquid-based, so act fast

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10
Q

Aluminum hydroxide

Drug class

A

Antacid

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11
Q

Aluminum hydroxide

Uses

A

Ulcer treatment; GERD

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12
Q

Aluminum hydroxide

Side effects

A

Phosphate depletion and sequelae (weakness, anemia, tetany, apnea)
Constipation
Safe for use in patients with renal failure (bonus: helps eliminate phosphate)

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13
Q

Atropine sulfate

Drug class

A

Anticholinergics

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14
Q

Atropine sulfate

Mechanism

A

Reduce acid secretion, reduce spasm

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15
Q

Atropine sulfate

Uses

A

Ulcer treatment

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16
Q

Atropine sulfate

Side effects

A

Anticholinergic effects
AKA, belladonna;
contraindications: known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)

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17
Q

Propantheline; Metantheline bromide

Drug class

A

Anticholinergics

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18
Q

Propantheline; Metantheline bromide

Mechanism

A

Reduce acid secretion, reduce spasm

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19
Q

Propantheline; Metantheline bromide

Uses

A

Ulcer treatment (taken 15-30 minutes before meals, and before bed)

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20
Q

Propantheline; Metantheline bromide

Side effects

A

Anticholinergic effects

Contraindications: known pyloric obstruction, hiatal hernia, or peptic esophagitis (not used much)

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21
Q

Cimetidine

Drug class

A

Histamine (H2) receptor blocker

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22
Q

Cimetidine

Mechanism

A

Inhibit 50-80% of 24 hour acid production

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23
Q

Cimetidine

Uses

A

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

One dose as effective as multiple;

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24
Q

Cimetidine

Side effects

A

Rebound acidity if stopped suddenly
Uncommon; headache, lethargy, confusion, depression, and hallucination
binds and interferes with P450

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25
Q

Ranitidine

Drug class

A

Histamine (H2) receptor blocker

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26
Q

Ranitidine

Mechanism

A

Inhibit 50-80% of 24 hour acid production

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27
Q

Ranitidine

Uses

A 
Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple;
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28
Q

Ranitidine

Side effects

A

Rebound acidity if stopped suddenly
Uncommon; headache, lethargy, confusion, depression, and hallucination
Binds and interferes with P450

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29
Q

Famotidine

Drug class

A

Histamine (H2) receptor blocker

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30
Q

Famotidine

Mechanism

A

Inhibit 50-80% of 24 hour acid production

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31
Q

Famotidine

Uses

A 
Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple
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32
Q

Famotidine

Side effects

A

Rebound acidity if stopped suddenly

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

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33
Q

Nizatidine

Drug class

A

Histamine (H2) receptor blocker

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34
Q

Nizatidine

Mechanism

A

Inhibit 50-80% of 24 hour acid production

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35
Q

Nizatidine

Uses

A 
Ulcer treatment (satisfy all 4 requirements); prophylactically for stress ulcers; GERD
One dose as effective as multiple
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36
Q

Nizatidine

Side effects

A

Rebound acidity if stopped suddenly

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

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37
Q

Misoprostol

Drug class

A

Prostaglandin E analog

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38
Q

Misoprostol

Mechanism

A

Decrease acid production, increase mucous and bicarbonate secretion

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39
Q

Misoprostol

Uses

A

Ulcer treatment when prostaglandin production decreased (RA patients taking lots of NSAIDs)

Not very effective, since endogenous prostaglandin levels are already high in duodenal ulcer patients

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40
Q

Omeprazole

Drug class

A

H/K/ATPase inhibitor

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41
Q

Omeprazole

Mechanism

A

Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don’t take with antacids)

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42
Q

Omeprazole

Uses

A

Ulcer treatment, treatment for H. pylori; GERD

For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin; large P450 interference; lowest bioavailability

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43
Q

Omeprazole

Side effects

A

Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)

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44
Q

Lanzoprazole; Dexlansoprazole

Drug class

A

H/K/ATPase inhibitor

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45
Q

Lanzoprazole; Dexlansoprazole

Mechanism

A

Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don’t take with antacids)

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46
Q

Lanzoprazole; Dexlansoprazole

Uses

A

Ulcer treatment, treatment for H. pylori (in combination with tetracycline, metronidazole & clarithromycin); GERD

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47
Q

Lanzoprazole; Dexlansoprazole

Side effects

A

Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)

