Upper GI Drugs Flashcards

1
Q

4 ways to treat PUD

A

Reduce gastric acid secretion
Neutralize gastric acid
Enhance mucosal defense
Eradicate H. Pylori

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2
Q

Examples of H2 blockers

A

Cimetidine

Famotidine

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3
Q

MOA H2 blockers

A

Directly block histamine stimulated acid secretion
Blunt parietal cell response to ACh and gastrin
Specific and reversible

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4
Q

AE of cimetidine

A

Lots of drugs intxs- inhibits CYPs

Gynecomastia and impotence at high doses

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5
Q

PPI example

A

Omeprazole

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6
Q

PPI MOA

A

Irreversible inhibit of parietal H/K ATPase proton pump –> prolonged inhib of gastric acid secretion

Admin as a prodrug
Hepatic metab

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7
Q

AE of long term PPI use

A

Inc risk of fractures
Dec B12 absorption
Inc risk of CKD

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8
Q

Which first line treatment would you give a pregnant female with PUD?

A

H2 blocker

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9
Q

Combining antacids

A

Want to combine to get best balance
MgOH2: diarrhea producing
AlOH3/CaCO3: constipating

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10
Q

AE of antacids

A

Can increase or decrease the absorption of many classes of drugs

Inc in urinary pH alters elimination of acidic and basic drugs

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11
Q

Examples of mucosal protective agents

A

Sucralfate
Bismuth Subsalicylate
Misoprostol

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12
Q

Sucralfate

A

Coating action
Admin before meal
Can adsorb other drugs - wait 2 hours
DO NOT CO ADMIN WITH ANTACIDS

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13
Q

Bismuth subsalicylate

A

Binds selectively to ulcers
Antimicrobial
Blackens stool/tongue
Do not use in children (Reyes)

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14
Q

Misoprostol

A

Mucosal protective agent
PGE1 analog
Inhibits acid secretion, enhances mucus and bicarb
NO PREG - uterine contractions

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15
Q

Tx for H. Pylori

A

PPI
Clarithromycin
Metronidazole or amoxicillin

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16
Q

Metoclopramide MOA

A

D2/5HT3 Antagonist
Peripheral 5HT4 agonist
Prokinetic: enhances ACh release

17
Q

Metoclopramide AE

A

D2 antag results in extrapyramidal parkinsons and tardive dyskinesia
BBW for long use resulting in irreversible muscle spasm

18
Q

Ondansetron MOA

A

Selective 5HT3 receptor antagonist

Little to no effect on muscarinic or dopaminergic receptors

19
Q

Ondansetron AE

A

headache and constipation