Upper GI Pharmacology Flashcards
1
Q
Buffering Agents (ACID)
A
o Mg (diarrhea ie. Explosive element) o Al, Ca Carbonate (Constipation)
2
Q
H2 Antagonists (ACID)
A
- Prototype: ranitidine
- Reversible antagonist at H2 receptors
- Drug Interactions: cimetidine inhibits the metabolism of a of a number of other drugs (CYP 450 Inhibitor)
- Side effects: generally well tolerated
o Cimetidine: Gynecomastia & Galactorrhea
3
Q
ranitidine
A
H2 Antagonists
4
Q
PP1 (Mucosal Defence Agent)
A
- Protype: omeprazole
- Irreversible inhibition of the proton pump
o Potent acid suppression - Side Effects:
o Short term use: well tolerated
o Long term use: issues are starting to emerge (elevated gastrin indicated in cancer)
5
Q
omeprazole
A
PP1
6
Q
prostaglandin (Mucosal Defence Agent)
A
- Prototype: Misoprostal
- PGE-1 analogue
- Adjunct to NSAID therapy
o Arthrotec = Diclofenac + Misoprostal - Side Effect:
o Dirrahea & Cramping
7
Q
Coating Agents (Mucosal Defence Agent)
A
- Protoype: Sucralfate
- Aluminum hydroxide + sucrose sulfate
o Forms paste
o Stimulates mucous & bicarb secretion - Side Effects:
o Acts locally
o Need to take 3 to 4 times per day
o Al causes constant constipation - Protype: Bismuth Salts (Bismuth Subsalicylate)
o Forms protective barrier on ulcer
o Enhances mucous & bicarb secretion
Inhibits growth of H Pylori and adherence to mucosa
8
Q
Misoprostal
A
prostaglandin (Mucosal Defence Agent)
9
Q
Sucralfate
A
Coating Agents (Mucosal Defence Agent
10
Q
Bismuth Salts (Bismuth Subsalicylate)
A
Coating Agents (Mucosal Defence Agent)
11
Q
H. Pylori Treatment
A
- Infection with H Pylori o Produces inflammatory canges in mucosa o Impairs mucosal defence o Imcrease acid secretion - Eradication of H Pylori provides a cure for ulcer - Combination of drugs are typically used o PPI plus: ♣ 2 AB or ♣ 2AB + bismuth
12
Q
Prokinetics
A
- prototype: metoclopramide
- D2 antagonist
o Effects on upper GIT
♣ Increase lower esophageal sphincter tone
♣ Increase contractions, gastric emptying
o Inhibits the chemoreceptor trigger zone
o Gastroparesis: Stomach motility works poorly or not at all - Side Effects:
o Related to D2 antagonism in the CNS
Movement Disorders
13
Q
metoclopramide
A
Prokinetics / D2 antagonist
14
Q
H1 Antagonists
A
- Prototype: Dimenhydrinate (Gravol) o Works in the brain in an area responsible for motion sickness - Also has antimuscarinic effects o Slows peristalsis - Side Effects: Drowsines
15
Q
Dimenhydrinate
A
H1 Antagonists