Some P450 interference; great bioavailability; dexlansoprazole is an extended release version

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48
Q

Rabeproprazole

Drug class

A

H/K/ATPase inhibitor

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49
Q

Rabeproprazole

Mechanism

A

Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don’t take with antacids)

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50
Q

Rabeproprazole

Uses

A

Ulcer treatment; GERD

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51
Q

Rabeproprazole

Side effects

A

Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)
Moderate P450 interference

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52
Q

Pantoprazole

Drug class

A

H/K/ATPase inhibitor

53
Q

Pantoprazole

Mechanism

A

Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don’t take with antacids)

54
Q

Pantoprazole

Uses

A

Ulcer treatment; GERD

55
Q

Pantoprazole

Side effects

A

Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)

No P450 interference; great bioavailability

56
Q

Esomeprazole

Drug class

A

H/K/ATPase inhibitor

57
Q

Esomeprazole

Mechanism

A

Inhibit >90% of 24 hour acid secretion (better than H2 antagonists); requires acid environment to activate (don’t take with antacids)

58
Q

Esomeprazole

Uses

A

Ulcer treatment; GERD

59
Q

Esomeprazole

Side effects

A

Headache, gynecomastia, gastric hyperplasia in humans and carcinoid tumors in rats long term (do not use long-term)

Some (?) P450 interference

60
Q

Sucralfate

Drug class

A

Mechanical protectors

61
Q

Sucralfate

Mechanism

A

Coat the ulcer crater, increase mucosal resistance (requires acid environment)

62
Q

Sucralfate

Uses

A

Ulcer treatment, treatment for H. pylori

For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin; big pill, need to take 4 times per day

63
Q

Sucralfate

Side effects

A

Aluminum toxicity possible in renal failure

64
Q

Bismuth salts

Drug class

A

Mechanical protectors

65
Q

Bismuth salts

Mechanism

A

Coat the ulcer crater, increase mucosal resistance

66
Q

Bismuth salts

Uses

A

Ulcer treatment, treatment for H. pylori

For H. pylori treatments, used with tetracycline, metronidazole, and clarithromycin

67
Q

Bismuth salts

Side effects

A

Aluminum toxicity possible in renal failure; turns bowel movements (and sometimes tongues) black

68
Q

Metochlopramide

Drug class

A

Promotility agent (dopamine antagonist

69
Q

Metochlopramide

Mechanism

A

Increase motor tone in lower esophageal sphincter (prevent reflux) and stomach (esp. antrum: improves gastric emptying); peripheral (stomach) and CNS (vomiting, via CRTZ) dopamine antagonist

70
Q

Metochlopramide

Uses

A

GERD, anti-emetic, gastroparesis

Can be used once/day for good effects

71
Q

Metochlopramide

Side effects

A

Hand tremor if used 4X/day (optimum use); possible extra-pyramidal symptoms, but not so severe

72
Q

Cisapride

Drug class

A

Promotility agent (dopamine antagonist

73
Q

Cisapride

Mechanism

A

Increase motor tone in lower esophageal sphincter and stomach

74
Q

Cisapride

Uses

A

GERD, gastroparesis

75
Q

Cisapride

A

Sudden cardiac death

Not really used much anymore

76
Q

Domperidone

Drug class

A

Promotility agent

77
Q

Domperidone

Mechanism

A

Improves gastric tone

78
Q

Domperidone

Uses

A

Gastroparesis

79
Q

Sulfasalazine

Drug class

A

Anti-inflammatory

80
Q

Sulfasalazine

Mechanism

A

Work from lumen to reduce inflammation

Sulfapyridine conjugated to 5-ASA to prevent its degradation, improve its absorption; bond broken in large bowel by bacteria

