Upper GI Drugs Flashcards
4 ways to treat PUD
Reduce gastric acid secretion
Neutralize gastric acid
Enhance mucosal defense
Eradicate H. Pylori
Examples of H2 blockers
Cimetidine
Famotidine
MOA H2 blockers
Directly block histamine stimulated acid secretion
Blunt parietal cell response to ACh and gastrin
Specific and reversible
AE of cimetidine
Lots of drugs intxs- inhibits CYPs
Gynecomastia and impotence at high doses
PPI example
Omeprazole
PPI MOA
Irreversible inhibit of parietal H/K ATPase proton pump –> prolonged inhib of gastric acid secretion
Admin as a prodrug
Hepatic metab
AE of long term PPI use
Inc risk of fractures
Dec B12 absorption
Inc risk of CKD
Which first line treatment would you give a pregnant female with PUD?
H2 blocker
Combining antacids
Want to combine to get best balance
MgOH2: diarrhea producing
AlOH3/CaCO3: constipating
AE of antacids
Can increase or decrease the absorption of many classes of drugs
Inc in urinary pH alters elimination of acidic and basic drugs
Examples of mucosal protective agents
Sucralfate
Bismuth Subsalicylate
Misoprostol
Sucralfate
Coating action
Admin before meal
Can adsorb other drugs - wait 2 hours
DO NOT CO ADMIN WITH ANTACIDS
Bismuth subsalicylate
Binds selectively to ulcers
Antimicrobial
Blackens stool/tongue
Do not use in children (Reyes)
Misoprostol
Mucosal protective agent
PGE1 analog
Inhibits acid secretion, enhances mucus and bicarb
NO PREG - uterine contractions
Tx for H. Pylori
PPI
Clarithromycin
Metronidazole or amoxicillin