81
Q

Sulfasalazine

Uses

A

Acute therapy for inflammatory bowel disease

82
Q

Sulfasalazine

Side effects

A

Toxicity coming from systemic absorption of sulfapyridine

83
Q

Olsalazine

Drug class

A

Anti-inflammatory

84
Q

Olsalazine

Mechanism

A

Work from lumen to reduce inflammation; 5-ASA dimer

Broken down into bowel by bacteria into 2 moleules of 5-ASA

85
Q

Olsalazine

Uses

A

Acute therapy for inflammatory bowel disease

86
Q

Olsalazine

Side effects

A

Less toxicity than sulfasalzine

87
Q

Mesalamine

Drug class

A

Anti-inflammatory

88
Q

Mesalamine

Mechanism

A

Work from lumen to reduce inflammation

Delayed release 5-ASA, for terminal ileum, colon

89
Q

Mesalamine

Uses

A

Acute therapy for inflammatory bowel disease

90
Q

Prednisone

Drug class

A

Corticosteroid

91
Q

Prednisone

Uses

A

Acute IBD, chronic IBD

Can be given systemically or as enemas

92
Q

Azothioprine

Drug class

A

Immunosupressive

93
Q

Azothioprine

Mechanism

A

Purine antimetabolite; interferes with DNA synthesis

94
Q

Azothioprine

Uses

A

Chronic therapy for IBD

95
Q

Methotrexate

Drug class

A

Immunosupressive

96
Q

Methotrexate

Mechanism

A

Decreases synthesis of inflammatory mediators

97
Q

Methotrexate

Uses

A

Chronic therapy for IBD

98
Q

Infliximab (Remicade); adalimumab; certolizumab

Drug class

A

MAb Immunosupressive

99
Q

Infliximab (Remicade); adalimumab; certolizumab

Mechanism

A

Binds and neutralizes TNFa

100
Q

Infliximab (Remicade); adalimumab; certolizumab

Uses

A

Chronic therapy for IBD

101
Q

Natalizumab; vedolizumab; ustekinumab

Drug class

A

MAb Immunosupressive

102
Q

Natalizumab; vedolizumab; ustekinumab

Mechanism

A

Binds to a4-integrin, prevents immune cells from invading tissue

103
Q

Natalizumab; vedolizumab; ustekinumab

Uses

A

Chronic therapy for IBD

104
Q

Prochlorperazine

Drug class

A

Phenothiazines (neuroleptic class)

105
Q

Prochlorperazine

Mechanism

A

Probable CNS interaction with dopaminergic receptor-antagonist (leading to reduction of stimulation in the CRTZ in the medulla)

106
Q

Prochlorperazine

Uses

A

Anti-emetic

107
Q

Prochlorperazine

Side effects

A

Largely extra-pyramidal (torticollis!)

108
Q

Promethazine

Drug class

A

Phenothiazines (neuroleptic class)

109
Q

Promethazine

Mechanism

A

Antihistaminic (H1 receptor), anticholinergic

110
Q

Promethazine

Uses

A

Anti-emetic

111
Q

Promethazine

Side effects

A

Somnolence (especially in the elderly)

112
Q

Trimethobenzamide

Drug class

A

Benzamide derivative

113
Q

Trimethobenzamide

Mechanism

A

Unknown effect on CRTZ

114
Q

Trimethobenzamide

Side effects

A

Low-side effect profile; possible extra-pyramidal symptoms, but not so severe

Not used much

115
Q

Tetrahydrocannabinol

Mechanism

A

Suppresses CRTZ, probably by anticholinergic mechanism

116
Q

Tetrahydrocannabinol

Uses

A

Anti-emetic

Now often administered in pill form

117
Q

Tetrahydrocannabinol

Side effects

A

Munchies

118
Q

Odansetron

Drug class

A

Serotonin (5HT3) receptor antagonists

119
Q

Odansetron

Mechanism

A

Blocks serotonin at 5HT3 receptor (in central CRTZ)

120
Q

Odansetron

Uses

A

Anti-emetic

121
Q

Odansetron

Side effects

A

Headache, dizziness, somnolence

Very safe for vomiting of any type (including drug-induced); can even be given to 6 month-old

122
Q

Granesitron

Drug class

A

Serotonin (5HT3) receptor antagonists

123
Q

Granesitron

Mechanism

A

Blocks serotonin at 5HT3 receptor (in central CRTZ)

124
Q

Granesitron

Uses

A

Anti-emetic

125
Q

Granesitron

Side effects

A

Headache, dizziness, somnolence

126
Q

Dolasetreon

Drug class

A

Serotonin (5HT3) receptor antagonists

127
Q

Dolasetron

Mechanism

A

Blocks serotonin at 5HT3 receptor (in central CRTZ)

128
Q

Dolasetron

Uses

A

Anti-emetic

129
Q

Dolasetron

Side effects

A

Headache, dizziness, somnolence

Pharmacology (26 decks)

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